ADHD is a serious issue
Do we really have attention deficit disorder or is this just drug companies attempting to profit from a diagnoses that doesn’t legitimately exist? New reports are beginning to shed light on America’s reliance on medication for behavioral tendencies, chiefly ADHD.
According to Keith Connors, a psychologist and early advocate for recognition of ADHD, “This is a concoction to justify giving out of medication at unprecedented and unjustifiable levels.”
At a recent conference in Washington with peers Connors, who is a psychologist and professor emeritus at Duke University, noted that recent data from the Centers For Disease Control and Prevention show that ADHD diagnoses have been made in 15 percent of high school age children, and that the number of children on medication for the disorder had soared to 3.5 million in 2016 from 600,000 in 1990.
Not by coincidence, the rise of ADHD diagnoses and prescriptions for stimulants over the last 20 years has coincided with a remarkably successful two-decade campaign by pharmaceutical companies seeking to publicize the syndrome and promote the pills to doctors, educators and parents. With the children’s market booming, the industry is now employing similar marketing techniques as it focuses on adult ADHD, which could become even more profitable.
While it may be true that children’s impulsiveness (but isn’t that what makes them children by definition in the first place?) and inability to concentrate has led to learning difficulties, there are many people with scant symptoms also receiving the diagnosis and medication. And perhaps not by chance — ADHD is now the second most frequent long-term diagnosis made in children, narrowly trailing asthma, according to a New York Times analysis of C.D.C. data. More than one in seven children in the United States receives a diagnosis of the disorder by the time they turn 18, according to the Centers For Disease Control and Prevention.
However, drug companies are now advocating the use of their drugs in instances of what many psychologists argue is relatively normal behavior, like carelessness and impatience.
The diagnosis of ADHD has become so prevalent that advertising has cast common childhood forgetfulness and poor grades as grounds for medication that can, among other benefits, ease family tension and result in “schoolwork that matches his intelligence.” This is a wide overreaching claim, which if told over and over by authoritative figures, can greatly influence the use of such drugs.
Aware that abuse is common, the Food and Drug Administration has cited every major ADHD drug — stimulants like Adderall, Concerta, Focalin and Vyvanse, and nonstimulants like Intuniv and Strattera — for false and misleading advertising since 2000, some multiple times. Hardly the most auspicious ratification for a parent seeking to address what they are told is their child’s developing ADHD and their inability to conquer adult life.
Questioning the long-term benefits of drugs versus plain therapy is Dr. Eugene Arnold, a child psychiatrist and professor at Ohio State University who told the NYT: “There was lost opportunity to give kids the advantage of both and develop more resources in schools to support the child — that value was dismissed.”
Dr. Lily Hechtman of McGill University in Montreal added: “I hope it didn’t do irreparable damage. The people who pay the price in the end is the kids. That’s the biggest tragedy in all of this.”
Yet part of the problem may well be that researchers and doctors are often funded and financed by the very drug companies that they ought to be viewing with a critical eye. Such funding often includes lucrative speaking and consulting fees.
As a result, typical findings by doctors specializing in the field (and naturally sponsored by the drug makers themselves) state that the disorder is under diagnosed, stimulants are effective and safe, and unmedicated ADHD would lead to significant risks like academic failure, drug dependence, car accidents and brushes with the law.
Raise your hand if you smell a moral and ethical dilemma brewing…
One can only imagine the frenetic energy of parents trying to get their children on such drugs in reaction to such drum beats.
Another factor that has contributed to the increasing use of ADHD drugs is the way schools and insurance companies go about addressing learning difficulties, often opting for the “cheaper” option of providing medication as opposed to ongoing therapy sessions.
Whilst some studies have shown that stimulant medication helped elementary school children to improve grades in reading and math by helping them concentrate, the concern is that long-term academic benefits have not been proven and that children become hooked on the drugs well into adulthood.
Then there’s the concern of how far advertising has gone in indoctrinating the use of such drugs as par for the course, whereas healthy degrees of skepticism should be par for the course.
Many in the field have gone on to express concern that ads advocating the use of drugs for ADHD tempt doctors, perhaps subconsciously, to prescribe drugs to healthy children merely to improve their grades or self-esteem.
Dr. Aaron Kesselheim of Brigham and Women’s Hospital in Boston, who specializes in pharmaceutical ethics, says: “Even though they’ll tell you that they’re giving patients unbiased, evidence-based information, in fact they’re more likely to tell you what the drug company told them, whether it’s the benefits of the drugs or the risks of those drugs.”
In the interim, it’s unlikely that there will be a slowdown in the use and the prescribing of drugs for behavioral issues — issues that might be best countered with good parenting, sleep, counseling, patience and understanding. But it only underscores our nation’s preoccupation with seeking “fixes” for ailments rather than going on the hard journey of therapy and self-development. Yet tell that to the drug companies who have over the last 20 years entrenched our culture with how to live life and become successful. It might just be the American way, to swap one perceived ailment for the reliance of another.