A recent New York Times front-page story about ADHD care gone awry concluded with disturbing quotes from a an information session that was held in Norfolk, VA last October. “ADD and Loving It?!” was sponsored by Children and Adults with Attention Deficit Disorder (CHADD)—the leading advocacy group for ADHD. The story raises questions about our country’s love affair with ADHD by detailing the tragic death of an aspiring medical student from the Norfolk-Virginia Beach area who became addicted to ADHD drugs.
Richard Fee attended college on full scholarship, played baseball, was well liked, and graduated with good grades. He had no history of ADHD, but he was diagnosed and medicated for the condition. About a year later, Fee died due to addiction to/withdrawal from Adderall.
ADHD drugs like Adderall have a high potential for addiction. They can cause sudden death from cardiac arrest and are required to carry a black box warning label—the strongest type of warning that the FDA can request on a drug’s product label.
Judging by the rate with which ADHD drugs are prescribed, American society is too love-struck by the supposed benefits of such medications to care about their warning labels.
In the mid-1990s, a published study sparked debate about the appropriateness of ADHD care in the Norfolk-Virginia area Beach (and nationally). It showed that 8-10% of elementary school children were receiving a dose of ADHD medication from school nurses. A follow-up study showed twice as many children were diagnosed with ADHD (17%) as were medicated mid-day by a school nurse.
As lead author of these studies, I experienced ad hominem attacks on my work. Rather than critiquing my research methods or data analysis, critics simply asserted that my findings were “highly suspicious.” Evidence corroborating my research findings has continued to accumulate.
The Centers for Disease Control and Prevention now estimates that 14% of American children receive a diagnosis of ADHD before the end of childhood. ADHD rates tend to be higher in southern states. Some communities like Richard Fee’s hometown are “hot spots” where ADHD rates exceed the national average.
The Virginia Beach-Norfolk area may be a “hot spot” thanks, in part, to my most outspoken local critic—Jeffrey Katz, Psy.D.). Dr. Katz is a national board member of CHADD—an organization funded by pharmaceutical dollars that advocates for ever-expanding ADHD drug treatment.
While facilitating the “ADD and Loving It?!” event, Katz recently assured the audience (that included Fee’s parents) that –as quoted in the original story—people who don’t really have ADHD would not experience beneficial effects of drug treatment and would not be motivated to continue taking ADHD medication. The harm of misdiagnosis and unnecessary prescribing of ADHD drugs was, according to Katz, “not much.” That’s a Big Pharma falsehood.
Science is clear that Adderall can have a positive effect and carry a risk for addiction for almost everybody—not just for people who have ADHD or pre-existing addictions.
Fee’s death represents an extreme—but not isolated—case. The painfully similar case of Kyle Craig was recently profiled in the national media. Craig was also a successful Vanderbilt University student who experienced a precipitous decline and death from Adderall. Both Fee and Craig feel victim to doctors and therapists who casually diagnosed ADHD and supported automatic drug treatment.
The more a drug is prescribed, the more it is diverted for recreational use. In the past, Katz repeatedly objected to my research findings, warning that my work discouraged parents from seeking the treatment their children needed. There has never been any evidence to support his claim.
Today, ADHD drugs are so ubiquitous on high school and college campuses that teens perceive drugs like Adderall to be a benign study aid. They also view such drugs as relatively safe for recreational use and freely mix them with alcohol—a potentially lethal combination.
Ritalin or Adderall aren’t the only problem. It’s our love affair with antidepressants and increasingly flirtatious behavior with powerful antipsychotics like Risperdal. Dangerous drugs once reserved for use with adult schizophrenics are prescribed increasingly often for young children.
Dr. David Healy, an internationally respected psychiatrist, noted in a February 2013 blog that until Prozac—the popular antidepressant—became available, depression was a rare disorder. Now, 25 years after introduction of Prozac, we have one prescription for an antidepressant for every man, woman, and child in the West. At any one time, 1 in 10 of us is supposedly clinically depressed. Ten percent of pregnant women are on anti-depressants with growing numbers of associated birth defects.
This Valentine’s Day let’s love our children and partners enough to think twice before falling for professionals with strong ties to the pharmaceutical industry. When they promise you’ll love your Adderall, Prozac, or whatever other pill they’re pedaling for Big Pharma, kiss them goodbye!
Dr. Gretchen LeFever Watson is a clinical psychologist and President of Safety and Learning Solutions. She serves as Principal Investigator for a regional Health IT Consortium funded by the Office of the National Coordinator for Health Information Technology. Contact her at [email protected].
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.