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Overselling A.D.H.D.

nytimes.com

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Re: Overselling A.D.H.D.

#81

Post by rootbear »

anexprogrammer wrote: post #58

As someone in my 5th decade, with lifelong ADHD (though given my age it did not exist in my youth, and was only diagnosed relatively recently), I'm wary of backing away from treatments until we actually do have real viable alternatives. It took far too long to get ADHD widely recognised, and even now it's often more likely to be received with humour than real recognition. Much more research, especially on other possi…

I identify with a lot of what you say. I was not formally diagnosed with ADD (now properly called ADHD-PI, the non-hyperactive variant) until a few years ago, in my 50s. I did well in school but ADD has been the bane of my career. I get bored easily with uninteresting tasks and the mental effort to complete them is exhausting. If I slip, and find something more interesting to do, it can annoy my boss, to say the least. I'd like at job that fits my brain better, but at my age, opportunities are rare. I'm now taking a mild dose of an amphetamine (Vyvanse) and it does help, but I still have to maintain a lot of self awareness so I don't wander off into the weeds.

Re: Overselling A.D.H.D.

#82

Post by [deleted] »

hellofunk wrote: post #3

I've always been skeptical of ADHD diagnoses, thinking that it was widely over-diagnosed and a problem in American culture more than anything, and not as commonplace in reality. My googling took me to this article which suggests I am wrong: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525089/

[deleted]

Re: Overselling A.D.H.D.

#83

Post by panglott »

scottmf wrote: post #53
sevenless wrote: post #50

Earlier quoted context omitted.

But what does "real" mean , exactly? That it's a recognizable pattern of behavior? That doesn't necessarily mean it should be treated as a disease.

Why not? People are suffering and we have safe medications which improve their lives. Not treating ADHD is far more dangerous. People with unmedicated ADHD are more likely to do poorly in school, abuse drugs/alcohol, suffer from depression etc.

We simply don't know what the impact is of administering powerful amphetamines to children upon their development. Is there a population of children that would "age out" of the ADHD spectrum and develop coping mechanisms, if they were not given pills that prevent that? In such a case, the medication is actually hampering their development.

Re: Overselling A.D.H.D.

#84

Post by reitanqild »

krinchan wrote: post #27

I've observed this whole drama unfold first hand. Having been born in the early 80's, I grew up on Ritalin and most of my classmates did too. I actually do have ADHD, but I'm unmedicated for well over 15 years now. This is completely by choice; every time a new doctor sees my medical history they basically ask in a rather pushy manner, "Ya want some pills for this?" I didn't grow out of ADHD, but I have had to learn…

> I can't work with silence, I always have to have music on. If I don't, I start wandering around the internet and getting nothing done.

> Pair programming is basically God's Gift to ADHD.

Just keep in mind that there is a huge variation, not every AD(H)D-er is the same.

> Taking the medication is hell.

Then you should possibly contact your doctor, it shouldn't be that way as long as you follow the recommandations, but sometimes even minor changes can make major differences, even changes in dosage or even type based on the same active ingredient.

> Then, they have to try to handle kids sporting events, social events, etc. on the weekends without it to try to keep their tolerances down.

This isn't R, is it?

Re: Overselling A.D.H.D.

#85

Post by chris_va »

pyre wrote: post #73
chris_va wrote: post #64

Earlier quoted context omitted.

A couple of points: Referring to an industry as "them" is not constructive. Comcast has a horrible reputation for internet service, does that mean we are all a part of "big tech" out to screw the little guy? Pharma companies will develop drugs that they think they can sell. If it were possible to create a stimulant variant profitably, companies would do so like any other rational actor. The epipen story is sad, I agr…

> The money for more drug research has to come from somewhere, though The EpiPen has been on the market for awhile. Why the sudden price hike? Were they operating at a loss before? This does not seem like a case of "we have to recover our costs" and comes across more of a case of "we are a monopoly so fuck you, give us your money."

Yes, but that is capitalism.

These companies primarily get created because investors want to see a return, the side effect is that they produce novel drugs.

So, no, they probably don't need to raise prices. Because they now have a temporary monopoly they are finding the monopoly price point as you say.

Having said that, try coming up with a better system to produce drugs.

Re: Overselling A.D.H.D.

#86

Post by jrapdx3 »

Since I've had the responsibility of managing the treatment of at least a thousand adults and adolescents with ADHD, it's a subject I've studied quite a bit. And as the medical literature attests ADHD is probably among the most researched of all medical conditions and its reality is unquestioned based on the scientific literature.

When people say "I don't believe in ADHD" I point out it's not like believing in Santa Claus, the reality isn't changed by our "belief". Might as well say "I don't believe in cancer", it's not going to make it disappear.

The fact is that ADHD has been shown to affect 4 to 5% of American adults and 5 to 8% of children. When the same diagnostic criteria are used, populations of other countries show comparable prevalence. This means it is a much more common disorder than usually considered.

The key issue in my estimation is the level of disability ADHD can produce in adults. Studies show devastating adverse outcomes in virtually all domains of functioning. People with ADHD fall far behind peers in educational achievement and employment, and far exceed peers in rate of divorce, motor vehicle accidents and injuries, greater rates of general health conditions and larger health care costs.

Furthermore, despite the availability and relatively low cost of effective treatments, among adults with ADHD only about 1/5 receive treatment. The total costs to the economy of untreated ADHD very likely is on the order of $100 billion annually in the US alone.

Bottom line is ADHD is a very common and disabling condition with a high cost burden to the individual, family and nation as a whole. We underestimate the impact of ADHD in all these domains at our peril.

Re: Overselling A.D.H.D.

#87

Post by Vraxx »

leereeves wrote: post #61
jackgavigan wrote: post #16

Earlier quoted context omitted.

The article addresses this issues: One clinician quoted in the book more or less admits defeat: “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.”

The article briefly mentions the issue then moves on. But is it true that "it’s too expensive to modify the kid’s environment" or simply that established powers make more money by "modifying the kid"?

In a way, those can both be true simultaneously. Just from the assumptions that the "established powers" make more money by modifying the kid implies that even if modifying the kid's environment cost $0, it would "cost" them lost profits of modifying the kid.

Costs are relative, and I think the point remains that the kid's parents are relatively powerless to alter the kid's environment significantly enough to solve the adhd problem. Thus, the decision of the cost/benefit analysis of modifying the environment vs modifying the kid falls to the "established powers", also known as, collective society.

Re: Overselling A.D.H.D.

#88

Post by pyre »

chris_va wrote: post #85
pyre wrote: post #73

Earlier quoted context omitted.

> The money for more drug research has to come from somewhere, though The EpiPen has been on the market for awhile. Why the sudden price hike? Were they operating at a loss before? This does not seem like a case of "we have to recover our costs" and comes across more of a case of "we are a monopoly so fuck you, give us your money."

Yes, but that is capitalism. These companies primarily get created because investors want to see a return, the side effect is that they produce novel drugs. So, no, they probably don't need to raise prices. Because they now have a temporary monopoly they are finding the monopoly price point as you say. Having said that, try coming up with a better system to produce drugs.

That is not capitalism. The existence of the FDA ensures that it is not a free market. Trying to label it as such is disingenuous.

The EpiPen product is basically a plastic housing around a syringe to make it easily injectable. There is no high sky-high R&D cost here.

Re: Overselling A.D.H.D.

#89

Post by sevenless »

scottmf wrote: post #79
sevenless wrote: post #69

Earlier quoted context omitted.

I'm sure some people's school grades benefit from taking amphetamine-like drugs, but that still doesn't imply they are suffering from a disease in the first place. It's far from clear why having the symptoms of ADHD should be considered a disease, in any objective sense. If kids are suffering because school is boring or society is restrictive, that doesn't mean there's something wrong with them .

>It's far from clear why having the symptoms of ADHD should be considered a disease, in any objective sense. We have children facing social rejection, failing/dropping out of school, becoming dependent on drugs, suffering from depression/anxiety and other mental illnesses, committing suicide, etc. In a perfect world we don't have to change our lives to fit into society at all! Unfortunately, the world isn't perfect.…

This analogy doesn't really work, because obesity is caused by living a modern sedentary lifestyle, whereas I'm suggesting ADHD is what we're labeling kids with for not living, or rebelling against, that sedentary lifestyle.

Obesity is a disease in an objective sense because it directly causes ill health. There's lots of studies to show that. The symptoms of what we call ADHD seem to simply be caused by unhappiness and boredom with the way we live today. We're demanding kids do something that makes them unhappy, and any reaction to it, is labeled a disease.

> take medication to help our bodies [...] function properly in this society, because we agree its advantages vastly outweigh its disadvantages.

This seems like a problematic kind of statement, because the implication is that people who don't fit into society should somehow be coercively medicated. What about their rights and bodily autonomy?

Re: Overselling A.D.H.D.

#90

Post by scottmf »

panglott wrote: post #83
scottmf wrote: post #53

Earlier quoted context omitted.

Why not? People are suffering and we have safe medications which improve their lives. Not treating ADHD is far more dangerous. People with unmedicated ADHD are more likely to do poorly in school, abuse drugs/alcohol, suffer from depression etc.

We simply don't know what the impact is of administering powerful amphetamines to children upon their development. Is there a population of children that would "age out" of the ADHD spectrum and develop coping mechanisms, if they were not given pills that prevent that? In such a case, the medication is actually hampering their development.

We have 80 years of data from giving children low doses of stimulants.

>In such a case, the medication is actually hampering their development.

Again, the actual data say otherwise. Medication tends to help children develop proper coping mechanisms. Not medicating is more likely to result in social rejection, drug abuse, depression, dropping out of school, and so on.

Most of this anti-medication sentiment is unscientific unfounded FUD.

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