According to the CDC, the rates of Attention Deficit Hyperactivity Disorder (ADHD) diagnosis in children continue to rise each year. In fact the number of reported cases of ADHD has increased by 42 percent since 2003. Add to those statistics the steady increase of ADHD diagnosis in adults and it’s clear to see that ADHD is a serious and growing medical condition.
Or is it?
Many in and out of the medical field argue that the rising ranks of ADHD sufferers are largely the result of aggressive ad campaigns by pharmaceutical companies, encouraging doctors to prescribe billions of dollars worth of drugs each year for a medical condition that may not exist at all. Looking at the arguments on both sides of the issue, there seem to be legitimate claims for both.
On the pro side of ADHD, many clinicians claim that, just like other medical conditions, ADHD comes with its own set of symptoms. And these symptoms can cause real problems with school, work, and relationships. In a recent New York Times Consults blog post discussing whether or not ADHD is a real disease, Dr. Russell A. Barkley, clinical professor of psychiatry at the Medical University of South Carolina argues that “Symptoms of A.D.H.D., like distractedness and impulsiveness can occur in varying degrees within the general population. As symptoms increase in severity, the condition can become more troublesome, eventually impairing a child’s major life activities.” When things get to that point, Dr. Barkley cautions, “it may be time to seek professional advice.”
According to Neurologist Richard Saul, whose new book, ADHD Does Not Exist: The Truth About Attention Deficit and Hyperactivity Disorder, is due to hit the shelves in February, seeking professional advice all too often results in a quick ADHD diagnosis and a prescription for stimulants that can lead to addiction. Based on years of experience treating patients who claimed that they had short attention spans and had difficulty staying focused, Dr. Saul contends that ADHD isn’t a disease at all, but merely a collection of symptoms. In fact, Saul says that the diagnosis of ADHD has no place in the American Psychiatric Association’s Diagnostic and Statistical Manual and he would like to see it removed.
As for the issue of overdiagnosis of ADHD, Dr. Barkley in his New York Times blog said that “There is no way to know in advance if a particular doctor is over diagnosing the disorder in the patients they see.” He went on to say that in his opinion, most doctors are “very conservative in giving a diagnosis.”
Regardless of which side you take in the ADHD debate, the rise in the number of prescriptions for drugs such as Ritalin and Adderall—along with a host of other stimulant drugs used to treat ADHD—is cause for concern. According to data from the National Institutes of Health, the fastest growth of prescribed drug use is among 13-18 year-olds. But ADHD prescriptions for adults are quickly catching up.
In an April 22, 2010 segment of “60 Minutes”, the disturbing trend of use and abuse of ADHD drugs among college students was examined. According to a survey of nearly 2,000 students at the University of Kentucky in Lexington, a full 34 percent of undergraduates admitted to taking ADHD drugs without a doctor’s prescription. In addition, 50-60 percent of Juniors and Seniors surveyed reported taking ADHD drugs. Apparently the longer students are in school, the more likely they are to use them.
This increase in the use and abuse of prescription drugs for ADHD has been attributed by a number of critics to aggressive marketing by Big Pharma. After all, with monthly supplies of many of these medications running into the hundreds of dollars, ADHD has become a major cash cow for drug companies. It’s no wonder that drug companies are spending large amounts of money to make sure physicians know how much these drugs can benefit their patients. Unfortunately, while promoting their products they tend to downplay the potential side effects of stimulant drugs, such as insomnia, anxiety, irritability, abnormal weight-loss, mood problems, self-destructive behaviors and even suicide. Not surprisingly, the FDA has cited every major maker of ADHD drugs on numerous occasions for making false and misleading advertising claims.
In weighing the arguments concerning whether ADHD is a legitimate medical condition or a fabricated franchise to generate billions of dollars for Big Pharma, the truth probably lies somewhere in the middle. ADHD most likely is a legitimate neurological disease. And there is plenty of evidence to support the benefits of medications used to treat it. However, the trend to over diagnose and overprescribe these medications clearly needs to be addressed. As the debate continues, hopefully physicians, parents and patients alike will become better equipped to make more informed decisions concerning ADHD.
That being said, if you’re legitimately concerned about a child who may have ADD or ADHD, you still shouldn’t hesitate to visit a doctor who can give you advice for your specific situation. A service like ZocDoc, the Yellowpages, or RateMD could help you find one who has experience diagnosing ADD and ADHD.