Step into a world where art, harmony, rationality, and the hidden laws of thought converge. At Astral Codex Ten, Scott Alexander delves into the concept of ṛta, an ancient Sanskrit word with far-reaching implications for our understanding of reality. With a focus on reasoning, science, psychiatry, and more, Alexander explores the intersection of diverse fields to shed light on the intricacies of our cognitive biases. Prepare to question your assumptions and confront the gray areas that shape our beliefs. Welcome to a blog that will challenge your mind and broaden your perspective. Welcome to Astral Codex Ten.

Welcome to Astral Codex Ten! Some of you are probably veterans of my old blog, Slate Star Codex. Others may be newbies wondering what this is all about.

I'm happy to finally be able to give a clear answer: this is a blog about ṛta.

Ṛta is a Sanskrit word, so ancient that it brushes up against the origin of Indo-European languages. It's related to English "rationality" and "arithmetic", but also "art" and "harmony". And "right", both in the senses of "natural rights" and "the right answer". And "order". And "arete" and "aristos" and all those other Greek words about morality. And "artificial", as in eg artificial intelligence. More speculatively "reign" and related words about rulership, and "rich" and related words about money.

(also "arthropod", but insects creep me out so I'll be skipping this one)

The dictionary defines ṛta as "order", "truth", or "rule", but I think of it as the intersection of all these concepts, a sort of hidden node at the center of art and harmony and rationality and the rest. What are the laws of thought? How do they reveal themselves, at every level, from the flow of electricity through the brain to the flow of money through the global economy? How can we cleave to them more closely, for our own good and the good of generations still to come?

In practice, articles (another ṛta relative!) here tend to focus on reasoning, science, psychiatry, medicine, ethics, genetics, AI, economics and politics. The political posts sometimes stray into choppy waters, and I have immense sympathy for people who are sick of that and prefer to pass.

But on the other hand, this picture:


The top and bottom chess sets in this picture are exactly the same color. Download it and check on Paint or Photoshop if you don't believe me. We use "as different as black and white" to mean obviously, undeniably different. But in fact a slightly different context can confuse our brains so completely that we mistake white for black and vice versa. I believe the same laws of thought apply in the frontal lobe as in the visual cortex. The same forces that transform gray chess sets to white or black, outside our conscious control or comprehension, influence how we think about policies, coalitions, and principles, making them appear self-evidently good or viciously evil. I think this is the century where we'll either learn to understand and deal with our cognitive biases, or else all kill each other.

(there will also be the normal kind of politics on here, where I yell at people for being crooks and liars, because I'm only human)

I'm privileged to be at the intersection of a number of communities exploring these concepts. The rationalist community is a group of people, mostly centered around the website Less Wrong, investigating reasoning and probability. The effective altruist community is a group, inspired by philosophers like Will MacAskill and Peter Singer, who work on how best to use charitable resources for the greater good. And I work in psychiatry, which it turns out is pretty relevant to questions about how people end up believing strange things - both as an investigative science and as a terrible warning. These groups aren't always great at reporting their ideas and conclusions to the general public, so I'm here to help. Most of the interesting stuff you see here will be influenced by at least one of them; most of the errors will be mine alone.

And finally, the highlight of my last blog was its loyal and active readership, who constantly corrected my errors, resolved my lingering questions, and inspired most of "my" best ideas. Substack has committed to do everything they can to help keep that community alive. I commit to doing everything I can to keep that community alive. So take a look around, and feel free to comment here, the subreddit, the Discord, or the vintage-style bulletin board.

But for now - welcome to Astral Codex Ten! I am genuinely glad you're here!

You're Probably Wondering Why I've Called You Here Today

Scott Alexander, opens up about his whirlwind year of internet fame, privacy concerns, and unexpected support. From being doxxed to receiving emails from New York Times journalists and a former GamerGate member, Scott shares the ups and downs of his experience. With humor and humility, he takes us on a journey through the unpredictable world of online notoriety. Don't miss this honest and thought-provoking piece that reminds us of the power and pitfalls of internet fame. 

Still Alive

Scott Alexander discusses their transition to Substack and addresses some of the concerns readers may have. They also explain their reasons for joining Substack, including the financial aspect, and how it will support their new medical practice. The author clarifies what content will be freely available and what subscribers can expect. Additionally, they offer a coupon for those who may be financially strained but still want access to certain content. Overall, this article provides insight into the author's motivations for joining Substack and what readers can expect moving forward.

Substack

First, thanks for following me to Substack.

I know some of you are skeptical. I was too at first, but Substack has gone above and beyond in allaying my concerns. They've let me test out a "no popup telling you to subscribe" feature. They've changed the comment section to be more like WordPress. We've agreed I'm here for a year, but if it goes badly I can leave in 2022 with no hard feelings.

And I know some of you are concerned about the risk of corporate deplatforming. My weak answer is that so far Substack has been great at resisting calls for this, I think it's worth rewarding them with my business, and I'm proud to contribute to companies that share my values. My strong answer is that if I start feeling too constrained, I'll leave. The past six months weren't fun, but at least I credibly signaled willingness to destroy everything and start over when needed. I'm saving the Substack mailing list regularly to my hard drive, and if I go somewhere else I'll let you all know.

And I know Substack is supposed to be an email newsletter thing, but consider reading it online instead so you can participate in the comments. If you miss the old layout, the anonymous author of Applied Divinity Studies has made a Chrome extension thing you can use to convert the Substack layout to the older one.

Paid Subscriptions

The boring reason I'm at Substack is money. I'm not supposed to talk about numbers, but you can read about the deal they offered Matt Yglesias here and draw your own conclusions. I'm trying to build a new kind of medical practice that provides affordable care to uninsured people. The risk of failure is high - I expect the medical care part to go fine, but I'm less sure I'll be able to make money off it. I need a stable income stream while I experiment with this, and this is it. I realize how weird it is to accept a steady day job as a writer to support your pie-in-the-sky plans to practice medicine, yet here we are.

From your perspective, the money works like this: if you like this blog, consider subscribing. $10/month or $100/year, which I hear is standard Substack rate. I already got a lot of subscriptions yesterday and I'm at zero risk of starving, but this will help me devote more time to blogging and get me over the hump in starting my new practice.

All "important" content will be freely available regardless of subscription status, but subscribers will get a little extra. In particular, there will be one subscribers-only Open Thread a week (on Wednesdays), along with the normal free Open Thread on Sundays, and occasional subscriber-only AMA (ask me anything) threads. I also plan to occasionally post shorter or lighter content for subscribers only, maybe once or twice a month. This would be along the lines of SSC posts like If Only Turing Was Alive To See This or Bulls**t Jobs (Part 1 of ∞). I might also paywall a few very impulsive Culture War posts, just to prevent them from going viral. I predict this will be less than 10% of content, and less than 1% of content weighted by some measure of importance.

Please don't buy a paid subscription if it would be financially stressful for you, or funge against your ability to support better causes. If you're deeply pained by the idea of not reading occasional shorter unimportant content, but also too poor to afford the full subscription, you can use this coupon. Please be honest.

I've complained before that subscriber models annoy nonsubscribers and clog up search engines by presenting stubs for posts most people can't read. After talking to Substack about this concern, they've agreed not to display any hint of subscription-only posts to nonsubscribers. I might occasionally remind you that they exist, but you won't get teased by the titles or see stubs that cut off halfway. If you do see these, something has gone wrong and you should let me know.

Advertising Wrap-up

Speaking of money, I think I've paid back everyone who took out advertising on SSC that didn't happen because the blog closed down.

If you took out advertising that got disrupted and I didn't pay you back, or I paid you the wrong amount, please contact me at scott[at]slatestarcodex[dot]com. If I have some other SSC-related obligation to you that I forgot about, remind me of that too.

Publicity

Still against it, sorry.

I've revealed my real name to prevent people from threatening me with it, but I'm still going by Scott Alexander.

I'm not interested in further pursuing a vendetta against the New York Times and I'm not going to respond to interview requests about it. I'd prefer my story not get used to support any political points more complicated than "newspapers should not reveal anonymous bloggers' real names", especially not Grand Narratives About Media.

My new psychiatry practice is (I think) potentially genuinely interesting, but I'd prefer people not get too excited about it until I've been doing it a year or two and can confirm that the business model actually works. My patients are random innocent people who happened to get matched with me at my past clinic and don't need to be ambushed for a news story about changing trends in mental health blah blah blah.

If it's a boring enough news day that you want to cover me, consider instead covering the many other fascinating and under-covered people and institutions in and around the rationalist community, some of whom are probably women or minorities or whatever. The Qualia Research Institute is doing absolutely picture-perfect mad science. Metaculus is fast becoming what PredictIt should have been; I intend to shill it pretty hard but I can't do it all by myself. Catherine Olsson, Ibasho, and MicroCOVID already have one WIRED article about how great they are, but they deserve at least a dozen.

Book Review Contest

I'll have more information on how I'm going to do this in a week or two. I still have all the entries you sent in, and I'm still accepting new entries at least for now.

Normal Posts

...will start next week. I have some from last year I still want to get up, so expect a few of them to be a bit outdated.

Logistics 

Discover the fascinating history behind ADHD medication in this intriguing essay. Explore how a 1950s diet pill, containing four different amphetamine salts, eventually morphed into the popular ADHD medication known as Adderall. Uncover the factors that contributed to its rise in popularity, including timing and marketing. Delve into the debate surrounding the choice of amphetamines in treating ADHD and whether the random combination of salts should be a cause for concern. If you're curious about the origins and efficacy of ADHD medication, this article is a must-read.

In the 1950s, a shady outfit called Obetrol Pharmaceuticals made a popular over-the-counter diet pill called Obetrol. If you're familiar with any of: the 1950s, shady pharma, or diet pills, your next question will be "did it contain amphetamines?" and the answer is yes, loads of them. Obetrol was a mix of four different amphetamine salts: racemic amphetamine sulfate, dextroamphetamine sulfate, methamphetamine saccharate, and methamphetamine hydrochloride. Why did they need four different kinds of speed? I'm not sure. The uncharitable explanation is: for the same reason Dr. Nick's Cure-All Home Remedy has twelve different herbs, ie customers think things with more ingredients are better.

By the 1970s, people figured out meth was bad, so Obetrol replaced their two methamphetamine salts with two more kinds of non-methylated amphetamine. But the FDA continued to crack down, and although the historical paper trail goes kind of dark, it looks like Obetrol had disappeared by the 1980s.

As usual in pharma, someone bought Obetrol Pharmaceuticals, then someone else bought them, and after a few iterations of this, all their intellectual property ended up with a company called Richwood. They decided to rebrand Obetrol as "Adderall" and pitch it as an ADHD cure.

Treating ADHD with amphetamines was hardly a new invention. Psychiatrists had been doing it since the 1930s, albeit with slightly different drugs. Remember, many organic chemicals come in two versions, a "right-handed" or "d" version and a "left-handed" or "l" version. Benzedrine (a 50-50 d/l split) and Dexedrine (pure d-amphetamine) were the treatments of choice throughout the mid-20th century. So why was it Adderall - a weird combination of four different salts selected kind of at random by a sketchy diet pill company - that caught on?

I'm not sure. My best guess is good timing plus good advertising. In the early 20th century, ADHD was called "minimal brain dysfunction" and diagnosed only in the most extreme cases. A few children with absolute and total inability to function at all got diagnosed and given Benzedrine or Dexedrine; everyone else was left to fend for themselves. As far as I know, this wasn't because doctors had a principled commitment only to diagnose extreme cases - I found a paper from 1975 arguing that up to 5 - 10% of children probably had minimal brain dysfunction, the same number estimated to have ADHD today. Parents just didn't know about it and didn't really have "take my kid to a psychiatrist" in their set of plausible options to consider.

In the early 1990s, psychiatric research, a series of popular self-help books, and the business interests of Richwood Pharmaceuticals all converged on the idea that it was important to get more people diagnosed with ADHD. Adderall entered the market at exactly the right time, and it became everyone's go-to ADHD medication.


US Ritalin consumption in millions of doses/year, probably a good proxy for number of ADHD diagnoses, approximately septupled during the 1990s (source)

Even if we agree that amphetamines are the right treatment for ADHD (many people don't!), how concerned should we be that the particular amphetamines we use are a random mix of salts selected by sketchy 1950s diet-pill peddlers? Dexedrine is an older formulation with pure d-amphetamine (sulfate). No l-amphetamine, no weird combination of salts. Should we just use that?

This is hard to study, because it's not obvious how to dose both medications. If we start out suspecting that both isomers are equally strong, we might dose 10 mg of Dexedrine vs. 10 mg of Adderall. But in fact we have reason to think that d-amphetamine is a bit stronger, so maybe 7 mg of Dexedrine vs. 10 mg of Adderall? But then any difference we find might just be a question of choosing the wrong doses rather than a real distinction.

Arnold, Huestis, and Smeltzer, 1976 and Gross, 1976 compare pure d-amphetamine to a mix of d and l amphetamines. Both studies find that both d-amphetamine and l-amphetamine are effective stimulants, but that d-amphetamine seems to work better for most people. A rat model also finds some modest superiority for d-amphetamine, showing that both isomers improve attention, but d-amphetamine additionally improves hyperactivity and impulsivity.

Is there any advantage at all to including l-amphetamine? AHS find that a small subgroup of patients seem to do better on it, but this is a study from 1976 and honestly I don't trust them to find small subgroups responsibly. And Gross finds that some people have fewer side effects on a mix of both than on d-amphetamine alone. This is a bit strange - shouldn't two chemicals have more side effects than one chemical? My guess is that d-amphetamine is just stronger, and so people getting their amphetamines as a mix of a strong chemical and a weak chemical are effectively on a lower dose and get fewer side effects.

James et al switch children back and forth between Adderall and Dexedrine to see which works best. They find the winner changes from measure to measure. But the tiebreaker was just asking the teacher which week the child seemed to be doing the best work in class, and the teacher chose a Dexedrine week almost twice as often as an Adderall week.

Joyce, Glaser, and Gerhardt claim to find that Adderall creates stronger and more prolonged changes in dopamine release than other amphetamines. But they use a bizarre dosing regimen which equates 0.5 nmol Dexedrine, 0.68 nmol Adderall, and 1 nmol racemic amphetamine as "identical doses" of each, based on a theory that l-amphetamine has no independent action but just modulates d-amphetamine. As far as I can tell this is totally false, and their study contradicts everything else I know, so I am going to nervously ignore it for now.

What about the evidence from patient ratings? Online databases contain several thousand of these...


...and they pretty conclusively show that on average patients prefer Dexedrine to Adderall. This is unblinded and uncontrolled, we don't know what dose any of them were on, and patients sometimes like addictive medications that aren't very good for them by normal medical standards. But again it seems like a pretty resounding victory for Dexedrine, which is what I'd expect. Honestly it's pretty weird that our go-to ADHD medication includes four random salts and a bunch of l-amphetamine when a pure d-amphetamine medication we could use instead is right there.

I do appreciate Dr. Charles Popper's contribution here; he notes that since Adderall has so many different salts, they take different amounts of time to get absorbed by your body, which means Adderall has a more gradual onset and offset compared to something purer like Dexedrine. Things with gradual onsets and offsets are probably less addictive and less likely to produce withdrawals and "crashes". As far as I can tell, this is the strongest pro-Adderall argument.

Vyvanse is the newest and most expensive member of the amphetamine stimulant family. It's lisdexamphetamine - ie Dexedrine attached to a random inactive molecule called lysine. As long as the lysine is attached, it can't stimulate anything. The body removes the lysine at a slow, consistent rate, which means that you get a slow, consistent release of stimulant into the bloodstream. This is advertised as especially good for people who are worried about addiction. It's hard to abuse or overdose on Vyvanse; no matter how much you take, your body will still only activate it at the same, slow rate.

My patients love Vyvanse. I try hard to convince people to take older, less expensive medications unless they're absolutely sure that the newer flashier one works better, but my patients are very convinced Vyvanse works better than Adderall. I used to think this was because something about the complicated timed release mechanism makes it "smoother". This is definitely what the pharma company that designed it wants me to think, and I admit there is some evidence for it.

But one neglected perspective is that once you take away the lysine, Vyvanse is basically Dexedrine, not Adderall. Almost everyone likes Vyvanse better than what they were taking before. But usually they were taking Adderall before. If Dexedrine is really better than Adderall - and common sense and the patient rating websites say it is - then that goes some of the way to explaining Vyvanse's superiority before we even get to the complicated timed release stuff. Pharmaceutical companies are always trying to re-release old medications in ways that bamboozle you into thinking they're new medications, so they can charge more money for them. In this case they did so good a job that I honestly can't tell if that's what they're doing or not.

Evekeo takes Adderall's questionable decision to include l-amphetamine and doubles down on it. Remember, Dexedrine is 100% d-amphetamine and Adderall is 75% d, 25% l. Well, Evekeo is 50-50. This should make it strictly worse than Adderall, and my patients' feedback seems to agree with this. The supposed point of making it is those studies that show a small subgroup of people seem to get some extra benefit from l-amphetamine. The real point of making it is probably as a me-too drug; it doesn't require any research, since l-amphetamine and d-amphetamine have both been around forever, but since it's new and different you can charge a lot of money for it.

I can't think of any situation where it would be reasonable to prescribe Evekeo as a first-line stimulant. If someone has done sort of okay on Adderall but has lots of side effects, and you put them on Dexedrine and they get worse instead of better, I suppose you could try putting them on Evekeo to see if they really are in the small subgroup of l-amphetamine beneficiaries. I'm just annoyed that this relatively rare legitimate use case serves a fig leaf for the inevitable Big Pharma campaign to push this new on-patent very expensive medication on a bunch of people who don't need it.

Desoxyn is the undisputed king of the patient rating websites. Here's the same graph as before, except I've added Desoxyn to the last column:


These are some amazing numbers. Adderall itself usually has one of the highest ratings of the thousands of drugs on the site, Dexedrine beats Adderall handily, and Desoxyn wipes the floor with Dexedrine (except on WebMD, which has the smallest sample size). This drug is getting ratings that shouldn't even be possible. And the patient summaries are in line with this - here are a few:

I have been on every derivative and variation of stimulant, SSNRis SSRI, Tricyclics, beta blockers and all sorts of combinations of above and never have come across such an amazing compound. as Desoxyn. I think that there is a definable difference in mood thoughts and the way thoughts flow with memory and with present day crises.

And:

After dealing with depression and ADD for most of my life, and having tried literally every conventional anti-depressant and ADD medication, I can honestly and without hesitation say that Desoxyn is the absolute best medication I've ever used to treat my ADD.

And:

How is this not more widely prescribed? My doc had me on Strattera at first, didn't help at all. Next I switched to Concerta, which worked, but increased my anxiety, and I had a crash. Next I switched to Adderall, which had almost the same effect as Concerta but on top of that I had no appetite. Finally I switched to Desoxyn and that's when my life started to turn around. My grades instantly went up and homework became fun for me. Math problems became like a puzzle, and history became fun, like watching a real-life movie. Right when I made the switch to Desoxyn, I got caught up on ALL my homework and my grades instantly switched from D's and F's to B's and A's. Not only that, but my social anxiety was completely GONE.

All the reviews are like this. And I bet all of these patients are telling the truth. Sometimes I read drug reviews and I wonder whether these people are special cases, or driven to exaggerate, but these descriptions match my impression of how the average Desoxyn patient feels.

What's the catch? Desoxyn is methamphetamine. The FDA and DEA discourage doctors from prescribing it, but it's still technically legal with an MD's prescription, and there are still some doctors who will use it for the most refractory cases. It is officially indicated for ADHD and obesity (really!), but gets used off-label for narcolepsy and various sleep disorders.

There's a lot of confusion around the difference between amphetamine and methamphetamine. On the one hand you have anti-psychiatry activists who will say that using Adderall for ADHD is exactly like giving kids crystal meth; on the other you'll have people who say that obviously normal amphetamine is okay, but meth-amphetamine is a demonic substance that will hijack your brain and destroy your life. The truth is more complicated.

Methamphetamine crosses the blood-brain barrier more effectively than unsubstituted amphetamine, but I'm not sure how much that matters since people take different doses of both, and a high dose of unsubstituted will end up with more reaching the brain than a low dose of meth. It seems to inhibit the dopamine transporter more effectively, which might matter, but I'm not enough of a pharmacologist to know how much. Meth takes effect more quickly, which seems to increase addictiveness in a sort of behaviorist sense where the sooner a stimulus gets reinforced, the more rewarding it will feel. If all of this sounds kind of weak to you, you're not alone. Shoblock et al write:

Despite the repeated claims of METH being more addictive or preferred than AMPH, proven differences between METH and AMPH in addiction liability and in reward efficacy have evaded researchers. Animals self-administer METH and AMPH at comparable rates (Balster and Schuster 1973) and humans prefer similar doses (Martin et al. 1971). Also, neither humans nor animals discriminate between equal doses of METH and AMPH (Huang and Ho 1974; Kuhn et al. 1974; Lamb and Henningfield 1994). Furthermore, while METH is commonly believed to be a more potent central psychostimulant than AMPH, no direct comparison on the potency of the two drugs to stimulate central processes have been verified. In addition, no previous study has directly compared the acute effects of the two drugs on locomotor activity, an important central process that contributes tothe definition of psychostimulant. Moreover, there are no known neurobiological differences in action between METH and AMPH that would account for the putatively greater addictive, rewarding, or psychomotor properties of METH.

I think there's been a little bit more research since then, but the general takeaway - that the science doesn't support the vast gulf between these two drugs in the popular imagination - still seems true.

What's going on? I think addicts use meth very differently from the way generally responsible ADHD patients use amphetamine. It's weirdly hard to find good data on methamphetamine route of administration, but this study shows that about 60% of users inject it, 23% snort it, and 52% smoke it - also, see this paper about "the second case of rectal methamphetamine abuse in the literature". Route of administration makes a really big difference in how addictive and dangerous a drug is (see eg crack cocaine vs. regular cocaine), and I think this is a big part of the difference between seemingly okay Adderall users and very-not-okay meth users.

But maybe even bringing up route of administration is getting too complicated. The simplest explanation of the difference between meth users and responsible amphetamine users is that the meth users take much, much more. This study asks abusers how much they use in an average day, and gets numbers from about 300 to 800 mg. An average clinical dose of either Adderall or Desoxyn would be about 20 mg a day.

So abusers are taking about 25x a normal dose, and are usually snorting or injecting it. I think this explains the lion's share of the difference between "methamphetamine abuse" and "responsible Adderall use" without having to appeal to chemical differences between meth and unsubstituted amphetamines. Those differences do exist, and they're one reason why drug abusers prefer the methylated version. They're just not as dramatic as you would think from seeing a successful college student on Adderall vs. a toothless vagrant on meth.

All of this would seem to suggest that doctors should be less scared of prescribing Desoxyn - except that if it were true, Desoxyn wouldn't have as big an advantage over Adderall as the ratings suggest. I'm not sure what's going on here. Maybe this is just the effect of the small but real advantages in BBB penetration and level of dopamine transporter inhibition. Or maybe it's at least partly placebo - an ADHD patient whose doctor gives them meth feels like they've been allowed to dabble in forbidden magics, and is properly grateful in a way that makes them feel like their medication is more effective. I'm not sure. I only have secondhand accounts to go on - I'm too much of a wuss to prescribe Desoxyn myself.

When I treat ADHD with amphetamines, I usually start with Adderall/extended release Adderall, even though realistically Dexedrine would probably be an equally good or better choice. If it's not working very well or there are too many side effects, I switch to Dexedrine/extended release Dexedrine. If Dexedrine doesn't work because it seems too strong or the patient "crashes" too hard afterwards, or if I'm worried the patient is at risk of addiction, I will try Vyvanse (or some other solution to stimulant “crashes”); if Dexedrine works less well than Adderall and I am very confused and the patient is in an experimenting kind of mood, I might try Evekeo. If none of these work, a braver person than I am might try Desoxyn. As for me, I give up on amphetamines and start looking at Ritalin, modafinil, or other options.

Know Your Amphetamines

Scott Alexander delves into the fascinating field of taxometrics to explore the ontology of psychiatric conditions. Are these conditions neatly categorical or are they best understood as a spectrum? Through thought-provoking examples, Alexander challenges our understanding of classification and explores the intricacies of distinguishing between different groups of individuals based on certain variables. From humans and rabbits to tall and short people, this intriguing essay invites us to question the nature of boundaries and to reconsider how we conceptualize psychiatric conditions. Prepare to have your perspective challenged and expanded in this mind-opening exploration.

Ontology Of Psychiatric Conditions: Taxometrics


Scott Alexander critically examines the notion of technocracy and its supposed benefits in this thought-provoking essay. He challenges the idea of evidence-based policy and argues that technocrats, with their insular culture and biases, may overlook the complexities of the real world. Alexander presents alternative case studies, from mandatory vaccinations to the interstate highway system, to highlight the potential pitfalls of top-down planning. By weaving together history, politics, and social issues, Alexander reminds us to question the unquestionable and consider the unintended consequences of technocratic approaches. Prepare to have your beliefs challenged and assumptions questioned.

Contra Weyl On Technocracy


Technocracy-Zilla: Origins

Scott Alexander delves into the world of prediction markets, highlighting their potential as trustless and decentralized sources of expertise. He explores three major prediction markets - PredictIt, Augur, and Metaculus - and their respective approaches to regulatory challenges. Alexander focuses on Metaculus, a platform using fake Internet points, and presents its predictions on the COVID-19 pandemic. From estimating the number of future deaths to the availability of vaccines, he shares intriguing insights that challenge our understanding of the crisis. Join him in exploring the fascinating world of prediction markets and their potential impact on decision-making.

Prediction markets are the future. They're a type of trustless, decentralized expertise that often equals or outperforms official sources.

But they're not quite the present. Right now I only know of three prediction markets, and none of them live up to their potential. As usual, it’s the government’s fault: betting on prediction markets is technically gambling, which makes it mostly illegal (of course, you can still buy all the Gamestop stock you want).

Each of the three big prediction markets tries to solve this in a different way.

PredictIt struck a special deal with the government where they can run a limited number of predictions as long as nobody is allowed to bet very much. They probably have the most users, but most of them are dumb money, and the restrictions prevent smart money from coming in and replacing them. Also, the market fritters away its limited number of predictions on dumb political horse race stuff. I think of this as a missed opportunity.

Augur is a decentralized Ethereum-based prediction market. Since it's crypto, it ought to be able to violate laws with impunity, and in theory this should make it the leader of the pack. In practice it's either nonfunctional or so minimally functional as to be useless. The team involved seems pretty dedicated and competent, and I assume they have some good reason for pretending their product currently exists instead of replacing the whole thing with a COMING SOON banner. I hope this will one day be our savior. But like the real Messiah, it’s taking its sweet time.

Metaculus solves the regulatory problem by using fake Internet points instead of money. This is a disappointing solution; it limits the user base to Internet obsessives instead of (say) investment bankers. Still, there are a lot of Internet obsessives. And the team running it is really top-notch, interested in pushing the limits of what prediction markets can do, and trying to focus on some of the most important questions.

I want to raise awareness of prediction markets, and right now Metaculus seem like the best people to raise awareness of. So welcome to Metaculus Mondays, where I make you listen to reports of how the prediction markets did this week and what they're predicting for later.

This week: the coronavirus.


Late last year, when coronavirus had already killed 285,000 Americans, Metaculus asked users to predict how many would be dead by the end of 2021. The guesses started at about 500,000. But as cases rose further through December and January, the guesses rose too, until now they're averaging almost 690,000 people.

Right now 440,000 people have died, so Metaculus expects another 250,000. Right now 3,500 people die of COVID daily. If that death rate continued, we'd be past their estimate for December by April. But it's reasonable to expect deaths to decrease as winter turns to spring, more people get vaccinated, and the usual control system causing people to lock down tighter as deaths rise kicks in. Still, I notice that every day their estimate rises slightly. Seems suspicious. I'm betting my fake Internet points on something a little higher, maybe 750,000, with a long tail in case of variants that can reinfect the already infected, or if so many people refuse vaccination that we don't have herd immunity for the danger period in winter 2021.

Moving on:


When will some official like the Director of the CDC announce that a coronavirus vaccine is available to any adult who wants it (as opposed to just front-line workers, only seniors, etc)? The question as asked is a little odd, since it will probably be available in some areas before others, but this is apparently about some kind of nationwide announcement.

Apparently Anthony Fauci said "as early as April", former HHS secretary Alex Azar said "March or early April", and former FDA chief Scott Gottleib says "heading into fall 2021". Metaculus users fall in the middle at May 19. This doesn't seem to have changed too drastically since the question opened in December. I don't think I disagree too strongly here.

Next up:


When will 50% of the US population be vaccinated? Metaculus defines this as getting both doses of a two-dose vaccine; right now 1.5% of Americans are vaccinated by this definition. Metaculus seems to think we'll reach 50% by June. My main reason for pessimism is that only about 50% of Americans really want the COVID vaccine immediately - the rest say they'll "wait and see". Some of those people probably will be satisfied once there are no major side effects. Others will see COVID rates go down (as they inevitably will during the spring) and decide they don't need it. I don't think the average Metaculan truly understands the difficulty involved in getting random people to accept public health interventions in any situation other than "you will die IMMEDIATELY if you don't do this". And there's a wild card scenario where the virus mutates, the vaccine doesn't work as well, and people decide it's no longer worth it.

Next up:


The specific question is "Will a new variant of SARS-COV-2 that, due to a mutation, can infect people who had immunity to a previous variant, cause more than 10M infections globally by the end of 2021?"

But I'm not happy with how it's phrased. My understanding is that probably some new strains will have a 1% or 10% or whatever chance of infecting already-immune people - lower than infecting coronavirus-naive people, but still more than zero. If a strain that can infect immune people at a 1% rate infects 10 million (mostly non-immune) people, does that count? Since this question doesn't say, I don't think it's that meaningful. Which is too bad, because it's probably the most important question of 2021 and the one that should be getting the most attention right now. Anyway, 260 people say an average of 37% chance, which sounds vaguely horrifying, even if we can't quantify exactly how horrified we should feel.


Okay, now we're getting into things we can be properly horrified about. The exact question is "Before 2023, will the United States CDC recommend that those who have already been vaccinated for SARS-CoV-2 (COVID-19) be vaccinated again due to a mutation in the virus?"

The average is 60% yes! This is probably going to happen! I might write more on this later, but we haven't prepared the regulatory framework we need to deal with this, gotten the public ready for this, or anything. Right now regulators' default assumption should be that we need to plan what to do about COVID-21, COVID-22, et cetera, and get to work figuring out how we're going to screw this up less badly than we screwed up the last one.


This one is some creepy deep magic. It's Metaculus really pushing the limit of what you can do with prediction markets. On September 1, before the US had really decided whether or not to hold human challenge trials for vaccines, Metaculus asked its users to predict how many Americans would die of COVID in 2021 if they (did/didn't) allow the challenge trials (ie experiments where they test vaccines by deliberately infecting volunteers). The market concluded that if they did, 295,000 people would die; if they didn't, 343,000 people would die.

You don't have to believe them if you don't want to. But this is a pretty impressive example of decentralized expertise weighing in on important inputs to a policy question. Should we hold human challenge trials or not? Well, if we don't, an extra 50,000 people or so will die. You can do this with any question. How much will global temperatures increase if we (do/don't) rejoin the Paris Agreement? How much will British GDP be in 2025 if there (is/isn't) Brexit? How many people will get shot by cops next year if we (do/don't) go ahead with some defund-the-police plan?

We shouldn't be the sort of straw-man technocrats who unthinkingly choose the lowest number because Our Metrics Perfectly Capture Reality. But in this case I’m pretty okay with being the sort of technocrat who thinks about it for a second, remembers that the lower number represents 50,000 real breathing human beings who get to be alive instead of dead, and then goes with it.

(in the real world, we didn't do human challenge trials, 100K people have already died this year, and it's only February)

And finally, since you've been bearing with me so nicely, here's something a little on the lighter side, from PredictIt:


All right guys, HERE'S HOW HILLARY COULD STILL WIN...

Metaculus Monday

In this engaging exchange, Scott Alexander challenges Mark Weyl's views on technocracy and offers a different perspective. Alexander acknowledges the limitations of his own understanding while providing context for his response. He also presents examples that go beyond the usual critiques of technocracy. The article delves into the role of mechanism design in democracy and invites readers to explore the nuances of this ongoing debate. Click to gain valuable insights on technocracy and its implications in society.

I am grateful for your taking the time to respond. There is a lot there to respond to and in general I think the exchange speaks for itself. However, I think there are few points where clarification is important for the exchange to be productive, which I'll briefly address here.

1. Let me start with concessions. There are many points where @slatestarcodex correctly highlights various areas where my grasp of beliefs and facts are limited or wrong, especially in the depth of my grasp of the views of the rationalist community. I freely admit that there are serious limits to how much I've been able to research the views of people in this community and I certainly hope they are not as I characterized them, though as I will point out below many elements of Scott's response confirm my concerns.

2. Given the last point, I fully acknowledge the danger of throwing stones lest I shatter my own glass house. However, leaving aside any blame, I think to make sense of my piece and Scott's response requires a bit of context that clearly he lacked. First, outside some specific blog post I wrote, I am best known as a mechanism designer. To cast me as a general opponent of technology and mechanisms runs against literally everything I am known for and have worked on my whole career. The piece was as much a self-critique and caution about taking the sorts of work I do in the wrong, over-zealous spirit as I had seen many in the rationalist community doing as anything else. Second, if responding to anything directly, it was this review of my book by https://www.aeaweb.org/articles?id=10.1257/jel.20191533 I think that piece perfectly exemplifies the spirit I am responding to and critiquing. I think we need to avoid that spirit of mechanism design.

3. Scott claims that critics of technocracy always critique precisely the same examples. This is odd, given that my essay has several examples outside that cannon. Did Scott not see these? I was blowing the whistle on one (https://promarket.org/2020/05/28/how-market-design-economists-engineered-economists-helped-design-a-mass-privatization-of-public-resources/) at roughly the same time I wrote the technocracy piece. These are contemporary, not chestnuts, and conducted by precisely the circle (https://promarket.org/2020/05/28/how-market-design-economists-engineered-economists-helped-design-a-mass-privatization-of-public-resources/)whose condescending critiques of transparency and public engagement I was responding to.

4. Furthermore, the positive examples of technocracy @slatestarcodex refers to are...surprising. Two examples. To call school desegregation a technocratic invention papers over decades of community activism for desegregation. Perhaps even more dramatically looking at the coronavirus as an example of the success of technocracy runs against pretty much any reasonable reading of the international data. Danielle Allen and I have a piece coming out on this (we were both deeply involved in developing a response plan here https://ethics.harvard.edu/Covid-Roadmap that significantly influenced now-President Biden's response), but perhaps the sharpest point here is that the country, Taiwan, which performed best in the virus was led in part by Audrey Tang who moved back to Taiwan after being immersed in and repulsed by the rationalist movement in Silicon Valley - see e.g. https://www.wired.com/story/how-taiwans-unlikely-digital-minister-hacked-the-pandemic/) and dedicated herself to doing things differently in Taiwan (see her amazing poetic job description here:

Twitter avatar for @audreyt
Audrey Tang 唐鳳 
@audreyt
My #OSOSNZ prayer. Thank you all fabulous people! 
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5. The last part of the piece is explicitly about the role I see mechanism playing in a democracy. I find it hard to understand how one could see the piece as opposed to mechanisms. My argument was that the appropriate way for mechanisms to be adopted is through public communication across lines of difference and in different value systems/communicative modes. One thing I find striking in the history of technology is that the vast majority of technologies that are actually useful today were pioneered by people who had similar critiques to mine here of technocracy, while those who zealous defend technocratic approaches have generally either not themselves actually developed successful technologies or have great technological dreams that have generally led to poor social outcomes. Consider Douglas Engelbart, Norbert Wiener, Jaron Lanier, etc. Calling people like this, most of whom were not even willing to express their views in the rationalistic terms I wrote in, "anti-technology" redefines technology to be only rigid and inhuman systems that fail. The process of socio-technological change has a far greater element of the "socio" when it succeeds than those focused on autonomous "technology" allow. Communication and collaboration outside of affordances of the technology itself are always critical to success. See, for example, Don Norman's Design of Everyday Things, or anything else in the field of human-centered design.

6. I think @slatestarcodex's insistence on breaking apart mechanisms v. judgement from top-down v. bottom-up misses a key part of the argument and of what sociologists of science have long said. There is no unitary thing called "science" or "mechanism". There are a variety of disciplines of information processing across academic fields, across cultures, across communities with in a culture, etc. "Mechanism" is just how one group of people seeks to claim that their mode of reasoning is uniquely unbiased and unaccountable to other ways of processing information. It is precisely this move, the unwillingness to think, speak or justify oneself on terms acceptable to those who think differently from you, that his response manifests and that concerns me.

7. A particularly striking example of this was his identification of "democracy" with the one-person-one-vote rule, an identification I have in the past been guilty of (hence the self-critique). This is not coterminal with what democracy means to most people, nor how most political scientists think of it. I will not belabor this here, but I think it is a nice illustration of how much one's views can be narrowed by only looking through a "mechanistic" lens.

8. On the AI stuff, more here (https://www.wired.com/story/opinion-ai-is-an-ideology-not-a-technology/) and much more coming soon in a paper I am writing with Divya Siddarth

Weyl Contra Me On Technocracy

Astral Codex Ten

Get ready to dive into a captivating book review of Henry George's "Progress and Poverty." In this thought-provoking analysis, the anonymous ACX reader explores George's radical economic ideas, including his perspective on land, labor, and capital. Discover how George's arguments challenge conventional notions of capitalism and socialism, offering fresh insights into modern crises like rising rents and homelessness. With its timeless advice and engaging writing style, "Progress and Poverty" continues to inspire economic thought today, even earning the attention and begrudging agreement of intellectuals like Paul Krugman and Milton Friedman. Don't miss this golden opportunity to explore a forgotten gem of economic theory.

Your Book Review: Progress And Poverty

In this gripping book review, an anonymous ACX reader explores the fascinating legal dynamics of Shasta County, California. The author delves into the unique aspect of the county's rangeland designations, shedding light on the misconceptions and informal code of neighborliness among the cattle ranchers. With vivid examples and thought-provoking insights, this review unveils the intricate connections between landowners, motorists, and the responsibilities that come with open and closed range designations. Prepare to be captivated by the unexpected consequences and human interactions that arise in the rural landscapes of Shasta County.

Your Book Review: Order Without Law

Join Scott Alexander on a deep dive into the world of Próspera, a private tech city in Honduras, where the boundaries of governance and societal advancement are being reimagined. Discover the story behind this ambitious project, from its inception to its potential to fight global poverty by challenging traditional systems. In this article, Alexander explores the concept of startup governments and investment opportunities, while also grappling with the profound question of how we can create real systemic change. Don't miss out on this thought-provoking exploration of a vision for a better future.

Prospectus On Próspera

Scott Alexander reflects on his past predictions about Donald Trump's presidency, grading himself on their accuracy. He examines the racial diversity of Trump's base, accurately asserting that his appeal reached beyond just white voters. While he correctly predicted Trump's Republican nomination, he underestimated the wider acceptability he gained and the subsequent general election outcome. Despite some missteps, Alexander highlights his early recognition of important trends that others overlooked. Dive into this candid assessment of political foresight to gain insights on Trump's presidency and the challenges of making accurate predictions in a complex political landscape.

Mantic Monday: Grading My Trump Predictions

In his latest book, "The Cult Of Smart," Scott Alexander challenges the prevailing narrative of American education. He delves into the myth that the system is failing and argues that it's actually performing as well as it can, given the socio-economic challenges it faces. Alexander exposes the deceptive tactics employed by education reform efforts, showing how they manipulate data to claim success. Drawing from behavioral genetics research, he also makes a compelling case for the role of genes in determining intelligence. This thought-provoking book questions long-held beliefs about education's ability to level the playing field.

Book Review: The Cult Of Smart

Scott Alexander delves into the controversial topic of charter schools, shedding light on the selection effects and loopholes that allow for certain schools to attract high-performing students. Through insightful comments and personal experiences, Alexander explores the impact of parental involvement, behavior management, and curriculum on the success of charter schools. He also raises important questions about the integrity of lotteries used for admissions. This thought-provoking article challenges our understanding of educational equity and the role of charter schools in fostering academic excellence. Prepare to have your perspectives challenged and your assumptions challenged.

Highlights From The Comments On Cult Of Smart

In this captivating book review, Scott Alexander delves into "The New Sultan: Erdogan And The Crisis Of Modern Turkey" by Soner Cagaptay. Alexander explores how Turkey's journey from flawed democracy to near-dictatorship under Recep Tayyip Erdogan offers valuable insights into the risks and mistakes that can lead to an erosion of liberal values. With a critical eye, Alexander highlights the complexity of Erdogan's rise to power and the unique factors that contributed to Turkey's democratic backslide. This thought-provoking analysis serves as an illuminating cautionary tale for other countries grappling with similar challenges to their political systems.

Book Review: The New Sultan

Step into the world of ancient medicine with Scott Alexander's captivating book review on Galen's work, "On The Natural Faculties." Alexander challenges the prevailing negative views surrounding Galen, a prominent figure in the history of medicine, and delves into the potential inaccuracies and misconceptions surrounding his legacy. Join him on this thought-provoking journey as he questions Galen's true intellectual capacity and the enduring impact of his writings. Discover the untold story of a remarkable figure who continues to shape our understanding of medicine to this day.

Your Book Review: On The Natural Faculties

Prepare to have your perspective on libraries and the preservation of historical artifacts challenged. In this thought-provoking book review, an anonymous ACX reader takes us on an eye-opening journey through Nicholson Baker's controversial work, "Double Fold." Delving into the destructive policies and misguided beliefs that led to the mass destruction of cherished books and newspapers, this essay sheds light on the failure of High Modernism and the urgent need to protect our cultural heritage. Prepare to be captivated by a clash of ideas and ideologies, as well as a compelling defense of Baker's groundbreaking argument.