The official definition of an epidemic refers to a condition that affects a "disproportionately large number of individuals within a population." Based on the latest data released by the Centers for Disease Control and Prevention, the United States is chin deep in an attention deficit hyperactivity disorder (ADHD) epidemic, and the waters are rising. While some say that the condition really is becoming more common, a scary thought for the future of our children's brains, many skeptics think that it's just a problem with doctors overdiagnosing the disorder. Either way, the numbers are rising.
Of course, people have been using the term "epidemic" for a while when describing the steady rise in ADHD diagnoses over the past decade or two. The American Academy of Pediatrics officially labelled it as such way back in 2000, and haters have been having a field day with the word since. It often goes in scare quotes or gets challenged in the comments section. But now that we know that a staggering 11 percent of American children have been diagnosed with the disorder — nearly one in five high school-aged boys has been diagnosed — it's time to start really thinking hard about what to do next.
A lot of people are tired of this debate and would probably react to the CDC's latest announcement as more of the same. Not the nation's leading doctors. "Those are astronomical numbers. I’m floored," pediatric neurologist Dr. William Graf told The New York Times. And it's only going to get worse. The American Psychiatric Association plans to broaden the definition of ADHD to allow more people to be diagnosed. Graf, who's also a professor at Yale Medical School, explains why the trend worries him, "Mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy."
This isn't exactly an epidemic we can easily contain. Perhaps the most challenging factor in the whole situation is the fact that ADHD is a psychiatric disorder, plain and simple, so the rhetoric around the condition being overdiagnosed inevitably runs the risk of downplaying its seriousness. Some people, especially young people, do have a chemical imbalance that hinders their ability to pay attention, and that leads to all kinds of problems in life, especially in school. The medication prescribed, often Adderall or Ritalin, has been proven to be helpful for many.
Critics say that the medication, not the disorder itself, is the bigger problem. They claim that doctors overdiagnose ADHD, perhaps in part due to the name-brand drugs being pushed so hard by pharmaceutical companies. Consider that there has been an eight-fold increase in the prevalence of ADHD in the United States between 1980, when the diagnosis was entered into the DSM and 2007. Unsurprisingly, the rate at which psychostimulants were prescribed has increased accordingly, jumping some 700 percent since the 1990s.
Adderall specifically exploded on the scene, after being introduced in 1996 and increased production by over 4,500 percent in the next seven years. Meanwhile, the pharmaceutical company has been pushing hard — and succeeding at — infiltrating the research community and patient advocacy groups in an effort that some say is leading to the ballooning number of diagnoses. After all, more diagnoses mean more prescriptions which mean more money for big pharma. This little video describes the process well, though it's hardly a scientific read:
But even skeptics recognize that there's something else going on. America's youth has never been more overstimulated, and some think that the medical community is responding to what's essentially a social condition with a pharmaceutical solution — and a very profitable one at that.
As Motherboard's own Kelly Bourdet reported a few months ago, some doctors even think drugs like Adderall are even being used as a solution to America's failing schools. If kids distracted by iPhones can't pay attention in high school physics class and bomb the state-level exams, it must be the kids' fault, not the schools, they say.
Well, one could write a book about Adderall, ADHD and what it means for America, and the debate is nowhere near resolution. The numbers are real, though, and based on the exasperated-sounding doctor's quoted in the New York Times report on the CDC's latest numbers, they could actually influence the medical community. Doctors surely knew that a lot of kids were getting diagnosed, but when you imagine one in five high school boys on pills, it really feels like something's wrong.
James Swanson, one of the top ADHD researchers of the past 20 years, explains the scenario in simple terms. "There’s no way that one in five high-school boys has ADHD," he said. "If we start treating children who do not have the disorder with stimulants, a certain percentage are going to have problems that are predictable — some of them are going to end up with abuse and dependence. And with all those pills around, how much of that actually goes to friends? Some studies have said it’s about 30 percent."
Oh, great. So not only are we turning our kids onto amphetamines, we're turning them into drug dealers, too. Three cheers for America.