Over Medicating Ourselves

"Society increasingly demands a  high level of performance on tasks that require sustained attention and multi-tasking."
"A rapidly increasing frequency of a once-rare condition may reflect increased recognition, but may also constitute a diagnostic epidemic."
"It's what I call a psychiatric fad, in which you have a medication which is known to work for certain people and you say, 'let's try it here, let's try it there'."
"And some of these patients do have a little bit more focus after you give them stimulants, because everybody is somewhat better focused if they get a stimulant."
Dr. Joel Paris, psychiatrist, McGill University

Sardaukar Blackfang / Wikipedia    Once considered rare, adult ADHD is rising sharply. In Canada, adults now account for more than a third of all prescriptions for ADHD medications, and while children still surpass adults as the main users of ADHD drugs (64 per cent versus 36 per cent), the number of adults on the drugs is increasing faster, according to Shire, makers of the ADHD drug Vyvanse

"Pharma has already created a wild and dangerous epidemic of prescription narcotics. Next on its agenda is pushing the sale of prescription speed."
"If we want to allow people to take speed for performance enhancement, or make it legal for recreational purposes, there should be a discussion of that."
"We shouldn't be sneaking in the legalization of speed for a fake diagnosis of ADHD in adults. It's medicalizing what should be a societal debate about the role of these medicines in society."
"You don't want to take speed -- and this is essentially speed -- if you're schizophrenic or have bipolar disorder, anxiety disorder, sleep problems or a whole host of other psychiatric conditions."
Dr. Allen Frances, professor emeritus, Duke University

As far as Dr. Francis is concerned, the increase in stimulant prescriptions meant for adult use speaks of the fallout of aggressive marketing by pharmaceutical manufacturers to doctors and the public. In the U.S. in fact, pharmaceutical companies advertise their products widely, in a manner not seen in Canada. Pharmaceutical companies anywhere, however, use their sales and marketing personnel to wine and dine physicians, handing out samples and convincing them that their products represent solutions to peoples' ills.

The public succumbs and so do their doctors. For physicians, responding to their patients' requests for medications is a whole lot easier than convincing their patients that they don't really need drugs when a change in lifestyle toward a healthier way of living could make them feel better. Trouble is people become accustomed to abusing their bodies, insisting they're too busy and haven't the time to exercise, to eat properly, to educate themselves about healthful living, or to deal with vexing situations.

Canadian adults are increasingly being diagnosed with Attention Deficit Hyperactivity Disorder, in many instances because the patients are convincing their doctors that this is what they have, despite that ADHD is a condition that surfaces in childhood, not adulthood. Along with the diagnoses goes prescriptions for speed-like stimulants. Even though the medical profession is becoming increasingly aware that people are abusing the system; using the drugs to obtain a mental-edge advantage.

Accounting now for over a third of all ADHD medication prescriptions, with their share of the $408-million Canadian market swiftly increasing, the situation has drawn the condemnation of psychiatrist Dr. Joel Paris who calls it a "diagnostic epidemic". And Dr. Frances too knows of what he speaks, having written the book Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma and the Medicalization of Ordinary Life.

Dr. Paris deplores the diagnostic criteria for adult ADHD, so wide-ranging that anyone experiencing problems focusing could be a candidate. He is concerned that drugs are being used by healthy people as pharmacological brain "enhancers". A situation that reflects the hyper-competitive corporate culture prevailing in society at present. People become motivated to try out stimulant prescriptions to solve the dilemma of social forces of high expectation in work performance.

He is also concerned that the very people who are being misdiagnosed with ADHD may have other compelling issues that are not being addressed, ranging from anxiety, depression or substance abuse when they find they cannot cope with everyday stresses. Dr. Frances chaired the task force that produced the fourth version of the DSM, the Diagnostic and Statistical Manual of Mental Disorders used all over the globe for the diagnosis of mental illness. His credentials cannot be faulted.

High-stimulant dosages of these drugs are capable of raising blood pressure and arrhythmia, erratic heartbeat in people with underlying heart structural changes. Health Canada recently upgraded its warning to inform people that ADHD drugs have the potential of increasing the risk of having suicidal thoughts. Dr. Anthony Rostain, professor of psychiatry and pediatrics at the Perelman School of Medicine, University of Pennsylvania added that stimulants are clearly being misused.

"There is no question that there are forces at work to push people to increase productivity. Sometimes it's very conscious-like: 'I'm just going to go in (to see a doctor) and say I have it when I don't'. That would be a form of malingering: it's feigning ADHD." Dr. Rostain, however,  doesn't agree that evidence exists of an "epidemic" of over-diagnosis, but feels instead that adult ADHD is a relatively recent phenomenon leading to increased diagnoses.

Children, he says, become "fidgety and squirmy", whereas "...in adults it may be more restlessness and an inability to get things done and constantly being late or disorganized." One thing is beyond dispute, irrespective of the issues, professionals in any field of study don't always form a monopolistic bloc of agreement; there are always those who view matters from a different perspective.

Children surpass adults as the main users of ADHD drugs (64 percent versus 36 percent). Over 4.5-million prescriptions were filled by Canadian drugstores in 2014. And Dr. Paris is adamant from his perspective as a psychiatrist that ADHD is a neurodevelopmental disorder that has its genesis in the childhood years. Official diagnostic criteria has it that an adult cannot have ADHD if he or she did not exhibit symptoms of it in their childhood years.