ADHD diagnosis needs a dose of reality

December 16, 2013 

Many are the parents who praise the drugs designed to curb or cure the symptoms of ADHD, or attention deficit hyperactivity disorder. Their children, they say, were unfocused, unmanageable and misbehaved or were unable to concentrate in school until they were diagnosed and got drug therapy to help them.

That belief is spread among parents who see similar symptoms in other children and quietly ask parents, “Do you think he might have ADHD?” Then those parents head to a doctor who interviews them and their child, has them fill out a questionnaire and writes a script for one of several drugs designed to address ADHD.

The New York Times reports that the reliance on drugs to treat children might have spread much too far. A Duke University psychologist and professor emeritus who helped legitimize the diagnosis of ADHD now thinks overdiagnosis has fed a perception that ADHD is epidemic. That, in turn, has led to too many children taking ADHD drugs, a boon for drug companies but a hazard for children.

“This is a concoction,” Keith Conners says, “to justify the giving out of medication at unprecedented and unjustifiable levels.”

Oversaturation

That Conners would speak out is no small matter to pharmaceutical companies, which make millions on the drugs and spend millions publicizing them, in ads directed at doctors and parents and even in comic books aimed at children.

The result of that kind of saturation, Conners believes, is that far too many youngsters are put on ADHD drugs at early ages, the ramifications of which are uncertain in the long term but might include at the least a feeling on the part of people who take the drugs that they can’t get along without them.

Doctors are responsible as well, facing criticism that too many of them prescribe the medications for kids without enough examination. Also possible is a quick diagnosis that addresses behavioral problems that might be helped simply with more discipline and structure.

A national disaster

The trend line supports the argument that the use of ADHD drugs has become a larger problem than ADHD itself. In 1990, there were 600,000 children on medication for the disorder. Today, the number is 3.5 million.

Conners says the soaring use of the drugs on children is a national disaster of dangerous proportions.

“The numbers make it look like an epidemic,” he says. “Well, it’s not. It’s preposterous.”

It happens that coinciding with that growth in the use of medications is a campaign from drug companies marketing the drugs just as they do those for all sorts of ailments, from depression to respiratory illness.

Some physicians believe the drug ads, with their scenic vistas and pictures of happy families, promise more than they can deliver. The Food and Drug Administration has cited every major ADHD drug for false and misleading advertising since 2000.

The FDA needs to take a stronger role in overseeing these medications and tightening the reins on them. Parents also need to be more careful in seeking drug solutions for behavioral problems.

There clearly are problems that can and should be addressed with drugs. The estimated percentage of children who qualify in that category is5 percent. But now, The Times reports, the diagnosis is seen in 15 percent of high school-age children. That doesn’t make sense.

Conners should be admired for speaking out and strongly so. More awareness, followed by stricter regulation, is needed.

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