The Business of Attention Deficit Disorder 246
Hugh Pickens DOT Com writes "Alan Schwarz writes in the NYT that the rise of ADHD diagnoses and prescriptions for stimulants over the years have coincided with a remarkably successful two-decade campaign by pharmaceutical companies to publicize the syndrome and promote the pills to doctors, educators and parents. 'The numbers make it look like an epidemic. Well, it's not. It's preposterous,' says Dr. Keith Conners, a psychologist who has led the fight to legitimize attention deficit hyperactivity disorder for more than fifty years. Few dispute that classic ADHD, historically estimated to affect 5 percent of children, is a legitimate disability that impedes success at school, work and personal life. But recent data from the CDC show that the diagnosis had 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 from 600,000 in 1990." (Read on for more.)
"Behind that growth has been drug company marketing that has stretched the image of classic ADHD to include relatively normal behavior like carelessness and impatience, and has often overstated the pills' benefits. Advertising on television and in popular magazines like People and Good Housekeeping has cast common childhood forgetfulness and poor grades as grounds for medication that, among other benefits, can result in 'schoolwork that matches his intelligence' and ease family tension. The FDA 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. And although many doctors have portrayed the medications as benign — 'safer than aspirin,' some say — they can have significant side effects and are regulated in the same class as morphine and oxycodone because of their potential for abuse and addiction. Meanwhile profits for the ADHD drug industry have soared. Sales of stimulant medication in 2012 were nearly $9 billion, more than five times the $1.7 billion a decade before, according to the data company IMS Health. 'This is a concoction to justify the giving out of medication at unprecedented and unjustifiable levels,' concludes Conners."
TED talk (Score:3, Informative)
See also https://www.ted.com/talks/ken_robinson_says_schools_kill_creativity.html [ted.com] . Watching that video will be one of the best 20 minutes you've ever spent.
Re:What is it then? (Score:0, Informative)
Is it big pharma pushing doctors to prescribe more? Is it doctors too lazy/busy to do a proper diagnosis? Is it mothers, fathers and teachers who seek to explain bad behavior and poor discipline (which is largely their fault) on medical conditions? Is it our foods which have changed over to GMO based content over the same period of time?
The basic cause of this is simple: lack of physical activity causes kids to be fidgety. They can't concentrate. Kids that fidget in class are disruptive. They are marked as "trouble".
Let them burn off all that energy they get from the sugars and carbs and mass market garbage foods they have shoved down their gullets by the schools and parents who don't have time to cook because a 40 hour week never really means that, and their commutes usually are longer than the time they spend with their kids.
This ADHD problem is a byproduct of the fast paced world we've created to "stay competitive, stay on top, and keep up with the Joneses".
ADD = The Business of Curing Stupidity (Score:4, Informative)
Re:American Culture? (Score:4, Informative)
I'm not american, lived and visited several parts of the world. Love to talk and fit in with the locals and socialize.
Of course it's all anecdotal, but I'm pretty sure that something odd is going on in American culture. The times i've been there I couldn't help but finding amazing how such large parts of the population take behavioral related medication. I mean, even most TV commercials I saw were for anti depressants, or even complenents to them.
But it's not the medication itself what caught my attention but how people itself claims to be unwell, not feeling like what people should feel or not behaving as people should behave. It's as if there was some sort of strong "need to be normal" or "need to be well" (whathever tha means), and that not being like that is not fitting in society.
It's not that where I am from (South America) people won't get depressed or have panic attacks, but you see such symptoms by far much, much less often. It's not misdiagnose either or that people chooses to put up with it instead of taking medication , I mean, it's very clear when someone is going through depression. In contrast, people here are more "unpolite", intimate,cares less about rules and socialize a lot more. I'm sure there has to be a relationship somehow, but I am no expert on the matter. As I said, it's just what I see, but I can't connect the dots.
So, I think that even if pharmaceutical companies capitalize on this stuff, I'm not that sure they created the situation, I believe it's more akin to a side-effect.
Being a depressed person and having to take medication, I find that my life is way better taking the anti-depression meds then not. Of course, it took 10 or so years to find the meds that work best for me and i've spent most my life not on them, but in the last 5 or so years I've been the most mentally level I have ever been in my life.
Sure, drug companies make money by selling drugs and they want to sell as much drugs as they can, if needed or not. But that doesn't change the fact that most of the drugs they sell do have problems they address & help.
I also have ADHD, which didn't get diagnosed until later in my life (also), and no one seemed to care growing up. But I'm not really down with taking speed for it, and really giving speed to kids is really stupid. I mean, they made laws against selling drugs around schools, yet they prescribed them a class a speed that is way better then any meth they could get.
Stuff like this is why there is no such things as a "free market" and why there needs to regulations. Mainly drug reps paying doctors to prescribe their drugs.
Re:This is the Problem. (Score:2, Informative)
perhaps we could get the masses equal access to decent medical care
There is no such thing outside of totalitarian regimes like North Korea. Even in communist China different people get vastly different quality of health care. And the attempts to control medical care by the federal government is doing nothing but leading to efforts like Medical VIP clubs [mdvip.com] where all the good doctors are taking care of well-to-do patients that can afford to pay a little extra. It hasn't helped to equalize health care at all, in fact it will only increase the disparity.
What's needed is less government intervention and more people shopping for normal health care to help drive down the costs. Of course the typical collectivist response to this is "OMG you can't shop around when you're bleeding to death." Which is nothing but a straw man, because emergency and trauma care is a much smaller proportion. Even shopping around for the best price on a procedure would put tremendous amount of price pressure on the providers if more people did it. Why would pharmacies compete on price when everybody is going to pay their $30 co-pay anyway. That's why you can find a 200% - 3000% difference in the cost of certain medications - most of the people buying it are getting the bill paid by somebody else.
Re: This is the Problem. (Score:4, Informative)
It's silly to use China and North Korea as your only examples. Scandinavia has much more equal access to health care, we use less money on it both in terms of total per capita spending and health care as percentage of GDP, and our average outcome is better. It is true that the fantastically well-off are best served in the USA, but most people are better served in Scandinavia.
The Scandinavian system works for Scandinavia, but it's paid for by one of the highest tax rates in the world. I believe Sweden actually has a tiered system, where you are required to purchase a basic level of health insurance, and if you can afford it you can optionally purchase better coverage. Of course these countries also have a homogeneous population with relatively healthy lifestyles, and the wealth do pay for private health care - they don't wait in line with the rest of the folks.
Re:Business Plan (Score:1, Informative)
Yes there was [cdc.gov].
Sugar causing hyperactivity is a myth, you goddamned moron.
Re:American Culture? (Score:5, Informative)
I think there's a bunch of interrelated issues in American culture, many tied to economics.
Parents want to their kids to be successful, and the general theory on this is that you have to do well in school early so that you can get into the right college so you can get the right degree so you can get a good job.
I think this leads to relentless pressure on kids, especially boys, to be "perfect" in school. Deviation from this leads parents to wonder what's wrong, when, in fact, what's wrong may be "he's an 8 year old boy." Parents believe and our culture does everything to reinforce the idea that if you screw up early you won't make it into the right schools, activities, college, etc. There's no room for error, no room to be an 8 year old boy for whom its perfectly normal to have a ton of physical energy and not a lot of focus on sit-still studies.
The educational system, especially in urban areas. There's this relentless focus on "the achievement gap" -- mostly blacks, but often including hispanics, not achieving the same test scores, grades, etc. as other students, mostly whites (although you could include Asians, they often outscore whites).
Fighting the "achievement gap" has led to two things. One, more testing and more focus on elementary education test scores, which has led to more intensive focus on reading and writing, which is challenging for all boys of elementary school age. We've taken something hard for young boys and kind of made it harder for them.
The second thing is that schools have tried to become social welfare delivery mechanisms. It's beyond obvious that the MAIN reason low-income blacks do poorly in schools is the absolute train wreck of urban black culture -- broken families, incarcerated parents, dangerous, crime-ridden neighborhoods. School districts can't solve this but they have devoted a lot of resources to it -- social workers, free meals, all kinds of social benefits to overcome the insurmountable problems when mom is on welfare or underemployed, dad is in jail or unknown, the neighborhood is a war zone, etc.
This well-intentioned but myopic attempt to solve the insoluble has led to schools losing their focus on kids generally, especially boys, as well as causing them to burn a lot of resources that could be better spent on programs that boys find engaging even though they might not contribute to the political issue of low test scores for black kids.
The last thing I'd add in is our culture's relentless, zero-slack atmosphere where everybody has to be plugged in all the time and there's no time for anything but work and more work. I hate it and I think it has a lot to do with why so many people, especially young people, are fucking snapping and going batshit with guns.
Combine it all together and you have parents terrified that their kid, performing poorly in 2nd or 3rd grade, needs to straighten out NOW or he won't go to college and will wind up poor and destitute.
It's a crazy conclusion but I tell you as a parent of an 8 year old who was in that same situation it absolutely flashes through your mind. My son was basically refusing to do assignments in class and when he did do them doing a very slapdash job, yet was scoring so high on standardized test we got a letter from the district that said he was in their "gifted" category! Of course we did everything we could (pediatric ADHD screening is an absolute joke, they don't even white-out that the screening questionnaire is made by the drug company) and went all out for a neuropsychiatric evaluation that basically said "Your son is really high IQ, school bores him and the tasks he does poorly on are really pretty poorly matched to 8 year old boys. He doesn't need ADHD meds." I'm glad we spent the money to basically learn the obvious because from a pediatrician perspective we could have easily been talked into meds, although even on the drug company ADHD screener we were iffy in terms of ADHD.