ADHD or Attention Deficit Hyperactivity Disorder, is one of the most commonly diagnosed pediatric mental health disorders. Yet, there is considerable debate among mental health professionals, media, physicians and public health officials about the diagnosis and the proper standards for clinical treatment.
At the center of this controversy is the possibility of over diagnosis of ADHD in children, which can lead to the possibility of overprescribing stimulant medications as a treatment option.
Is this a reasonable question that lends itself to rational debate? The number of children diagnosed with ADHD each year continues to rise rapidly which inevitably leads to the increase in prescribed medications to treat this psychiatric disorder. Given a history of underdiagnoses and lack of treatment for ADHD, is this really a problem or are we just paranoid about the risk of taking more medications?
Diagnosis: Let’s look at the data.
Recent data from the National Center for Health Statistics shows that as of 2015, 10.2% of U.S. children ages 5-17 were diagnosed with ADHD. The number of boys diagnosed was more than twice as much as girls diagnosed (14.1% vs 6.2% respectively). Using data collected between 2012-2014, results indicated that children 10-17 (7.7%) were 1.5 times more likely to be diagnosed than children 5-9 years old (11.8%). Moreover, these statistics become even more intimidating when you consider that nearly a quarter of those diagnosed are less than 200% below the poverty line, and nearly 20% were on Medicaid or uninsured.
A 2011 study published in the American Academy of Child and Adolescent Psychiatry journal reported that of the 3.5 million children diagnosed with ADHD 69% were taking ADHD medication. Between 2007-2011 medication treatment increased by 28%!
Medication: Risks and potential complications
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Such statistics represent a daunting trend in the diagnosis and treatment of ADHD in children, particularly when medication is often prescribed as a way to address the behaviors that characterize this condition. Medications such as Ritalin, Adderall, Vyvance or Concerta are often prescribed to treat ADHD. The Drug Enforcement Agency classifies these stimulants as Schedule II drugs, meaning they have a “high potential for abuse” and “with use potentially leading to severe psychological or physical dependence.”.
Studies have shown that children, particularly those with co-occuring disorders are more likely to suffer from severe complications, hospitalizations or even death. These potential problems are fueled by the growing concerns about the potential risk behaviors that often accompany the legal and illegal use of these stimulant medications in children.
Children diagnosed with ADHD during adolescence (ages 10-15) and treated with short term stimulant medication were more likely to suffer from substance abuse, addiction and engage in more risky behaviors. The situation becomes further complicated when you add alcohol to the equation or when you consider the number of teens who are taking stimulant medication without a prescription for “social reasons”. Results from recent studies indicate that more teens are taking stimulant medications (without a prescription) as a way to lose weight, stay awake and concentrate more on exams. Perhaps it is these cases that are directly attributable to the increased number of emergency room visits, behavioral and psychiatric problems and other complications that arise from the growing acceptance of the use of ADHD medications.
There are several ongoing investigations about the number of children being diagnosed with ADHD and the safety of prescribed treatment medications. While agencies such as the Food and Drug Administration (FDA) has issued warnings about the potential for adverse reactions to these medications, they are still routinely prescribed as part of a comprehensive treatment approach. As always, its best to get medical advice from a licensed medical professional before starting any new medication or treatment.
So is this really a problem or are we just paranoid? I think there is still more room for debate. But either way… given the drastically rising trends in the use of medications, I think this is going to be a hard pill to swallow.