I would like to take a moment to address an article that appeared February 2, 2013 in the NY Times titled Drowned in a Stream of Prescriptions. There has been a terrible tragedy exposed in the practice of treating ADHD with the death of Richard Fee. From all accounts, this case was mismanaged. Unfortunately, most people only got to hear the headlines and a few “talking points” that highlight the dangers of Adderall when misused. This has done a tremendous disservice and created unwarranted fear for the many children and parents of children who truly do have ADHD.
Let me be clear. Stimulant medications are serious medications that are safe when used PROPERLY to treat people who have been THOROUGHLY and ACCURATELY diagnosed with ADHD. A proper diagnosis involves, at a minimum: a full family history (including reports from family members when available), a medical screening to rule out other possible explanations for symptoms (sleep apnea, thyroid problems, etc.), symptoms existing exist before age 12, and present in at least two different settings (as reported by outside observation when available, not just personal report). Clearly, this exploration was not done in the case of Richard Fee as his grieving parents would certainly attest.
There is no question that stimulants meant to treat ADHD have been misused and abused by high school and college students who DO NOT have ADHD for their own academic advancement. In the professional field this is known as “Diversion” (read The Diversion of ADHD Medication) for an in-depth insight into this social, legal, and ethical problem).
The issue of the use and abuse of Stimulant medications must be addressed more aggressively. There are some specific changes that MUST be made.
First, there is no legal standard to determine WHO may diagnose ADHD. Currently, any Psychiatrist, Nurse Practitioner, Neurologist, Family Doctor, Psychologist, Master Level Counselor or Social Worker can diagnose ADHD regardless of specific training or knowledge. This leaves the door open for inadequate and abusive practices in the diagnosis and ultimate treatment of ADHD.
Second, we must make it WIDELY known that it is ILLEGAL and DANGEROUS to pass around or sell Prescription Stimulants. There are many students both in high school and college who have had their ADHD medications stolen, have been pressured and bullied to “share”, or have struggled to do without in an effort to make money. We must aggressively enforce the law to protect not only the abusers of the drug, but the people who are often victims of undue pressure and theft.
Third, we must do more to demystify ADHD and the honest, safe use of Stimulant medications as ONE part of an overall treatment for ADHD. To help this along, please read Raise Awareness… Establish World ADHD Awareness Day.