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Trump Nose Best - Adderall Use is Nothing to Sniff At

John Kruse MD, PhD
6 min readJan 22, 2019

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Internet commentators have been nosing into whether Mr. Trump habitually snorts Adderall, a stimulant medication prescribed for Attention Deficit Hyperactivity Disorder (ADHD). Derisive and joking commentary pervades this buzz. However, if true, we should probably applaud the allegations. First, they constitute at least tacit acknowledgement of Mr. Trump’s ADHD. Secondly, they indicate his acting in ways that might actually mitigate some of his ADHD-driven problems.

Several lines of cocaine, I mean investigation, lead to Mr. Trump’s purported history with stimulants. Reports going back decades assert that doctors prescribed Mr. Trump phentermine. The FDA approved the stimulant medication phentermine for weight-control, but physicians also prescribe it off-label to treat ADHD. Phentermine prescriptions receive less government scrutiny than more tightly controlled stimulants like Ritalin or Adderall. During the presidential campaign two years ago, pundits extensively discussed Mr. Trump’s sniffing, grimacing and hyperactivity, and whether these behaviors indicated a habit of snorting cocaine or other stimulants. Months ago, individuals who worked on the reality show The Apprentice claimed that Mr. Trump routinely snorted Adderall while on the set. The issue achieved greater prominence following Mr. Trump’s recent Presidential Address, with a flurry on Twitter noting that his frequent sniffing and visibly dilated pupils might both indicate ongoing Adderall snorting.

I examined video footage of the border wall Presidential Address, comparing it to his other presidential performances. Mr. Trump’s pupils are substantially larger during the Address than during other speeches, under what appear to be similar indoor lighting conditions. (Brightness strongly influences pupillary dilation.) However, even more blatant than a change in the size of his pupils, during the Address he made many fewer head and body movements, many fewer hand gestures, twitched less, and uttered more organized sentences, in a calmer cadence, than he displays elsewhere. While some of this behavior may be in direct response to the structure of reading from a tele-prompter, we have certainly seen him go off track in other speeches, despite help from a tele-prompter. The combination of simultaneous physiologic, behavioral, and cognitive changes in…

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John Kruse MD, PhD

Psychiatrist, neuroscientist, father of twins, marathon runner, in Hawaii. 100+ ADHD & mental health videos https://www.youtube.com/@dr.johnkruse6708