A Nation of Kids on Speed

Jun 17, 2013 by

Six million children in the U.S. have already been diagnosed with ADHD. Plenty more will follow.

Walk into any American high school and nearly one in five boys in the hallways will have a diagnosis of attention-deficit hyperactivity disorder. According to the Centers of Disease Control and Prevention, 11% of all American children ages 4 to 17—over six million—have ADHD, a 16% increase since 2007. When you consider that in Britain roughly 3% of children have been similarly diagnosed, the figure is even more startling. Now comes worse news: In the U.S., being told that you have ADHD—and thus receiving some variety of amphetamine to treat it—has become more likely.

Last month, the American Psychiatric Association released the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders—the bible of mental health—and this latest version, known as DSM-5, outlines a new diagnostic paradigm for attention-deficit hyperactivity disorder. Symptoms of ADHD remain the same in the new edition: “overlooks details,” “has difficulty remaining focused during lengthy reading,” “often fidgets with or taps hands” and so on. The difference is that in the previous version of the manual, the first symptoms of ADHD needed to be evident by age 7 for a diagnosis to be made. In DSM-5, if the symptoms turn up anytime before age 12, the ADHD diagnosis can be made.

It’s also easier to diagnose adult ADHD. Before, adults needed to exhibit six symptoms. Now, five will do. These changes will undoubtedly fuel increased prescriptions of the drugs that doctors use to treat ADHD: stimulants such as Ritalin and Adderall.

Even before DSM-5, doctors were already on track to prescribe enough stimulants this year for each American man, woman and child to receive the equivalent of 130 mg of amphetamine (about 40 five-mg pills of Adderall) and an even greater amount of the very similar drug Ritalin. In this era of excessive prescribing, we seem to have forgotten the cautionary history of amphetamines in America—a history that shows how overprescribing stimulants leads to widespread dependence and addiction.

Since their introduction by the pharmaceutical company Smith, Kline & French in 1937, amphetamines have been prescribed for maladies that had more to do with societal expectations than genuine mental illness. American soldiers received stimulants during World War II to boost morale and improve performance in combat.

Meantime, back at home, amphetamine was heralded as the first antidepressant, and shortly thereafter, as an ideal weight-loss pill. One 1955 advertisement for AmPlus amphetamine tablets assured users that they would be “beachable by summer.” Decades would pass until research demonstrated the lack of long-term benefit for most cases of depression and weight loss, but the lack of proof didn’t hold doctors back from liberally prescribing stimulants to millions of housewives in postwar suburbs.


via Pieter Cohen and Nicolas Rasmussen: A Nation of Kids on Speed – WSJ.com.

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