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Education Medicine The Almighty Buck Science

The Business of Attention Deficit Disorder 246

Posted by timothy
from the drug-'em-all-let-god-sort-'em-out dept.
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."
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The Business of Attention Deficit Disorder

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  • by ohieaux (2860669) on Monday December 16, 2013 @09:44AM (#45702859)
    Meds are not always the answer and a child psychiatrist is the best person to know. We had our son tested twice (3 years between). The first was borderline. We saw no improvement and after more discussions with the school (attention and not behavior issues) we had him tested again. These were real tests that took hours, over several days. He scored high and received the diagnosis. But, they didn't want to try meds at first.

    We met with the school (teachers and school psychologist). A plan was devised and it seems to be working. He gets a break to walk around, occasionally, and some extra time on some tests. I'm much happier that the school was able to make a couple of accommodations, and the teachers are happier to have one less zombie in the classroom.
  • by Connie_Lingus (317691) on Monday December 16, 2013 @09:50AM (#45702895) Homepage

    lol...how clueless.

    "non-profit" hospitals abound in the U.S, yet they still charge almost the exact same rates as your evil "for-profit" ones. They all use a pricing sheet called the "chargemaster" that they guard zealously.

    non-profits still have to pay salaries to retain talent, pay utilities etc etc.

    "No wonder MD Anderson’s operating profit in 2010 was $531 million on revenues of $2.05 billion. That’s a 26-percent profit margin, unheard of in any service industry other than hospitals. Being a “non-profit” organization, it pays no income taxes." http://www.commentarymagazine.com/2013/08/01/why-non-profit-hospitals-are-so-profitable/ [commentarymagazine.com]

    the "non-profit" tag is pretty much nothing but a "feel-good" marketing gimmick to assuage socialistic-types.

  • American Culture? (Score:5, Interesting)

    by goruka (1721094) on Monday December 16, 2013 @09:53AM (#45702901)
    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.
  • by fldsofglry (2754803) on Monday December 16, 2013 @09:53AM (#45702903)

    I can't help agree with a poster above, who recommended the Ken Robinson video.

    I also wanted to add that I think the way that our modern education system works has a lot to do with parents seeking a diagnosis for little Bobby "who just can't sit still".

    I used to work in the environmental education field for quite a few years. I can say that I loved to have kids with "ADHD" in my group, because they were the ones turning over rocks and logs and activity searching for things. What is seen as a detriment in one setting, seemed to be an advantage in another setting.

    An interesting thing to note is often how I would find out about their conditions. Since I did do some work at overnight facilities, I would sometimes would be told ahead of time medications and conditions a child had. But most of the time, I found out about it by a teacher saying something like: You know, so-and-so has a ADD/ADHD and he is just doing SO well out here.

  • Re:What is it then? (Score:5, Interesting)

    by RetiredMidn (441788) on Monday December 16, 2013 @09:56AM (#45702917) Homepage

    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".

    Crap. My son was diagnosed in the early 90's. We resisted the diagnosis at first, then balked at medication. In the end, the medications did help him succeed in school and at such activities as soccer, where the difference in his ability to pay attention was easiest to observe.

    The counter-intuitive thing about ADHD medications is that they are typically stimulants, hardly something you would think of giving to a hyper-active child. Our doctor described the symptoms as something more akin to the restlessness that can come with drowsiness than an over-active mind or metabolism.

    Maybe some parents diagnose and treat to make life easier, but I'm here to tell you that we specifically did not medicate my son during weekends and vacations, partly to minimize the medication, and partly to be able to observe his baseline behavior to see whether it changed over time.

    As for teachers, my wife has taught first and second grade for about 20 years, and in her school system, teachers are prohibited from offering a diagnosis or even acknowledging the possibility when asked; that is the domain of medical professionals, not teachers. YMMV, of course.

    All that said, ADHD is certainly over-diagnosed, and that was almost certainly the case back when my son was diagnosed, at the early end of the chart in TFA. I have to say I was shocked at how much more prevalent the diagnosis has become. I tend to lay the blame at the feet of Big Pharma marketing treatments to lay people; the lengths they go to in advertising in magazines (with pages of fine print that few read or understand) and television, carefully staying within the guidelines of regulations (that clearly aren't helping) is absurd.

  • Re:What is it then? (Score:5, Interesting)

    by p00kiethebear (569781) on Monday December 16, 2013 @10:46AM (#45703437)

    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".

    You sir are full of shit.

    Lack of physical activity? Are you serious? I was training in gymnastics for sixteen hours a week when I was diagnosed. I was winning state and regional medals until I was fifteen.

    It's always fucked up to me how all the people who have never had ADD are always first to know exactly everything about it. You've never had to struggle with academics and social skills because the only things you could focus on were the ones that were rewarding to you. It's not a cut and dry case of being 'fidgety' and rarely is it a case of discipline on part of the parents.

    ADD made my elementary school days hell for me. It was almost impossible to get along in regular social situations with exception to times I was with other kids that had ADD. It was hard for me to pay attention to what I was reading when all I could focus on were INTRUSIONS into my focus from say, the sound of the kid behind me wheezing. The ticking of someone's watch. Hearing the hum of a fan turning on and off at regular intervals and noticing it always happens every 4 minutes. The way a cute girl across the room wore her hair differently today or maybe she got her ear pierced and I'm distracted by how red it's made her earlobe and how she's scratching it often. Maybe today I've noticed the teacher got a new watch and it's super shiny. He asks if there are any questions and I raise my hand and ask about the watch. Everyone laughs at me since the question had nothing to do with the lecture but I can't understand why no one else was so interested in the cool looking timepiece.

    ADD is not an inability to focus. It is a deficit with the ability to filter out the intrusions into your senses that make focusing on what others seem to find important nearly impossible at times. Let's face it, it's hard to have perspective about how important it is to know about the revolutionary war when you're 10 years old.

    Don't be so quick to have all the answers when your understanding of the issue is clearly incomplete.

    ADD is STILL affecting my life. I struggle with it every day. This morning is a perfect example. I WAS trying to sleep. I woke up to pee and decided to read slashdot in bed while I let sleep take over again. But I read your retarded comment and it has made it impossible for me to go to sleep. Why? Because I can't seem to filter out your bullshit. Your asinine opinion on the matter has intruded into my focus on getting a healthy night's sleep. I tried to let it go and just lie down but I couldn't stop focusing on your stupidity and I won't be able to until I post this. Hell, even after I hit submit I'm still going to toss and turn for a half hour while I try to divert my attention to happy butterflies and fluffy sheep to count.

  • Re:Business Plan (Score:5, Interesting)

    by JMJimmy (2036122) on Monday December 16, 2013 @12:58PM (#45704835)

    ADHD is very real and can be easily diagnosed with a brain scan but that's too expensive to actually do (thought patterns are radically different from the norm).

    There are two main types, ADHD-Hyperactive which is when the middle strip of the brain grows faster than the rest. This is the excitement centre of the brain. There are various theories from lead to gut bacteria as the cause but in the end, most people can/do grow out of the serious effects of it because the rest of their brain eventually catches up. The second type is ADHD-Inattentive (aka ADD). This is genetic and is a serious condition. Far far fewer are diagnosed with this version (3 in 10 diagnosed) In addition to structural differences in the brain it prevents the executive centre of the brain from properly communicating with the with the memory centre (among other things). This may not seem like such a big deal until you consider our society: The executive centre of the brain controls task/time management which includes everything from getting dressed in the morning to getting work done so you can keep the job that supports you. Active memory recall? All but gone. People with this disorder can remember things, just usually not when they want to let alone need to. All that schooling is in there, just not accessible on a test or in the workplace without reminders to jump-start the process of remembering.

    Stimulants help like you wouldn't believe. They don't cure because there is far too little known and because there's a genetic component it's very difficult to "cure". When I forget to take my pill/run out - people notice right away. They'll ask me if I'm hungover or if I need to go to the hospital. Part of that is the stim withdrawal, part is just the norm for ADHD-I. The reason the profits have soared is not just because of diagnosis rates it's because a patent was granted for Concerta, a time release version of Ritalin. At up to $4/pill it was crazy expensive but the alternative was having to take 3-4 pills a day with Ritalin... a task which isn't "easy" to accomplish for ADHD-I types.

    I'll grant you that there are millions more diagnosed than probably need to be but that just makes it harder for those who are legitimately diagnosed.

  • Re:Business Plan (Score:4, Interesting)

    by dj_super_dude (86692) on Monday December 16, 2013 @06:50PM (#45708885)

    I was diagnosed a few years back (I'm in my early 30's now, so around 29ish) with ADHD-Innatentive and to be honest I was very sceptical (not to mention my family or other people I told). I had been battling with depression since my teens, and after going through a great deal of different medications I saw another PDoc.

    He explained to me about research (sorry I don't have the citations needed) which talked about the inatentive form of ADHD being linked with some kinds of anxiety and depression. In my case past medical help had been treating only part of the whole, and suggested we try treating the ADHD as well.

    The diagnosis (well the treatment) really changed my life - it gave it back to me and you really can't put a price on that. I will have to take medication for the rest of my life unless some major breakthrough happens, which isn't beyond the realms, but should that breakthrough not happen so be it - I have finally found something which works for me, and I'm happy.

"The greatest warriors are the ones who fight for peace." -- Holly Near

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