The preponderance of Attention deficit hyperactivity disorder in children aged 4-17 in 2011 was 11%. Around 6.4 million children in that age group were diagnosed with ADHD, and 4.2 million were prescribed psychostimulants, according to the CDC. Attention deficit hyperactivity disorder is a neurodevelopmental mental disorder where one has difficulty controlling behavior, problems paying attention, etc. Stanford Newmark claimed in The Wall Street Journal that a good amount of children are diagnosed after a 15 to 20 minute visit with a pediatrician. There are many opinions regarding overprescription of stimulants to children with ADHD. Some believe this increase is due to a misdiagnosis at an early age of childhood in children who are commonly immature. Others believe that the over prescription is simply a myth and that there is insufficient evidence to support it. ADHD is very real, but there may be some alternatives before going straight to the pill. So I want to know, are ADHD medications actually overprescribed in America?
I reviewed three studies done on children with ADHD to see if there is a common outcome:
1,285 children and their parents in four United States communities partook a epidemiological survey in the MECA or Methods for the Epidemiological of Child and Adolescent Mental Disorders Study. This particular study focused on three main aspects: the frequency of the diagnosis of ADHD itself, medication prescription, and alternate methods such as psychosocial services. For the results of ADHD diagnosis, only 5.1% of all the children had met the full criteria for an ADHD diagnosis. Although, when it comes to the prescription of stimulants, 12.5% who met the ADHD criteria were treated. This was accurately prescribed, however, due to the fact that these particular children had very high levels of ADHD symptoms.
This study itself can not prove that there is not an over prescription of stimulants in ADHD children, simply that it is too small and that is it a survey. However, this study supports the claims that medication is not over prescribed due to the fact that most of the ADHD diagnosed children were not prescribed the medication. This shocked me because most of the articles I read supported the common claim that this over prescription is absolutely prevalent.
- National Health and Nutrition Examination Survey
3,082 United States children aged 8-15 were surveyed from 2001-2004. Of those children, 8.7% met the criteria for ADHD. Of the 8.7%, 38.8% of those children were prescribed medication. Surprisingly, the poorest children in the study were the least likely to be given ADHD medication despite the fact that they are the most likely to have ADHD.
This study is difficult to say whether medication is over prescribed or not because most studies, like this one, fail to touch upon whether the medication is really needed as compared to their diagnosed ADHD status.
- International Studies
I was curious how this was concept was in children outside of the United States to see if they were having the same “problem”.
A structured interview regarding 1,897 Latino/Hispanic children aged 4-17, was conducted in Puerto Rico to see if they are treated with medication for ADHD or not. Only around 7% of the children diagnosed with ADHD, and only 0.2% without a diagnosis were treated with medication.According to this population, medication prescription is actually under prescribed rather than overprescribed. However, A study in Iceland (a country with a similar stimulant usage as the US), ⅓ of the youngest children studied were 50% more likely to not only be diagnosed with ADHD, but also prescribed medication.
Together these studies help prove that it is really mixed throughout the world on the prescription of ADHD medication when diagnosed. There is simply no way as of right now to determine whether either side is true or not. Certain articles supporting the idea that the stimulants are over prescribed claim that the increase of stress on the average American family has a drastic effect on the frequency of ADHD. However, the studies I have seen so far claim that there is not a significant problem in this “overprescription” in America. This is why we are split on this idea. There is simply no way of saying for a fact which side is correct.\
“Are ADHD Medications Overprescribed?” WSJ. Wsj.com, 14 Sept. 2012. Web. 27 Nov. 2016.
“Are Stimulants Overprescribed? Treatment of ADHD in Four U.S. Communities.” Are Stimulants Overprescribed? Treatment of ADHD in Four U.S. Communities. N.p., n.d. Web. 27 Nov. 2016.
Froehlich, MD Tanya E. “Prevalence, Recognition, and Treatment of Attention-Deficit/Hyperactivity Disorder in a National Sample of US Children.” Attention Deficit/Hyperactivity Disorders | JAMA Pediatrics | The JAMA Network. N.p., 01 Sept. 2007. Web. 27 Nov. 2016. <http://jamanetwork.com/journals/jamapediatrics/fullarticle/571105>.
N.p., n.d. Web. <http://www.sciencedirect.com/science/article/pii/S0890856709609850>.
“A True ADHD Epidemic or an Epidemic of Overdiagnosis?” Psychiatry Advisor. N.p., 11 Mar. 2016. Web. 27 Nov. 2016.