Recently, concerns have been expressed about overdiagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD or ADD) and overprescription of drugs prescribed for medical treatment. Some scholars (Dr. Richard Bromfield, Dr. Peter Breggin, Dr. David Stein, and Dr. Keith Conners) argue that stimulant medications that are generally used to treat ADHD are not always necessary and have been considerably overused, especially for young children. Others assert that the opposite it true: ADHD has not been overdiagnosed, but rather “heightened awareness of the disorder has fueled the rapid growth of ADHD cases” (“Are ADHD Medications Overprescribed?”). They also say that drugs used to treat ADHD are safe and rather effective, with minimal side effects (for example, Dr Koplewicz, the head of the New York based Child Mind Institute). The thesis of this essay is that ADHD is overdiagnosed and stimulant drugs are overprescribed among children and young adults.
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Concerns about frequency of ADHD overdiagnoses and ADHD drugs overprescription expressed by scholars and laymen alike have been based on alarming statistics. While prior to 1970, the ADHD diagnosis was quite rare among American schoolchildren and could hardly be found in young people and adults, in the period between 1980 and 2007, the number of ADHD diagnoses skyrocketed. As Dr Connor observes, “there was an almost 8-fold increase of ADHD prevalence in the United States compared with rates of 40 years ago” (Connor, “Problems of Overdiagnosis and Overprescribing in ADHD”). In their turn, Safer et al assessed the prevalence of the disorder in U.S. schoolchildren as little as 1 per cent back in 1970s, as 3-5 per cent during 1980s, and up to 5 per cent by the end of 1990s (Safer et al 533). The number of Attention-Deficit/Hyperactivity Disorder diagnoses in kids aged 3 to 17 increased from 3.3 million back in 1997 to 4.4 million in 2002 (Pringle, “Kids on ADHD Drugs: A Dangerous Path to Addiction”). The data analyzed within the National Survey of Children’s Health back in 2007 allowed estimating that as many as 7.8 per cent of young people aged 14-17 were diagnosed with ADHD, with 4.3 per cent being regular users of stimulants for the disorder (Visser et al S99).
Merikangas et al provide data that the rates of prescribing drugs for ADHD-diagnosed kids multiplied 4-fold in the period between 1987 and 1996. They further increased by 9.5 per cent during 2000-2005. Today, as Merikangas et al observe, more than 4 per cent of kids and young people use stimulants across the States (75). In his article “Is Ritalin Overprecribed? - YES”, Dr Richard Bromfield from Harvard Medical School draws the attention of readers by emphasizing that the use of Ritalin, the methylphenidate-based stimulant used to treat ADHD, has grown almost six fold over the last two decades. He also observes that nearly 6 per cent of boys of school age in the United States take this drug to remove the symptoms of ADHD (Bromfield, “Is Ritalin Overprecribed? - YES”). Similarly, Dr Sam Newmark from the University of California cites the following data on overdiagnosis. The 2010 study revealed that the smallest kids in American kindergartens (in particular, children born in August) were 40 per cent more likely to get the ADHD diagnosis and twice as likely to be prescribed ADHD drugs as the oldest children who attend kindergartens (in particular, those who were born in September). The 2012 study confirmed these results for the children aged 6-12 (“Are ADHD Medications Overprescribed?”)
Interestingly, the increase in the number of ADHD diagnoses and medication prescriptions has been simultaneously fixed in other developed countries. For instance, the study conducted by the scholars from Ruhr-Universität Bochum and University of Basel in Germany found that ADHD was largely overdiagnozed in German children. Specifically, the findings of the research conducted by Bruchmüller, Margraf, and Schneider, and published in Journal of Consulting and Clinical Psychology this year, confirm that “overdiagnosis of ADHD occurs in clinical routine” due to the fact that therapists often do not adhere to DSM-IV criteria, as well as International Classification of Diseases Criteria. Besides, the overdiagnosis is attributed to gender bias since “a boy might be seen as a more prototypical ADHD child and might therefore receive an ADHD diagnosis more readily than a girl would.” (Bruchmüller, Margraf, and Schneider 128). In Great Britain, the situation is very much alike. Statistically, the data on rates of Ritalin prescription over the last two decades rose from a small number of 2, 000 prescriptions back in 1991 to 14, 700 in 1996. By 1999, the figure rose up to 158, 000 prescriptions. In 2003, the number of prescriptions was as high as 314, 500 (Hendrick 296).
One of the reasons of increasing public concern about ADHD overdiagnosis and subsequent medication overprescription is the profits made by large pharmaceutical companies. There has been evidence that U.S. pharmaceutical corporations use a variety of bribing techniques to make physicians more inclined to prescribing stimulants and make them speak in favor of certain drugs. Besides, the marketing strategies are quite aggressive, focusing on the consumer directly. It has been found that pharmaceutical corporations spend billions dollars from their annual budget to promote the artificial overdiagnosis and overprescription of stimulants for ADHD treatment. Given the fact that “the societal cost” of ADHD for each individual in the United States is between $12, 005 and almost $17, 500 or between $36 and $52 billion in general (data from 2005), the likelihood of for-profit organizations’ interest in increase in the number of ADHD patients is quite high. Staggeringly, there is enough evidence to claim that drug companies use immoral and often illicit techniques to boost their sales of drugs prescribed for ADHD treatment. For example, Maria Angell, the author of the book “Truth about Drug Companies”, states that drug representatives frequently invite doctors to fancy dinners for the purpose of discussing particular drugs, give them expensive presents, and provide them with “bags full of assorted drug samples” (Angell cited in McCloskey, “Adolescents Misuse ADHD Medications due to Doctor’s Overprescribing”).
Finally, it is the widespread ADHD medication abuse by students on college campuses that worries the experts and laymen. Recent studies have documented increased nonmedical use of Adderall, Concerta, and Ritalin by college students for the purpose of improving their academic capacity (Arria & DuPont 417). Bogle and Smith in their study of illicit use of methyphenidate report interesting data. The rate of illicit use of the stimulant remains steady or even decreases among high school students, but reaches up to 31% among the population of self-reporting college students (Bogle & Smith 157). In one recent research that surveyed 81 students diagnosed with ADHD, more than 60 per cent reported diverting the medication for someone who was not prescribed to take it (Arria & DuPont 417)In conclusion, the alarming statistics of ADHD overdiagnosis and stimulants overprescrition along with recent findings on physicians’ lack of competence and possible bias (due to bribery) while making prescriptions provides ground for claiming that this issue remains a big problem in U.S. medical sphere. Together with data on the number of students illicitly using anti-ADHD drugs, this statistical evidence calls for urging the government to take necessary measures to ensure ADHD is not overdiagnosed and Ritalin and similar drugs are not overprescribed or used illicitly.
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