Doctors can still prescribe cocaine as a topical anesthetic, and ADHD patients regularly get prescriptions for amphetamines. But I thought you were a nurse?

There are, and they aren't just for ADHD. That's the primary usage, but not the only.

Most of the ones that are prescribed are amphetamines. OTC you have similar options, just not quite so potent, for sinus congestion: ephedrine and pseudoephedrine.

Generally, you won't get uppers as uppers. As in meant to treat energy levels and such the way the uppers that were popular in the seventies got used medically. For that, you get into "off label" stuff like amantadine that isn't an upper in the usual sense of the term, but can improve alertness and counter fatigue. However, it is a cns stimulant, just not an amphetamine. That's just one example, but there are a decent number of medications that can give an "energy boost" by tweaking neurotransmitters in one way or another.

That's the thing though, uppers qua uppers, aren't prescribed any more. The default is to attempt to treat what's got the patient "down" rather than the symptom. The days of being prescribed black beauties is long gone. The things they were prescribed for just aren't really treated by them (or other stimulants), so they're only used as a last ditch effort now.

That being said, if you've been unable to tolerate other options, or they've failed, you can occasionally run into people using prescribed amphetamines for extreme fatigue, obesity, and things like narcolepsy. Very, very rare, but it does happen. Iirc for narcolepsy that aren't even a first choice, or a second. They're down the list a ways.

Good doctors won't even recommend other stimulants for regular fatigue. Caffeine in particular, they're not going to say you should drink more coffee if you're feeling run down, and there were doctors in the past that would. Bad doctors will still sometimes say shit like that, so if anyone reading this hears that from a doctor, find a different one.

As far as old school uppers go, the reason they're not in use for the things they used to be is that there's way too many side effects and drawbacks. Hell, the reason they're used for ADHD is because of a side effect. And they still come with risks and drawbacks, there's just not many other options there. Nobody has pinned down a better way to manage the detrimental parts of ADHD without stimulants. Notice I said better, not that there aren't any other options. There are, though I might argue that when you're blocking norepinephrine reuptake, it amounts to a stimulant, and some of those options do that.

Anyway. It's been close to fifty years since doctors were prescribing uppers for much of anything. By the time the mid eighties rolled around, awareness of the problems caused by such drugs had become common, so doctors were pulling back. Tbh, I think it was a bit too far, because they also got resistant you prescribing stimulants when it was warranted, the way docs (and the governments) now are overreacting with opiates and benzos. But things went back to a more practical prescription policy by the end of the nineties, and I expect it'll do the same with the current bugbears probably by the mid 30s.

For those curious, one of the illnesses I've seen prescribed stimulants for is MS. Another is Parkinson's. While amphetamines aren't a first choice for either, some stimulants can be vital to leading a decent life with either of those. I've seen it tried with Alzheimer's a couple of times, I've seen them used for palliative care (very rarely, but still). And all of those have some degree or another of non amphetamine stimulants used as part of an overall regimen, but amphetamines are still sometimes used.

In all reality, there's just better drugs nowadays. Your classic uppers were like shotguns, medically. Yeah, you'd put some pellets in the intended target, but you'd also be finding them in wings and legs instead of vital organs. Amphetamines stimulate everything, and have so many side effects. Add in the addiction potential and damm near any other option is better. But with the advent of more narrowly targeted drugs (like things that selectively target serotonin, epinephrine, or dopamine), they just aren't good.

I thought you were a nurse

Most ADHD meds would likely fall under "uppers" (amphetamines). Many antidepressants probably would be labeled "uppers" though they aren't stimulants in quite that way. Many steroids are prescribed for various things (I've been given them to try and kick a nasal infection without using antibiotics) and would probably be considered "uppers".

I'm sure there's more I'm forgetting.

Bruh you don't even need a doctor to buy nicotine or caffeine. The indications for uppers vary depending on what you're trying to achieve in what part of the body and how.

For ADHD there's various types of amphetamines and also some things aren't actual stimulants but can act similarly like SNRIs. For just specific types of narcolepsy there's modafinil. For obesity there's phentermine. For unclogging your sinuses there's pseudoephedrine, but that's OTC in a lot of places. I was recently chatting to one of the pharmacy techs who says they apparently actually do stock cocaine. Apparently it's in some kind of nasal jet device that she's pretty sure is used to stop a severe nosebleed. They can also just put literal adrenaline or noradrenaline into you to various goals (usually cardiovascular).

One of my coworkers came to psych out of the ICU and sometimes we'll be looking at a blood pressure and I'm like 'well you're the ICU nurse what do we do with this' and she's like 'fuck if I know I don't have an IV for levo!' Man fuck IVs actually she's always on about the PICCs. She hardly even knows how to do a straight stick them ICU nurses are spoilt.

Steroids. You want some energy in your life, get prescribed some of that. Getting off of them really hits home how much they work, even when you taper off.

Depending on country, but most people with ADHD are pretty much prescribed meth.

Hospitals even keep cocaine on site to use as a blood vessel constrictor.

Interesting that no one mentioned antidepressants. They're more long term uppers, but I still would broadly put them in the "upper" category.

I go to my PCP for PCP.

i love amphetamines as much as the next guy but let's not forget modafinil also exists

Had a stomach bug one time. Went to the ER (in hindsight I probably didn't need to go). They were giving me fluids and something that had me crawling out of my skin. I just felt like I needed to move but I had an IV and monitors hooked up to me. Then they pushed some benadryl and I came floating down from that previous high. No idea what the stimulant was, but I did not like that feeling.

Amphetamine based medications are used for adhd - the primary thing adhd means is not enough serotonin, so amphetamines counter that directly. I am on Lysdexamphetamin-, it does help

It's not a good idea to approach a doctor looking for substances. Better on the dark web if you are seeking to get high. Doctors respond to symptoms, not prescription requests.

Most ADHD medication (ritalin, etc) is basically just medical grade methamphetamine.

Do doctors even prescribe benzos outside of like super short term use, anti-seizure medication or procedures?