There is widespread scientific uncertainty as to whether the problems experienced by individuals diagnosed with ADD/ADHD are a result of biological problems or social, cultural, and economic factors. But despite uncertainty within the scientific community, ADD/ADHD has become the most prevalent child disability in North America; and its primary treatment is psychotropic medications, Adderall and Ritalin.
But quite disturbing is how prevalent Adderall and Ritalin use really are. Adderall sales increased from $10 million in 1996 to $520 million in 2003, while Ritalin use has increased 800 percent since 1994 (Moynihan and Cassels 2005; Clarke 2008). These are striking statistics, and we should question whether ADD/ADHD really is that common.
There is a lot to be said both about the expansion of the disease category ADD/ADHD at the conceptual level, and role of the pharmaceutical industry in promoting the disorder as a neurobiological problem that must be treated with psychotropic medications. I hope to write about these topics more extensively elsewhere. But I think there is one important observation to be made here: the industrialized world is spending billions of dollars every year diagnosing and treating an ambiguous mental disorder called ADD/ADHD in the midst of a global health crisis in which millions of children and adults in the developing world die from treatable illnesses each year. The pursuit of economic profit severely disables our collective moral conscience.
I appreciate your comment, Madelyn. I hope I can clarify a few things for you.
I’m a philosophy grad student; I am allowed and in fact encouraged to think critically about the way things are in the world. That means questioning very important and controversial topics like issues in the philosophy of psychiatry, regardless of what 75 ADD/ADHD experts have to say.
I have never once suggested that ADD/ADHD does not exist – I think many people suffer from the disorder, and I have a close friend who in fact does. What I’m suggesting is that ADD/ADHD is over-diagnosed and over-treated with psychotropic medication. That’s not a radical claim to make.
I have done extensive research on the pharmaceutical industry, its overwhelming and often unethical influence over medical science, the expansion of disease categories, conflicts of interest, etc. etc. Just because I don’t cite 75 psychiatrists – who, I would like to mention, are often paid top dollar by pharmaceutical companies to advocate for ADD/ADHD as a ‘neurobiological problem that should be treated with drugs’ (the conflicts of interest are absolutely frightening) – does not at all imply that I’m totally unaware of the hard facts. I have a number of very credible sources from which I have developed ideas, including ideas for this blog post. If you’re interested in reading an article or two on the topic, I have a huge list, all which are written by PhDs and published in reputable journals. I’d also like to recommend that you check out Ray Moynihan and Alan Cassels, “Selling Sickness: How the World’s Biggest Pharmaceutical Companies are turning us all into Patients.” If you’re not a reader, there’s also a documentary that does a great job of pulling out the important arguments from the book.
I’m sorry that my blog post made you angry. Hope this helps!
Let me point out one thing to start: I agree in large part with the International Consensus Statement. I believe – and I think the post above does, too – that ADHD does exist, and so does ADD. I think there are problems with the ICS, though:
-It’s not international. There are eight countries represented in the signatories, with the vast, vast majority being from the United States. This brings up questions about the cultural basis for ADD and ADHD diagnosis that haven’t been addressed by any of the studies included in the ICS.
-It doesn’t classify as a scientific consensus by any stretch of the imagination. If in a multi-billion dollar industry – where millions of dollars in promotional money is given to ADD “support groups” and doctors who diagnose ADD and ADHD – you can find only 75 people who would actually sign a statement in support of ADHD as being under-diagnosed, then you should find some other supporting evidence before declaring a consensus on all the issues they touch upon in their remarks.
-It doesn’t address any of the longstanding criticisms of ADD and ADHD diagnosis. I don’t think the post we’re commenting on was trying to say that ADHD doesn’t exist – just that it’s grossly overdiagnosed. There’s a lot of evidence that speaks to this: mostly, it’s evidence that shows that our ways of classifying what counts as ADD and ADHD have broadened, changed, and otherwise made to cover more and more people – and that these changes are most likely a result of marketing by the pharmaceutical industry. If ADHD is being maligned as erroneously diagnosed in the press, then I would have expected an article in defense of current practices to have argued against specific claims. Instead, the ICS states very clearly that ADHD exists – and then uses the overwhelming evidence in favour of its existence as a premise to jump to other unjustified conclusions. There are serious issues about the diagnosis of ADHD, and I would love to see non-circular arguments in favour of why it is now such a prevalent disorder. I haven’t seen any such arguments, though.
I have worked with ADD and ADDers for 20 years, and I promise you that you have been misinformed. I hope you will prove to be a responsible journalist here in the blog-o-sphere and fact check your conclusions before you “write about these topics more extensively elsewhere.”
On the sidebar of the home page of my blog (http://www.ADDandSoMuchMore.com) is for a link to a pdf download of the International Consensus Statement on ADHD, web-published January 2000, and in Clinical Child and Family Psychology Review, Vol. 5, No. 2, June 2002 with facts you have never seen, I’m quite sure.
The International Consensus Statement was signed originally by 75 of the world’s leading ADD experts, and is archived on the website of one of the more visable of the signatories, Dr. Russell Barkley. In addition to fifteen and a half 2-column PAGES of supporting references, EACH expert has included crendentials and contact information.
So, now you don’t even have to troll the web in search of clinical studies and statistical reports. It would be responsible, however, to read them before you offer your opinion on ADD again.
xx,
mgh (Madelyn Griffith-Haynie, SCAC, MCC – blogging at ADDandSoMuchMore and ADDerWorld – dot com!)