ADHD

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The history of ADHD policy and regulation nationally from 1992 to 2012, in WA from 1993 to 2011 and in NSW from 2007 to 2011 is that regulatory capture occurred in the majority of policy development and regulatory processes. These ‘captured’ processes have been associated with subsequent ADHD child pharmaceuticalization. Conversely the only ADHD-critic dominated process identified occurred in WA in 2002 and was associated with subsequent ADHD child de-pharmaceuticalization. The findings of this thesis are consistent with Abraham’s assertion that regulatory capture is a significant driver of pharmaceuticalization.

PDF of full thesis available at Martin Whitely PhD Thesis Copy – ADHD and Regulatory Capture in Australia PDF

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Stephen Colbert’s ‘Meducation’ plan for America’s third rate public schools – Don’t laugh too hard it is already happening!

A video and transcript of Colbert’s ‘Meducation’ rant is available at http://www.dailykos.com/story/2012/10/11/1143009/-Stephen-Colbert-on-medicating-children-to-improve-their-grades

On October 10 2012 American comedian Stephen Colbert coined the term “meducation” to describe the growing practice of drugging with ADHD amphetamines, American children with mediocre school grades, who do not have a diagnosis of ADHD.The catalyst for the mock right wing political commentator’s endorsement of ADHD drugs as smart pills was a front page article in the New York Times in which peadiatrician Dr Michael Anderson advocated their widespread use to compensate for America’s third rate public education system. Doctor Anderson said “we’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.” Unlike Colbert, Dr Anderson is not a comedian but unfortunately for some of the children of Ganton Georgia he is their doctor.

In his comedic monologue Colbert argues the child drugging program should be extended beyond amphetamines. “Folks, I believe this is a great fiscally responsible answer, but we can do more.  I mean, we might be cutting arts programs, but one tab of acid, and your kid will be seeing colours you can’t find in a Crayola box.” Colbert’s mock rant concludes with a serious warning; “Now, of course, eventually it may turn out that drugging poor students creates more problems than it solves.  In which case, we’ll have to stop trying to change our children, and think about changing ourselves.”

Despite Dr Anderson’s claims and Colbert’s mock endorsement, ADHD amphetamines are anything but ‘smart drugs’. Unique long term (8 year) Australian research shows that children diagnosed ADHD and ‘ever medicated’ with amphetamines were a staggering 950% more likely to be rated by their teacher as “performing below age-level” than children diagnosed with ADHD and ‘never medicated’. (see http://speedupsitstill.com/2010/02/17/excerpts-from-the-raine-study/ ) And as pointed out by Colbert the USA, the home of ADHD child drugging, lags most comparable developed nations (and a few second world nations) in terms of academic achievement.

The message is pretty clear – if you want to dumb down – speed up!

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By Martin Whitely MLA

The off colour Australian colloquialism ‘you can’t polish a turd but you can cover it in glitter’ is a fitting analogy for the danger of legitimising ADHD as a diagnosable mental illness by developing treatment guidelines. However, treatment guidelines are being developed and the more conservative the treatment guidelines, the fewer children risk damage with the long-term administration of amphetamines.

That is why I welcome the release by the National Health and Medical Research Council (NHMRC) of the Australian ADHD Clinical Practice Points (CPPs) as a small but significant step in the right direction. (The CPPs available at http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/mh26_adhd_cpp_2012_120903.pdf )

Eventually ADHD will be regarded as an embarrassing footnote of history and society will collectively wonder how anyone ever thought it would be a good idea to give amphetamines to children. But in the meantime improvements like those in the ADHD CPPs, although modest, will hopefully see fewer children diagnosed and drugged.

That said, the CPPs are far from perfect. The statement that, “…stimulants might be considered for this age group (under 7 years)” leaves the door open for drugging very young children.[1] The manufacturers prescribing information for all stimulants state they should not be used in children under 6 years, since safety and efficacy in this age group have not been established.[2] Any clinician ignoring the manufacturers warning is inviting a future law suit for negligence.

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How can this be? Don’t bother asking because privacy laws shield the drug company applications for PBS listing from public scrutiny.

by Dr Martin Whitely

ADHD drug Concerta is a slow release form of methylphenidate (the active ingredient in Ritalin) that can be taken once daily.  It was first licensed for use in Australia by the Therapeutic Goods Administration (TGA) in 2003 and subsidised via the Pharmaceutical Benefits Scheme (PBS) for use by children in 2007.

Recently Concerta’s manufacturer Janssen-Cilag (a subsidiary of Johnson and Johnson) applied to “extend the current Authority required listing” on the Pharmaceutical Benefits Scheme for Concerta “to include use in patients diagnosed with attention deficit hyperactivity disorder (ADHD) after the age of 18 years”. The Pharmaceutical Benefits Scheme Advisory Committee (PBAC) “rejected the application on the basis of uncertain efficacy and safety in the proposed PBS population and hence uncertain cost-effectiveness, and high and highly uncertain cost to the PBS.”[1] In response Janssen Cilag commented that “Concerta is already available on the PBS for use in adults who were diagnosed with ADHD ≤ 18 years. This submission requested the same access for all adult patients regardless of the age at which they were diagnosed. We will consult with the PBAC with regards to a future resubmission.”[2]

Janssen Cilag raise a valid point; How can Concerta be ok for children and yet have “uncertain efficacy and safety” for adults? Read the rest of this entry »

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The Scientific American recently published an article suggesting that “cognitive and behavioral therapies that help young people reduce impulsivity and cultivate good study habits are costlier and take longer to administer [than ADHD drugs], but may be more efficacious over time”.

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On May 2, 2012, the American Psychiatric Association announced changes to its proposed DSM5.[1. see http://www.dsm5.org/Pages/Default.aspx ]  Psychosis Risk Syndrome, or as it was officially proposed to be called, Attenuated Psychosis Syndrome, has been dropped. This is great news because as has been highlighted on this website numerous times, Psychosis Risk Disorder was a flawed concept with the potential to be an iatrogenic health disaster. In addition most of the dangerous changes proposed for the already absurdly broad ADHD diagnostic criteria have been abandoned.  Four extra ADHD criteria had been identified for inclusion in the DSM5. They were:

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A review of the medical records of 937,943 Canadian children showed that children born in December, the last month of their school year intake, were much more likely to be diagnosed and medicated for ADHD than their classmates born in January.

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The world’s most popular independent online news service, The Huffington Post, recently published two significant blogs suggesting that Western Australia and France offer lessons on how to tackle the global ADHD epidemic.

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Anecdotal evidence indicates that too many Western Australian children in the care of the state that are managed rather than cared for.  Managed with a range of psychotropic drugs including, antidepressants, anti-psychotics, amphetamines and anti-anxiety ‘medications’ as a cheap substitute for the intensive support they so desperately need.

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The following article written by L. Alan Sroufe, Professor Emeritus of Psychology at the University of Minnesota’s Institute of Child Development was published in the New York Times on 28 January 2012 (original available at http://www.nytimes.com/2012/01/29/opinion/sunday/childrens-add-drugs-dont-work-long-term.html?_r=1&emc=eta1 )

Ritalin Gone Wrong – New York Times, January 28, 2012 by L. Alan Sroufe

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