ADHD and Pharmaceutical Fearmongering.

ADHD and Pharmaceutical Fearmongering.

It’s never difficult to find articles about how ADHD is some trumped-up condition made up to excuse poor behavior and/or line the pockets of the medical industry. Whether the writer assumes one or both of these, it’s necessarily bound together with denial, ignorance, and hyperbolic claims. Sometimes all you can do is get angry, but other times the writer gives you a chance to deconstruct his points. The Price of ADHD Business is that second kind.

He opens with this blockbuster:

Over 12 million children and young adults consume ADHD stimulant and psychiatric medications in the United States. Pharmaceutical corporations generated near 9 billion dollars in 2012 for ADHD stimulant drug sales, representing 5x the 1.7 billion in sales ten years ago.

Shocking, isn’t it? Except that in the US, the Pharmaceutical Industry makes about $345 billion a year. That means that psychiatric medications make up a whopping 2.6% of the bottom line. Hardly one of their biggest players, compared to drugs for cholesterol, pain management, and cancer treatment, which are much better performers when it comes to percentage of business. Also, notice the subtle slide from “ADHD stimulant and psychiatric medications” to “ADHD stimulant drug sales,” because this will be important.

More alarming, this rate of consumption represents 3x the world’s children combined, according to data collected by Scientific American. The business model of behaviorally assessing and prematurely medicating young school age children with powerful stimulant and psychoactive drug therapy for over 40 years is now under fire. The Government Accountability Office (GAO) Child Foster Care Drug Audit Report uncovered dangerous and unethical prescribing practices. Widespread abuses of overmedicating young foster care children with ADHD stimulant as well as psychiatric medications prior to ruling out nutritional, physiological, and environmental risk factors were uncovered by the largest child foster care prescription drug audit in American history.

Of course, being a first-world country, it’s more likely that we have 3x the children being treated for, say, cancer or juvenile diabetes, or any number of other childhood diseases, so there’s something of a leap from claiming that 3x the children being treated means that something is being treated too much – or “prematurely.” I notice also that the source of the alarmist rhetoric comes from a study of children in foster care. Well, this is a problem with foster care, not with all children. Foster care children are more likely to have disabilities, both physical and mental, meaning they’re more likely to actually need treatment. They’re also covered by state medical programs that make it pretty easy to get treatment that a self-payer parent might not be able to obtain. There’s more, but if a mere scratch on the surface can reveal that we’re comparing apples to oranges, there’s not much need to go even deeper.

In today’s America parents, educators, and prominent healthcare professionals challenge the 40-year ADHD business model, as the ADHD diagnosis rate surpasses epidemic status in 2014. The symptoms of ADHD are real and in many cases can be debilitating to children as well as adults. Especially in the young child population, the ADHD business model of assessment and treatment requires immediate reform. Children have a right to receive comprehensive bio-assessments as well as behavioral assessments to determine cause of their symptoms prior to powerful stimulant and psychoactive drug therapy.

Yes, we have a serious epidemic of about 5-8% of the population. That’s massive. Not. Notice how he snuck in the disclaimer (like, some of my best friends have ADHD!!!) but still calls the diagnosis and treatment of ADHD a “Business Model.” I sense a broken irony meter. Also, have you ever taken any of these medications? The stimulants are among the least powerful ones out there, with the most immediate effect (no two-month waiting period) and little to no withdrawal problems. Lumping them in with all psychoactive medications is disingenuous, especially for someone banking on his rep as a Pharmacist.

The Diagnostic and Statistical Manual for Mental disorders (DSM) lists ADHD as a mental disorder. The DSM diagnosing criteria, created by psychiatrists, involves a subjective behavioral assessment process which forces children primarily into premature drug therapy. Although seven out of ten children may exhibit an initial positive behavioral response to stimulant drug therapy for focus and attention, the long term side effects are now known.

Yes, they are, and they’re not terribly scary. Children who start using methylphenidate or dextroamphetamine medications may grow up to be as much as one centimeter shorter than their peers. Of course, they’ll also grow up happier and more successful and less likely to abuse drugs than their non-medicated ADHD peers, but that runs counter to the narrative here.

The Johns Hopkins Child Center Study results of 2013 prove that stimulant drug therapy should not be the primary intervention in young children. This study followed four year old preschool children who were diagnosed by their physicians for ADHD and medicated with stimulant drug therapy for a six year period. When the ADHD assessments were reviewed at age ten, over ninety percent of the children were worse off in their condition. Long term side effects of ADHD stimulants may include anxiety, minor depression, as well as aggressive behavior. Additionally, the Hopkins study determined that ADHD causes an economic burden to the US exceeding 45 billion dollars, annually.

To the first sentence I say, “Well, duh.” The primary intervention should be behavioral, with medications added to supplement as needed. This is not news, and it does not run counter to what any Medical Association is recommending, even the American Psychiatric Association, which says “Behavioral therapy and medication can improve the symptoms ofADHD. Studies have found that a combination of behavioral therapy and medication works best for most patients.” Add to this yet another lie, because what the Johns Hopkins study revealed was (prepare to be shocked) that ADHD doesn’t go away, and medications don’t cure it, just relieve the symptoms while they are in effect. And the economic burden he’s talking about? That relates to the consequences of untreated ADHD – people in jail, people who are substance abusers, people who are unable to work, people who have other health issues that are related to ADHD.

Many parents are not aware that a diagnosis of ADHD for their child is a diagnosis for mental disease in accordance to the DSM. Once a young child is placed on ADHD stimulants including Adderall or Ritalin prior to ruling out causative risk factors, there is an increased health risk. Additional medications for the treatment of long term side effects may be required due to the development of other behavioral symptoms.

Actually, parents know this, because lots of the evaluations are related to getting assessments for school. And it’s not the stimulants that increase the risk of further diagnoses and additional medications as much as the fact that ADHD is usually not alone, and the co-morbid conditions are discovered because the children are being observed and treated by doctors. The medications don’t produce these problems.

For example, the GAO drug audit uncovered a 2,200 percent increase in drug expenditures for atypical antipsychotic medication reimbursement to the state of Michigan during an eight year period from 2000 to 2008. Children in foster care, as the report states, were abusively prescribed powerful antipsychotic medications including Abilify, Zyprexa, Seroquel, Geodon and Risperdal. The Michigan Medicaid system was billed an increase of 40 million dollars during an eight year period just for this one class of medications in foster care children. US Senator Thomas Carper, requestor of the GAO drug audit and chairman of the Homeland Security & Government Affairs Committee, stated “I was almost despondent to believe that the kids under the age of one, babies under age one, were receiving this kind of medication”.

Remember what I said about the creep from the “all psychiatric medications” to “ADHD stimulant medications”? Here we go with another false equivalency. Antipsychotic medications are the last resort, used for treating not just ADHD, but ADHD with serious comorbids that would make the children a danger to themselves or others. Also, remember that this is the foster children, not all children with ADHD as a whole. AND keep in mind that several of these antipsychotics are essential for the treatment of schizophrenia and seizure disorders, which are probably too legitimate to mention in the context of this article. So the figures on antipsychotics for foster children in one state is cherry-picked data that in no way reflects that there is an epidemic of children with ADHD receiving inappropriate medications.

Should ADHD be labeled a mental disease especially in young children who have not been given the right to find the cause of their symptoms prior to stimulant drug therapy? Or, should ADHD be classified as a symptom of condition with underlying causative nutritional, physiological, and environmental risk factors?

Um, yeah, it should. Get inside our heads, mister – it’s definitely a mental disease. It’s certainly not something we can choose or turn off at will. And the cause of their symptoms is mental – the other “causative” factors have been thoroughly debunked as “causes” in study after study. So this is a giant flaming strawman.

The German magazine, Der Spiegel, quoted a prominent American ADHD psychiatrist in their February 2, 2012 issue. Dr. Leon Eisenberg, who coined the term ADHD over forty years ago, stated “ADHD is a prime example of a fictitious disease.” At age 87, this was Dr. Eisenberg’s last interview prior to his death. During the last forty years, he was involved in pharmaceutical trials, research, teaching, as well as the development of social policy pertaining to child psychiatry. He was a recipient of the Ruane Prize for Child and Adolescent Psychiatry Research. Currently, over fifty percent of psychiatrists on the DSM panel responsible for ADHD diagnosing and treatment protocols have direct business ties to drug manufacturing corporations.

All that education, and Mr. Granett doesn’t know how to check snopes. How sad. As to that second claim, well, a link would be nice, but I’m not surprised it’s absent, since the actual ties would be openly disclosed and not as incriminating as the author would like them to be.

Dr. Thomas Insel, Director of National Institute of Mental Health, stated on April 29, 2013 “patients with behavioral conditions deserve better… the current assessment process lacks validity.” He supports research that better treats and may even prevent the development of behavioral symptoms in children.”

Again with a diversionary link. Psych Central has some validity, but “The Verge”? Really? Why not link to the NIH’s Research Domain Criteria which explains that what this means is that the NIH wants to have research focused on multidimensional approaches to research, and research that is targeted towards evaluation of symptoms and behaviors rather than whole conditions, because we now know that there’s a lot of crossover and and a narrower approach will produce more successful and useful research. Oh, but that would not support the POV of the author. That’s OK, now you can see what Insel was really talking about. You’re welcome.

ADHD symptoms can be reversed through a process of differential diagnosing. The elimination of nutritional, physiological and environmental risk factors prior to premature drug therapy is the new ADHD Business Model for helping children and adults reclaim their behavioral and mental health. The Action Plan for Childhood Behavioral Conditions discussed in the book Over Medicating Our Youth as well as the upcoming 2nd edition T he American Epidemic: Solutions for Over Medicating Our Youth provides critical bio-assessment information to find the cause of ADHD symptoms. This action plan provides an informational template to unite parents, teachers as well as all healthcare professionals for the purpose of helping children win the battle against behavioral challenges.

Many assessments help determine the cause of ADHD symptoms. Learn how bio-assessments for reactive hypoglycemia, diabetes, the brain-gut connection, cervical spinal alignment, exercise, whole food nutrition, brainwave optimization, and nutritional enzyme supplementation may reverse ADHD symptoms.

And now, ladies and gentlemen, we begin our final descent into woo. ADHD symptoms cannot be reversed by any of these things, and. . .OMG, this whole thing is an advertisement for. . .wait for it. . .a book co-authored by Frank J. Granett! It’s so good that he had to cite himself! And real medical terms weren’t sufficient, so we have to make up some that sound really sciency, like “differential diagnosing,” and “reclaim their behavioral and mental health,” and “bio-assesment” so we can sell ineffective treatments to gullible patients. Blood sugar problems can be diagnosed and treated without ADHD medications. The “brain-gut connection” has no supportive research except in patients with full-blown Celiac Disease. Cervical Spinal Alignment is Chiropractic’s uglier younger brother, even less useful than regular Chiropractic for treating anything, much less neurological conditions. “Brainwave Optimization,” don’t even get me started. As for the rest, we already touched on how none of these things are causative, so they are not going to be curative.

But this is what it usually comes down to, isn’t it? The voices that protest the loudest that ADHD is a fake disease created to make money by the pharmaceutical industries tend to end up thinking that it’s real enough to be treated by whatever they themselves are selling. If only there were an all-natural cure for hypocrisy. . .

  • Amtram

    By the way, if you have ADHD and want a support community that’s free of woo, you might want to check out http://adhdcommunity.boards.net/. It’s new, but we’re working on filling it up with good content and making it a great place for rational minds to bounce all over the place.