You Probably Have ADHD

By Allison McCabe 12/23/13

Deceptive marketing and celebrity endorsements have created an ADHD culture, much to the delight of the pharmaceutical companies.

photo: Shutterstock

I recently took a six question quiz on the website Everyday Health to determine if I have adult ADHD. The quiz was written by “Psychcentral Staff” and included questions such as “When you have a task that requires a lot of thought, how often do you avoid or delay getting started?” And “How often do you feel overly active and compelled to do things, like you were driven by a motor?” I answered honestly, and got this result: “ADHD may be likely.” I have never been diagnosed with ADHD, I am generally focused and calm and no one would ever describe me as hyper. After reading my results, however, I had my doubts. Or maybe I wanted to have my doubts; wouldn’t it be nice to have a condition which would allow me, after receiving the right diagnosis and medication, to miraculously make new friends, get better grades, finish projects, and have among my similarly-diagnosed peers people like Adam Levine, lead singer for Maroon 5?

According to the CDC, childhood diagnoses of ADHD have risen from 600,000 in 1990 to 3.5 million today and 15 percent of high school age kids are diagnosed with ADHD. These numbers represent “a national disaster of dangerous proportions,” according to Dr. Keith Conners, a long time proponent of recognizing and destigmatizing ADHD. Despite the numbers, Dr. Conners says that there is no ADHD epidemic. Instead, “This is a concoction to justify the giving out of medication at unprecedented and unjustifiable levels.” 

Every single major ADHD medication has been in trouble with the FDA for misleading advertising, some more than once.

Pharmaceutical companies have spent the past two decades engaging in aggressive and sneaky marketing that has included diagnosis- and drug-pushing doctors, playing on parents’ fears, and involving schools in the effort to attract, diagnose, and treat kids who suffer (or who appear to suffer) from ADHD. Ads for ADHD medication targeting parents feature headlines such as “Reveal his potential,” and “Thanks for taking out the garbage.” One ad has a hand-drawn picture of a kid and in large, childish writing, states: “Today I got a good mark. And made a new friend. What a great day!” In one particularly manipulative ad, a cheerful mom appears under the headline “I am not a bad mom;” the mom explains that her son’s school was ready to throw him out if his behavior continued. After taking the ADHD medication, however, her son “has become a thousand times better" and she has presumably been exonerated from bad motherhood.

Every single major ADHD medication has been in trouble with the FDA for misleading advertising, some more than once.

ADHD medications are marketed to doctors by psychopharmacology experts such as Dr. Joseph Biederman, a Harvard University child psychiatrist who is a huge proponent of stimulant medication to treat ADHD. Dr. Biederman also believes that the disorder is significantly underdiagnosed, and that failure to medicate will almost certainly cause risks as serious as drug dependence and problems with the law. As an example of Dr. Biederman’s enthusiastic support of stimulant medication for ADHD, in 2006 he told Reuters Health, “If a child is brilliant but is doing just OK in school, that child may need treatment, which would result in their performing brilliantly at school.” According to the marketing efforts aimed at doctors, much of which has been based on findings from Biederman’s research, ADHD drugs will “allow your patients to experience life’s successes every day.” One brochure for Adderall XR contains the remarkable statement that “Amphetamines have been used medically for nearly 70 years. That’s a legacy of safety you can count on.”

A Senate investigation in 2008 found that Dr. Biederman’s research was largely funded by drug companies, including Shire, the manufacturer of many of the leading ADHD medications. He was also paid $1.6 million for speaking and consulting. Dr. Biederman denies that the money had any effect on his research.

The more insidious marketing efforts are the ones that are not obvious. The main advocacy group for people with ADHD is CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder). CHADD was started in 1987 with the goal of bringing more attention to ADHD and its treatment. According to the group’s website, CHADD was founded “in response to the frustration and sense of isolation experienced by parents and their children with ADHD. At that time, one could turn to very few places for support or information. Many people seriously misunderstood ADHD. Many clinicians and educators knew little about the disability, and individuals with ADHD were often mistakenly labeled ‘a behavior problem,’ ‘unmotivated,’ or ‘not intelligent enough.’” CHADD offers advocacy, support, and a CDC-funded clearinghouse for “evidence-based information about ADHD.” They put out a magazine called Attention with articles such as “What’s in a Parent’s ADHD Tool Box?”

Pharmaceutical companies know what they’re doing: in 2012, sales of stimulants reached almost $9 billion, up from $1.7 billion in 2002.

I checked the website's funding, and found no mention of the fact that the group was started with seed money from Ciba-Geigy Pharmaceuticals, the primary manufacturer of ADHD drug Ritalin. Furthermore, the drug company provided funds to create “fact sheets” about treatment, one of which claimed: “Psychostimulant drugs are not addictive.”

CHADD has also lobbied the DEA to loosen government restrictions on stimulants and has worked on an educational video about ADHD with the Department of Education. The 11 main sponsors for CHADD’s 12th annual conference in 2000 were all drug companies. Shire led the pack, and was also revealed to have paid $3 million so that CHADD’s magazine, “Attention” would be delivered to doctors’ offices across the country.

Perhaps the most deceptive—and saddest—marketing efforts are the ones aimed at children.  “What’s Up with Astra?” is a comic book about a girl who has trouble with school and friends because of her inability to focus or stay still. Fortunately, a group of superhero medical experts called “the Medikidz” show up to tell Astra that she has ADHD. They explain how the disorder works in her brain, and introduce her to “Nora and Dopey,” who teach her how she can treat her ADHD.

The Medikidz were created by two pediatricians who were frustrated by the lack of child-friendly resources available to explain medical conditions. In addition to ADHD, the comic books deal with diseases and disorders including brain tumors, cancer, and allergies. According to their website, “Credibility is the cornerstone to the Medikidz offering - professional medical writers and doctors write all the content, which is subsequently peer-reviewed by leading consultants in each respective field. Medikidz also gains the endorsement of established and well-regarded medical institutions, foundations and spokespeople.” 

According to the New York Times investigation, however, credibility may not be such a strong cornerstone for Medikidz, at least in the case of the ADHD comics. Shire paid to have them produced. From the comic: “Medicines may make it easier to pay attention and control your behavior!”

Drug makers also enlist schools to help with their recruitment. Diagnoses are almost too easy when resources such as the American Psychiatric Association include criteria for ADHD such as “makes careless mistakes” or “often has difficulty waiting his or her turn.” The New York Times article describes the case of Andy Perry, a rambunctious child from Mercer Island. Andy’s public school teachers recommended to Andy’s parents that he be evaluated for ADHD and medicated with Ritalin. The school psychologist gave Andy’s mother a pamphlet which included the statement: “Parents should be aware that these medicines do not ‘drug’ or ‘alter’ the brain of the child. They make the child ‘normal.’” Later, Andy’s parents noticed the Ciba-Geigy logo on the back of the pamphlet. The school acknowledged that the pamphlets had been provided to them by representatives from the drug company.

Andy Parry was on Ritalin for three years even though, according to his father, he never had ADHD.“Somebody came up with this idea, which was genius. I definitely felt seduced and enticed. I’d say baited,” Andy’s father told The Times.

Pharmaceutical companies know what they’re doing: in 2012, sales of stimulants reached almost $9 billion, up from $1.7 billion in 2002.

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Allison McCabe is the editor in chief of The Fix. She has written for LA Weekly, Village Voice, Junk: a literary fix, Ramshackle Review, Main Street Journal and others. Follow Allison on Twitter.