Epistemic status: my best guess at the truth, with many of the standard medical-advice disclaimers omitted

Many people I know are aware of drugs for basic ailments, but don't bother using them because they're too much trouble to carry around. But using a pill organizer basically eliminates this overhead. For me, having a pill organizer has dramatically reduced the negative effects of insomnia, jetlag, nausea, diarrhea, headaches, etc., and significantly increased my operational capacity. In total, it has probably increased my productivity by over 3% over the last few months, and also increased my quality of life substantially. (But note that I think most people won't get such a large benefit). Just using the alertness adjustment drugs to curb jetlag saves me about 3 hours of productive time each way on critical trips.

Example pill organizer layout

Here are the exact steps I followed, which take less than an hour and cost about $30:

  • Get a 10-slot pill organizer (4 for $10 on Amazon). Not the same as a weekly pill organizer.
  • Get a few basic pills from your local drugstore, supermarket, Amazon, whatever. I suggest the following:
    • ibuprofen 200mg (Motrin, Advil) for pain, fever, etc. [1]
    • caffeine 100mg, optionally with l-theanine
    • loperamide/simethicone 2mg (anti-diarrhea)
    • dimenhydrinate (Dramamine, anti-nausea) [2]
    • melatonin 0.3mg (mild sleep aid)
    • doxylamine 25mg (Unisom, sleep aid to be used sparingly) [3]
  • This gives you 4 slots left for whatever other drugs you benefit from or are prescribed, maybe things like
    • aspirin 81mg (in case of heart attack, also another option for pain)
    • modafinil 200mg or armodafinil 150mg (suppresses sleep drive). Note that this dosage is way too much if you don't have narcolepsy.
    • stimulants e.g. amphetamines, nicotine
    • anti-anxiety meds [4]
    • allergy meds (if these are antihistamines they could double as other things)
    • electrolyte pills: sodium, potassium, magnesium
  • Put the pills in the medication organizer, and label each compartment with the medication and dosage, using a permanent marker. You can erase the labels with alcohol wipes if needed.
  • Carry it around in your backpack or purse.
  • If those particular drugs don't work for you, try others that do the same thing. Our civilization has invented these multiple times and there's a good chance at least one works for your particular body.

In December, I lost my pill organizer. In the few days it took me to order a new one, the following things happened:

  • I had to stay up late to finish work, which threw my sleep schedule off. Without melatonin my sleep was out of phase for a few days, losing me about 10 hours of work.
  • I had mild food poisoning and had diarrhea for much longer than necessary, which was very unpleasant and lost me ~3 hours of work.
  • Someone asked if I had ibuprofen. They probably had a headache or period cramps or something for hours, or had to walk to a store. Either way, they suffered for at least an hour.

All six of the basic substances listed are over the counter, have fairly low abuse potential, and have few harmful interactions (other than, say, caffeine increases wakefulness and doxylamine decreases wakefulness). However, I highly recommend doing basic research into the substances you're using (e.g. reading the wikipedia page), especially if you're customizing.

Notes

[1]: One could also add acetaminophen (Tylenol); ibuprofen has an anti-inflammatory effect which acetaminophen does not have but taking it too often can cause GI bleeding or kidney damage.

[2]: A doctor I know suggests replacing this with ondansetron (Zofran, anti-nausea/vomiting) which requires a prescription but has almost no side effects, and is probably safe during pregnancy too.

[3]: Hypnotics (sleep drugs like Unisom) are not recommended as an intervention to improve sleep in the long term compared to other interventions like melatonin, CBT-I or light therapy.

[4]: A doctor I know suggests alprazolam (xanax) or clonazepam (klonopin), which both require prescriptions and are addictive.  Use only in highly stressful situations as needed.

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Ads and paywalls are only optional if you're ok freeloading.

(I can see arguments for either blocking ads or bypassing paywalls, but not both with the same views.)

Thanks for reminding me. I now have subscriptions to Wirecutter and some things on Patreon/Substack but wish there were a better way to incentivize good content than subscribing to entire news sites, especially when 99% of articles on many news sites are vacuous.

This is true, but I'll expand the discussion to somewhere more niche than I normally see it go: consider getting a tool like ublock origin and using custom filters to remove distractions.

When I see other people use the internet, it boggles me how many parts of web pages are useless to them but allowed to stay for no reason. I take out things like cookie warnings I've seen countless times, the very distracting sidebar on StackOverflow[1], or anything else that has a risk of dragging me off course.

I mention this because I notice people usually associate these programs only with ads, when a philosophically anti-adblock person could get a hell of a lot of benefit out of removing annoyances instead, while never doing anything they think would hurt the webpage's wallet.


  1. There's rarely a time I don't want the answer to some pedantic and obtuse question about math, tabletop games, or whatever else, but the time is equally rare that I am on SO and am not, for example, trying to solve a bug or something. ↩︎

Many people don't realize how effective migraine treatments are. High-dose aspirin, tryptans, and preventers all work really well, and can often reduce migraine severity by 50-90%.

Also, most don't yet realise how effective semaglutide is for weight loss, due to the fact that weight loss drugs have generally been much less effective, or had much worse side-effects previously.

Balding treatments (finasteride and topical minoxodil) are also pretty good for a lot of people.

Many people don't even realize that they have migraines, and treat their recurring headaches with NSAIDs or acetaminophen, instead of the vastly more effective triptans. And as you say, few are aware of the new and miraculous CGRP inhibitor class of migraine preventative drugs.

Bypass paywalls doesn't work on the mobile browser.

How do you avoid bug bites?

There are lots of bug repellents. Being from a dry climate I have little experience with this, but Wirecutter recommends picaridin-based repellents, and I expect a tiny bottle of 100% DEET to be practical enough to carry around everywhere.

The idea here seems to be something like:

  1. Everyone knows you can handle jetlag, nausea, and diarrhea with pills.

  2. People don't actually do this because keeping the pills around is inconvenient.

  3. Maintaining a pill organizer makes it convenient.

My guess is that #1 is actually not the case, and the main reasons people do not treat these as optional is that they don't know these can be handled with pills, they don't know how to handle these with pills, or handling these with pills doesn't actually work well for them.

Yeah, I definitely didn’t know a good chunk of the stuff listed in the OP (and in fact suspect that at least some of it is not true and/or comes with significant drawbacks not listed).

I "know" that nausea can be handled with a pill, but it had never occurred to me to carry around a couple anti-nausea pills.

How often do you suffer from nausea? I'll admit to the fact that I carry around none of these because I never need them (except for the fact that I keep a bottle of melatonin on my bed).

I get motion sickness easily, but I don't often suffer from nausea because I avoid doing things that make me motion sick (e.g., reading in the car). If I took anti-nausea pills, I could do those things more.

Just wanted to say I've purchased a pill organizer based on your recommendation, and plan on checking out your anti-diarrhea and anti-nausea picks! I'll also probably slot in Tums for acid reflux.

Personally, I found a weekly pill organizer very helpful because I could tell whether I had already taken my meds or not.

Here's a Share-a-cart link to grab all of the 6 basic pills + pill organizer on Amazon for ~$57. (Click on the link, click "Send all to cart", and then "Add to cart" at the bottom).

I did very minimal research for this and mostly just clicked on the first fine-seeming product per item on the list, and did not check whether things were vegan, the best possible product in each category, etc. Commenting mostly to encourage people to use services like Share-a-cart when publishing shopping lists to make it super easy for people to buy things you recommend.

If there's something wrong that's causing recurring issues (e.g. diarrhea), then taking medication to prevent diarrhea is fixing the symptom and obscuring the cause. It obscures any signal that might lead to identification of the cause while exposing you to the medication's side-effects.

For example, someone with lactose intolerance (but who doesn't know it yet) goes from "I notice that when I eat x, I get diarrhea for the next week" without medication, to "I eat what I want and experience no symptoms, but I do notice I have been feeling more tired and low in energy over the past few months" with medication.

How could one end up taking the correct medication without knowing first that they're lactose intolerant? 

I don't see how that could happen. To end up taking lactose pills you need to know there is something wrong with your lactase tolerance in particular. 

There are extra costs here that aren’t being included. There’s a cost to maintaining the pill box - perhaps you consider that small but it’s extra admin and we’re already drowning in admin. There’s a cost to my self identity of being a person who carries around pills like this (don’t mean to disparage it, just not for me). There’s also potentially hidden costs of not getting ill occasionally, both mentally and physically.

This is amazing, thank you!

I once had a multiple day hospitalization following use of modafinil (to prevent jetlag) during a flight -- checkups found no clear cause. This is obviously N=1, but still makes me wonder if there's some adverse interaction between modafinil and pressure changes. Would be interested if anyone has had similar experiences and/or knows of a relevant mechanism.

What were the symptoms that led you to go to the hospital, and what did they observe there that convinced them to have you stay after the initial exam?

Sleeping 22 hours a day for 2-3 days pre-admission and fever. I think the presumption was those sorts of symptoms merit careful investigation. Don't remember if there were any particular test results that were remarkable. IIRC there weren't.

Seeing as the modafinil was not prescription, and I've never heard of similar symptoms from others, it's quite plausible my pills were just contaminated with some other substance. Still should probably update against taking modafinil without prescription, since this contamination risk is just as important as side-effect symptoms.

So you procured study drugs from an illicit source, took them, felt your body temp rise, stopped taking them, spent the next few days sleeping like crazy, and presented at the hospital?

Did they do a tox screen (meth and similar stimulants?)

I posted on another thread a while ago, according to dancesafe, counterfeit modafinil that's actually low dose methamphetamine was being marketed in Berkeley. I'd expect this to be common, because the following reasoning is a 'flash of inspiration' I'd expect a drug dealer to have...

Nerds have money -> nerds want study drugs -> most study drugs are stimulants -> pill press is cheap -> meth is widely available -> dilute the meth doses you'd usually sell to tweakers, put in pill press to look like study drug, sell to nerds.

Brilliant plan right?

That certainly sounds scary, but seems unlikely in my case. No tox screen, but also did not buy locally in Berkeley, and had previously used the pills without problem.

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