News - 75 per cent of ADHD diagnoses wrong - 10th Nov

[Fry-d-]

75 per cent of ADHD diagnoses wrong, report says
By TIM CLARKE
November 10, 2004
From news.com.au

THREE-QUARTERS of children believed to have attention deficit hyperactivity disorder (ADHD) have been wrongly diagnosed, an inquiry in Western Australia has found.

A parliamentary committee into ADHD, which tabled its final report today, has also found WA heads the nation in the prescription of dexamphetamines in the treatment of ADHD.

It said such a statistic was alarming.

Because many children may be receiving stimulant medication that is not necessary or warranted, the WA government has been called on to help develop a consistent method of diagnosing ADHD.

The standing committee, chaired by state MP Carol Martin, heard from WA's ADHD assessment team, which said the condition was vastly over-diagnosed in the state. Many suspected ADHD patients were later found to suffer from other conditions.

"Statistics show that following thorough multi-disciplinary family assessment, only 20-25 per cent of children are given a confirmed ADHD diagnosis," the report quoted the assessment team as saying.

"In our experience, many of the children misdiagnosed with ADHD in fact are assessed to be suffering from significant developmental and learning disorders; attachment problems, anxiety or depression."

Coupled with the misdiagnosis was the nationally high rate of prescriptions of stimulant drugs prescribed by WA doctors to treat ADHD – due, the report said, to a lack of knowledge about other possible therapies.

"By virtue of their training and workload it is likely that paediatricians are more prone to use drug therapy in the first instance than the other therapies recommended for the management of ADHD," the report said.

"There may be many children receiving stimulant medication when it is not necessary or warranted," the report said.

"The committee remains troubled by the absence of long-term studies into the effect of stimulants on the individual, in particular young children, who may begin taking the medication at a very early age, and continue to do so throughout their formative years."

The committee said the commonwealth government should be urged to investigate the disproportionate use of dexamphetamine on the Pharmaceutical Benefits Scheme. The state government was asked to research the safety of long-term use of stimulant drugs amongst youngsters.

Michele Toner, executive officer at the Learning and Attentional Disorders Society of WA (Inc), said the report highlighted the poor level of treatment available in WA for disorders such as ADHD.

"The availability of services for the treatment of ADHD in the public health system is abysmal and this needs to be urgently addressed," Ms Toner said.

"There is no treatment in the public health system of WA for adults with ADHD, and no guidelines exist for the diagnosis and treatment of the disorder in adults."

The Sunday Times

I heard this first on HACK then saw the report on Seven news. This is something I feel very strongly about. It is definately a huge problem in Perth as far as I can see. The over presciption not only leaves young growing kids on strong medication when they shouldn't be, but it's giving the kids a source of amphetamines for recreational purposes when they realise for themselves they don't need the medication.

Like the guy interveiwed on HACK said its seem to become the norm in Perth for a problem to be recognised and rather than try and find the source of the problem and fix it, it seems to be accepted to just prescribe some drugs and hope it will go away. Antidepressants for another example.

 

[Killing_time]

I concur, although it is good when exam time comes 'round.
Just pop' 'round the local high school and bash some kid for his medication, from what I gather he or she's more than likely to have some.
Kidding
I know numerous people who have gone and got dexxie prescription so they can get some poor mans speed, it's sad that it's so easy.

PEACE

 

[Doooofus]

Yep, young kids are strongly over-medicated, it's something that needs to be addressed. And Killing_Time... you dont gotta bash them, you just gotta wave the cash in their face No, but seriously, it has got to stop being given out like damn candy.

 

[astro^boi]

Poor kids...being scattered at such a young age...oh the agony!
As a parent...wouldnt they notice their kids acting opposite to what dexamphetamines are suppose to do to real ADHD children...and wouldnt they stop to think...mmm my kid might not have ADHD and get them off the drug??

 

[lok1]

Are they mis-diagnosing ADHD as ADD as well?

 

[ksi]

Interesting. And I dont really believe in ADHD. Dont think ritalin or speed will have good effects in the long run for alot of the patients who are taking it right this moment.
And I concur that alot of medications are overprescribed to especially young kids (think of the changed rules for prescribing prozac; they can prescribe it for children now) and that's pretty alarming.

 

[phase_dancer]

Treatment today --> Addiction tomorrow 8)

A very sad state in my books.

These are the kids with the "biggest eyes". They observe more, process more, feel more and question more....

In my uneducated evaluation, I believe the "symptoms" of these disorders are a result of kids becoming confused by intuitive and sociological conflict. Sometimes the easiest way to avoid the confusion is to do just that; change when it becomes difficult, even if it seems erratic to others.

Let's face it, conformity and compliance are expected minimum standards in todays world. Kids are expected to behave like adults long before they are 18, yet are denied all the rights of an adult.

Kids who show little or no ability (desire ? ) to conform are classified as disturbing, yet for many of these kids, the world they confront everyday is greatly disturbing; out of order and wrong by instinct. Because they see the world differently, they feel left out of everyone else's world. What "cures" this I believe, is when they find their passion in life - a thing they find easy application with - which for many unaffected people, doesn't come until early adulthood or later.

Sure these kids require more attention and dedication, but they are the gems of society IMO: rough at first, but with attention and care a shiny, well faceted individual is produced who isn't so afraid to challenge accepted practice, but has learned to work with a system rather than against it. Just like grown-ups should


I'm sure I would have been diagnosed myself as ADD or something similar, but the disorder wasn't invented at that time. There were other conditions but it would seem these were reserved for the really tough cases or those displaying psychotic tendencies. When I finished High school in the mid seventies, I had never heard of, or known of anyone who had ever been prescribed amphetamine, not one person!

IMO, in most cases, I believe the last thing that should be done is to chemically suppress or confine this broader perception. Hasn't psychology advanced enough to offer an alternative to the chemical compliance so readily prescribed?

 

[chrisisparanoid]

wow. very well said mate.

 

[pill_jockey]

Yes these kids probably are gems that do need to be shined up but unfortunately people are inherently lazy, humans like electricity prefer the path of less resistance and as such prescribing dexxies has become the preferred option for any problematic child. It seems sad but that is the way the human species seems to be evolving or maybe that should be regressing.

 

[Pseudo G]

As a school teacher, I would not be prepared to devote a large percentage of my time to attend the needs and cares of a few individuals as the rest of the class suffers.

As a school teacher in WA, I would estimate the percentage of students in each class I take who have ADHD or ADD to be less than 10%. Unforunately, this less than 10% often consumes around 80% of my time and effort. I believe there is case that the dosing of students CAN benefit them but generally has a greater benefit to their classmates as a whole.

Students perscribed dexies are often very lazy to take them and phone calls from parents on their mobiles reminding them to take their medication is the norm.

Many of these ADHD and ADD students are extemely bright, often smartest in the class. But they cannot concentrate and have difficulty focusing for more than a few minutes. The difference in ADHD and ADD students on dosing is jaw dropping. They of course still misbehave sometimes, dosing doesn't stop misbehaviour if the students intends on being a problem, but it does give the student the ability to restrain themselves, to focus on their work when they want to and be valuable contributors to the classroom.

Having said that, any sort of amphetamine use from a young age can't be good for you.

There is some debate in Western Australia if we are infact over perscibing these meds, or we just happen to be "world leaders" in the diagnosis and treatment of ADHD and ADD.

Something else I've experienced is that students who misbehave or don't do the work fly the "I have ADD you know" flag. As in it becomes some excuse for not working or misbehaving. I'm not sure where they get this from, but I suspect it's from the parents who fly the "It's not my fault, my child has ADD" flag.

 

[rm1x]

Well put PD and Pseudo G
I don't think I can really add to this, I am above avgerage intelligence (have adhd) and there is a definiate improvement in my behaviour when I am medicated. However, the downside to me being medicated is that I become robot like, my last S/O actually pointed this out, she said that I had lost all of my personality that attracted her to me in the first place.
The cool thing about it though is that ADHD/ADDr's see things in a big picture as opposed to just one section. I don't know, it's hard to explain what I mean.
My ex S/O said one of the things she loved about me was that I had a different view on the world to anyone that she had ever met, and I guess ADD/ADHD ppl do

WA does seem to over prescribe the medications, but could this just mean that the condition is more prevelant than once thought?

 

[rm1x]

I forgot to ad that it's quite easy to tell the difference between someone who is just misbehaved and someone with ADD/ADHD.

 

[Fry-d-]

Pseudo G cheers for your input. Its interesting to hear from the other side of the fence from people who cop the brunt of these kids.

I feel there is a tendency by parents to use ADD as an excuse for kids they can't control though. Some kids may have issues fair enough but some times its the parents can't be assed or the kids are running amock and the parents want a cop out rather than to be blamed for a bad up bringing.

 

[Fry-d-]

Children selling $1 'speed' medicine
By Amanda Banks 12nov04
Taken from the Sunday Times

STIMULANTS prescribed for ADHD are becoming the poor man's speed - sold for less than $1 a tablet to young people wanting to party and stay awake to study.

West Australian research has found nearly 10 per cent of high school students admit using ADHD medication without a prescription, reporting that the drugs are easy to get from friends and peers.

National Drug and Alcohol Research Centre information manager Paul Dillon said anecdotal evidence suggested some young people were selling up to 20 of the tablets at a time. But there was not enough research for an accurate assessment of illicit use across the country.

Mr Dillon said parents had to be made responsible for monitoring their children's drug use.

"When it comes to pharmacy drugs, we live in a society where it is disgusting how willing we are to drive our kids to be pill-poppers from a very young age," he said.

"There has to be some sort of parental responsibility. This is not organised crime, it is just children on-selling."

Growing evidence of a black market in prescribed stimulants has been highlighted in a West Australian parliamentary report that has also revealed alarming levels of over-prescription to treat ADHD - attention deficit hyperactivity disorder - in children.

The side-effects of ADHD treatment drugs such as dexamphetamine and Ritalin include a loss of appetite, weight loss and insomnia.

Use of the drugs can also lead to headaches, nausea, dizziness, tremors, blurred vision, muscle cramps and hair loss.

The bipartisan inquiry's report highlighted a survey of nearly 230 high school students in which almost 8 per cent admitted using prescribed stimulants such as dexamphetamines without a prescription.

"A significant number of submissions raised the issue of misuse of stimulant medication, with a particular concern being the selling of medication for recreational or study purposes," the report said.

The report said the need for children to take the medication at school because of its short therapeutic effect created the opportunity for the drugs to be sold.

It said that in New Zealand, slow-release medication had been funded under a pharmaceutical benefits scheme to avoid the need for children to take medication to school.

It also found that children could fill repeat prescriptions over short periods of time, prompting a recommendation that regulations on dispensing be overhauled and pharmacists be granted better access to patient databases.

Mr Dillon said research by NDARC on children aged over 15 had failed to identify young people using prescription stimulants, but anecdotal evidence said otherwise. The suggestion that just under 10 per cent of students could be using non-prescribed stimulants was significant.

Paul Hutchins, an expert in the stimulant field and head of the child development unit at Westmead Children's Hospital in Sydney, said the diversion of stimulant drugs was a significant issue and should not be downplayed.

But Dr Hutchins said that in the context of substance abuse by adolescents, the diversion of prescribed stimulants was minor and there were other drugs with more side-effects being used by young people.

This is definately topic of the week for a few people. Theres been absolutely stacks in the paper and on the news about ADD/ADHD and dexamphetamine use/misuse.

 

[archie]

Pseudo G : sorry, but your viewpoint is morally insane. They should be dosed up on drugs for the benefit of their CLASSMATES?? uhm. NO.

Children should only be given meds when it is in their best interest.

(Disclaimer, I have ADHD and I'm not on meds)

 

[phase_dancer]

Thanks for the link Fry-d-

Pseudo G, I have to first say thank you for your honest real life appraisal. For many of us, ideas of dealing with class disruption are never considered. Of course, when asked, everyone has their own ideas on how they'd handle such situations, but the reality is - whether these ideas are effective or not - they would invariably require additional resources.

This is where the root of the problem undoubtedly lies. And it cannot be dumped upon teachers to solve completely.

So I thank you for your comments Pseudo G. From your position as a teacher, I can understand the frustration. I don't wish to take you to task on anything, but from your perspective as a teacher, I would like to ask you a few simple Q's

~~~~~~~~~~~~~~~~~~~~~

Do you think the numbers of kids displaying these symptoms has risen over the past 5-10 years?

Do you feel home life is the strongest environmental factor?

You mentioned you thought there is benefit to other class members when sufferers are medicated, but at the same time you seem to question the long term benefit to those medicated. Would you then call this a "quick cure" remedy for many?

~~~~~~~~~~~~~~~~~~~~~~

I think these kids definitely require more one on one teaching. I've found that when a child fitting this description finds a teacher he/she respects, attitude can change completely.

Although I'm against corporal punishment in any form, I do wonder if the increase in those diagnosed with ADD or ADHD has anything to do with the fact that we no longer have it.

When I was at school the cane was still very much allowed and - while there were those who constantly played up and got canned for it [genuine attention disorder perhaps?] - most kids knew when to pull up and did so. In other words, that fear of the cane did to some degree compel individuals to behave in class.

I'm not all suggesting we bring back the cane, but perhaps every school needs a broader range of resources and a few extra teachers specially qualified in this area.

 

[smileyfish]

Many thanks to Pseudo_G for giving us the teachers' perspective

. I guess I think one of the bigger problems is the size of classes that teachers are expected to control and the lack of alternative resources for dealing with difficult children. My mother is a preschool teacher and has seen class sizes increase to a level where she feels uncomfortable due to economics.

I recall a boy in my primary school who was constant trouble, despite frequently getting caned. On meeting his mother I was surprised to find a genuinely concerned, loving and involved parent who was seriously at her wits end - made me stop and think at the time Yes, I'm sure there are general ADD and ADHD cased (why do we never hear about ADD anymore?), although I also suspect that diagnoses are regularly made without seriously infestigating alternatives and that drugs are too often the first port of call.

I am of above average intelligence and have suffered from depression all my life (whether or not this is linked to intelligence is debatable). When times have been bad and I've ended up at the doctors/councellors the first response has always been to put me on antidepressants, and the majority have not suggested any other options, including concurrent councelling (which psychologists will tell you is a must!). Now as a concerned adult I ask questions and investigate alternatives, but a child just takes what they are given, and frazzled parents are often going to trust their doctor and put their hopes into a simple solution.

Yes, such drugs do work, but they address the symptoms, not the problems driving the symptoms, and this is what frustrates me. Take away the symptoms and you can claim the problem is solved, but it's not. You just end up with a reoccuring problem and long-term drug use of which the consequences aren't really known. Hardly an ideal situation. I'd love to see some serious, long term studies into these things, and if the current media attention aids this, then it's a start!