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You Probably Have ADHD

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photo: Shutterstock

By Allison McCabe

12/23/13

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Was the idea to diagnose as many people as possible there from the start? Roger Griggs came up with Adderall in 1994. After buying a small company that produced Obetrol, a weight loss pill, Griggs suspected that the medication might be effective at treating what was then called Attention Deficit Disorder, so he tried to create a new name for the drug that included ADD. He eventually came up with “ADD for All,” which he then shortened to Adderall. “It was meant to be kind of an inclusive thing,” Griggs said.

Adderall immediately became competition for what was, at that time, the predominant ADD treatment, Ritalin. Shire, sensing a business opportunity, bought Griggs’ company for $186 million and then spent millions more to host conferences for doctors and pay physicians to extol the benefits of Adderall.

At one of these meetings, Shire hired Denver psychiatrist Dr. William Dodson to do a presentation on the long acting formula of Adderall, Adderall XR. Dodson encouraged doctors to “educate the patient on the lifelong nature of the disorder and the benefits of lifelong treatment.” Studies show, however, that probably 50 percent of children with ADHD do not suffer from the disorder as adults. Furthermore, there is very little research on how effective or dangerous long-term use of the medication may be.

In other words, an ADHD medication website just diagnosed me with “likely” ADHD.

The New York Times obtained Dodson’s powerpoint presentation from the conference. Among other assertions, the document claimed that stimulants were not “drugs of abuse,” and that the side effects were “generally mild.” It also warned of the dire future that awaits children with ADHD: “job failure or underemployment,” “fatal car wrecks,” “criminal involvement,” “unwanted pregnancy,” and venereal diseases. Dodson did not mention, however, whether the use of stimulants would have any effect on those outcomes.

After creating a virtually self-sustaining childhood ADHD diagnosis and treatment market, drug companies are now targeting adults.

On Bloomberg TV, Shire’s chief executive Angus Russell stated: “The fastest-growing segment of the [ADHD] market now is the new adults who were never diagnosed.” Prescriptions for ADHD medication for adults have tripled since 2007. In 2012, 16 million adult prescriptions were written.  Shire once again saw a money making opportunity early on and took the initiative by rehiring Dr. Dodson in 2004 to write a pamphlet to “help clinicians recognize and diagnose adults with ADHD.” Dr. Dodson put the number of adults with ADHD at 10 percent of the general population, rather than the more widely accepted 3 to 5 percent. The higher percentage was a more accurate measure, according to Dodson, because it included people who had been diagnosed as children. “Once a child has ADHD, he does for life. It doesn’t go away with age.”

Shire followed up its claim of high adult rates of ADHD diagnoses with ads targeted at adults. It ran web ads on sites like MTV, hulu, and youtube. The ads claimed that “adults with ADHD were almost two times as likely to be divorced” and that “ADHD was found in 32 percent of adults with a depressive disorder.” Again, the ads omit any research showing that medication has any effect on these outcomes. In order to remind adults that they have not grown out of their childhood diagnosis, Shire also sponsored the Adam Levine ad in which the singer states: “I remember being the kid with ADHD. Truth is, I still have it.” 

Adults with ADHD have a higher statistical probability of being drug or alcohol addicts than adults without the disorder. According to a 2007 survey, “more than 15 percent of adults with the disorder had abused or were dependent upon alcohol or drugs within the previous year. That’s nearly triple the rate for adults without ADHD.”  Many addicts in recovery do not want to take an amphetamine-based medication, and would rather suffer with their symptoms or look for alternative treatments. Shire, unwilling to lose any potential drug buyers, addresses the concerns of addicts in the adult ADHD booklet by including a quote from one of Dodson’s patients: “If you give me a drink or a drug, I’ll abuse it, but not this medication. I don’t consider it a drug. Drugs get abused. Medication helps people have satisfying lives.”

When ADHD is diagnosed and treated correctly, children and adults can thrive. When it is misdiagnosed, it can lead to children feeling there is something wrong with them and adults looking outside of themselves for a solution to benign problems such as having trouble focusing. With the over-saturation of advertising, quizzes, paid doctors, and cute gimmicks—especially the Shire-sponsored “Roadhd Trip,” a “mobile consumer outreach program” that uses a big rig truck to travel the country providing ADHD screening for adults—how can anyone know if the diagnosis he or she receives is correct or just a result of clever marketing? And since the medication promises to improve your life (while warning that lack of treatment can lead to outcomes such as divorce, drug addiction, and depression), there is little motivation to truly question the diagnosis.

On the self-screening quiz, underneath my diagnosis of “ADHD May Be Likely,” there is an additional helpful message: “people who have answered similarly to you typically qualify for a diagnosis of ADHD or ADD and have sought professional treatment for this disorder.” The website also has video of people “owning” their ADHD and a form to order “Your ADHD Action Guide.” Next to all this information, and clearly delineated in an information box, is the qualifier: “This website was developed by Everyday Health and sponsored by Shire.” In other words, an ADHD medication website just diagnosed me with “likely” ADHD.

Shire and other pharmaceutical companies have created two generations of people dependent on stimulant medication. Their marketing techniques have made it nearly impossible to determine if any of those people were wrongly diagnosed and treated. As a result of all these clever drug pushing strategies, the drug makers have made billions of dollars. By firmly entrenching ADHD diagnoses and amphetamine-based medication in our culture, the pharmaceutical companies have created guaranteed and increasing profits with no end in sight. As a publication put out by the Shire-funded advocacy group CHADD stated, “ADHD: ‘It’s everywhere YOU want to be.'”

Allison McCable is the Senior Editor of The Fix. Her last feature was on mandatory drug sentencing.

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