Attention Deficit/ Hyperactivity Disorder (ADHD) And Medicine
Introduction
ADHD (attention deficit/hyperactivity disorder) is a familiar condition to Americans and to societies across the globe. The typical treatment for children and adults is medication. The symptoms appear to be manageable using medications and therefore research into other options have not received much attention. The benefits for the use of medication are numerous, yet today’s society is proving that this modality is not the perfect cure. “The diagnosis of ADHD is made by obtaining a history from at least two sources that describe the behavior of the child as consistent with the core symptoms of ADHD. ” CNS stimulants, namely, amphetamine based stimulants, methylphenidate, dextromethamphetamine, dextromethylphenidate, and modafinil, are the first line of treatment for ADHD. These medications have proven beneficial for symptom management yet, they also have the potential for abuse and harmful long-term health effects. Not everyone abuses medication, and the control of ADHD symptoms may be accomplished with other modalities.
Counter-Argument
There is a need for treatment of ADHD, the symptoms children and adults have, are not figments of their imagination: they are real. “Attention deficit/hyperactivity disorder (ADHD) is a common diagnosis in children with developmentally inappropriate behaviors of inattention, impulsivity, and hyperactivity. ” (Miller-Horna et al. , 2008) The problems do not stop there. “Children diagnosed with ADHD have an increased risk of psychiatric comorbidities such as oppositional defiant disorder (ODD), conduct disorder (CD) and mood disorders. ” These disorders are more difficult for society to deal with than ADHD. “If untreated, ADHD may result in lack of academic achievement, poor interpersonal relationships, low self-esteem, and increased incidence of substance abuse. ” Society has a responsibility to everyone who is a part of it. Health and safety concerns include higher rates of unintentional injuries and emergency department visits.
ADHD as a chronic disorder is very costly over a lifetime, because of the increase in adult symptoms, diagnosis for adults has increased, therefore more assistance, medication, research along with family care is required. “As recently as some 15 years ago, the prevailing opinion was that ADHD would “outgrow” in adolescence and that treatment after this age would no longer be necessary. However, recent studies (based on DSMIV criteria) show that ADHD persists into adulthood”. “Given the significant and wide-ranging effects of ADHD, pursuing the most effective ways of managing ADHD in children and adolescents is imperative. ” At this point in time what society has available is medication. ArgumentThere is strong evidence of abuse but, not all people will abuse medicine. A study, on military children showed that the stressful event of parent deployment did not increase ADHD medication. The outpatient visits for mental and behavioral health did increase “Parental deployment was associated with a decrease in medication events overall. All types of medication events including dosage changes, medication additions, and medication initiations, decreased or remained constant during parental deployment. ”
Medicine is what is abused, while people are the ones doing the abusing. The risk for abuse of medication should be a concern. Society has proof that some people will abuse medicine or sell it, so others can abuse it. Some ADHD medicines are Schedule II drugs because of their high potential for abuse and risk of severe psychological and physical dependence. “Because of this, Adderall, Ritalin, and Dexedrine are legally available only through prescription, with a limit of 30 days’ worth of doses and no refills. ” People are creative and have found ways around the system of controls. “Obtaining medications with potential for abuse such as ADHD drugs or opioids from multiple prescribers, is a way to obtain scheduled medications for diversion or abuse. This behavior is called doctor shopping”. College students are excellent examples of this. In the study accomplished by DeSantis et al. , 2008, here are a few of the student’s reactions and comments: Selling their leftovers is simply seen as a morally inconsequential win/win decision. As James framed it, “What am I going to do with all those pills? “To take it every day, ” explained David, “would really mess you up. You would never eat or sleep well. You just can’t do it, really. ” So I figure, if I can help out some friends and make some beer money, life is good. ” Most viewed its use as not only physically and psychologically harmless, but also morally acceptable, because it was used for academic purposes and not for social entertainment. the illegal use of ADHD medication seems to be stigma free for the overwhelming majority of our participants. Women in this study touted stimulants for their ability to suppress appetite. ” The most interesting, and unexpected, advantage that led students to use stimulants was not productivity but increased intelligence and heightened cognitive aptitude. As Mitch simply but succinctly remarked, “The stuff is like an academic anabolic steroid. These comments and behaviors are not being properly countered, because the negative long-term effects are not evident to the college age students: they believe there are none. This should be changing shortly with the increase of adult ADHD diagnosis, society will be learning more. “There has been increasing concern that adults with ADHD are at greater risk for developing adverse cardiovascular events such as sudden death, myocardial infarction, and stroke as compared to pediatric population. ”
Cardiovascular disease is a major health concern today. “The cardiovascular epidemiological literature has shown that even modest increases in BP and HR have been associated with increased risk of adverse cardiovascular events. ” There needs to be studies and informed decisions made about the true risks involved with ADHD medicine. With an aging population being prescribed ADHD medicine, awareness of the effects of combining medicine and alcohol and tobacco also needs to be looked at. Adult bad habits when combined with well-intentioned ADHD medicines could have synergistic effects, the damage could be catastrophic. Our children are asking for more information from their primary care providers. They want to be spoken to as the individual who has the condition, who could choose to comply or not to comply with the prescription. They want to understand for themselves what is happening to them and why, they know they are supposed to rely on their Doctor for this information. To get feedback from family, friends, and the internet is useful, but they are not the technical experts. “The average youth had over eight questions about ADHD and its treatment. Non-white and older youth were significantly more likely to be less adherent to their ADHD medications. ” This one action could have a large impact on Dr. Shopping, on college level abuse and on adults who have adverse cardiac reactions to ADHD medications. Issues with ADHD medicine include: negative side effects (sleep and appetite), label stigma, low or noncompliance to name just a few. In the article by Charach et al. , (2011): “A 2011 report by the Agency for Healthcare Research and Quality (AHRQ) reviewed research on both effectiveness of varied ADHD treatment approaches in at-risk preschoolers and long-term effectiveness of treatment at all ages. The report concluded that for preschoolers at risk of ADHD, the strength of the evidence for parent behavior training was high, while evidence was low for the use of methylphenidate in this age group. The report identified little quality research on treatment outcomes in other age groups and concluded that the few well-designed studies (one of methylphenidate use, one of atomoxetine use, and one combining the use of psychostimulants with behavioral/psychosocial interventions) all demonstrated low strength of evidence. ”
Conclusion
Parents and people are asking for help; ADHD is real. To prescribe medication and consider it controlled is irresponsible and ineffective. To allow the abuse of prescription medication is irresponsible. Society has a responsibility to use the best modality for symptoms and disabilities. “Although further study is needed, as a whole, these studies suggest that ADHD coaching is a promising behavioral intervention for children and teens with ADHD and a useful part of multi-modal treatment. ” Multi-modal treatment includes many areas: diet, homeopathic, naturalistic, behavioral, cognitive, many different means and they can and should be used together. Medicine because of the inherent dangers should be a last resort.
