Earlier this month, the pharmacy management company Express Scripts released an ADHD study with surprising numbers and implications for adults. According to the researchers at Express Scripts, ADHD medication prescriptions have increased 35.5 percent from 2008 to 2012 for those with private insurance, with the total number of privately-insured users of ADHD medication topping out at 4.8 million in 2012.
Of those 4.8 million, 2.6 million are adults - a quite startling increase from 2008, in which 1.7 million adults were diagnosed and medicated for ADHD. Even more surprising was the increase in use of ADHD medication from females ages 26 to 34, a group which experienced an 85 percent increase during the four year time period.
The report notes that the huge surge in females using ADHD medication perhaps results from missed diagnoses when females are young, mainly due to displaying different, less noticeable symptoms than their male counterparts: “Since females tend to present the inattentive form of ADHD and do not display disruptive behavior in school, their symptoms may be overlooked in childhood. As they age, they may become more aware of their symptoms and consult their physician."
This new-found awareness most likely stems from the fact that the symptoms of ADHD are much better publicized and treatable, with the diagnosis of ADHD in children becoming more and more commonplace: “What commonly brings someone in is they see their child being evaluated and recognize symptoms in themselves,” stated Dr. Len Adler, the director of adult ADHD at New York University’s School of Medicine.
While doctors are prescribing ADHD medication to more and more adults, there are those in the medical community who express concerns about this high-level of medication, such as Dr. Claudia M. Gold:
"I have concerns about this trend of diagnosing and treating ADHD, particularly in this population of young mothers. If we label this behavior as a disorder and prescribe a pill, we are not placing responsibility (blame) squarely on the mother? Do we not have a responsibility as a society to care for mothers to support their efforts to care for the next generation? Will the motivation to find more creative solutions, such as flexible parental leave, and valuing of self-care (the airlines recognize this need in the instruction to adjust your own oxygen mask before your children's) be lost?"
Dr. Gold's primary worry is that the high rise in prescriptions for women ages 26 to 34 represents a simple increase in the stress in adult lives, especially for women trying to juggle the stresses created by holding full-time job, raising children, and taking care of the majority of household tasks.
Dr. David Muzina, vice president of specialist practice at Express Scripts, also expressed concerns about the rising number of adults being prescribed ADHD medication, holding doubts about correlation versus causation: “The part that we are concerned about is how much of this drug use is related to over-diagnosis and over-treatment of symptoms that aren’t really a condition.”
With 2012 profits near $9 billion for stimulant medications, up nearly $7 billion from one decade ago, Big Pharma and other corporations may be to blame. Considering the majority of Americans will be insured this year following the Affordable Care Act mandate, perhaps the causal reason as to the increase in ADHD diagnoses will be determined soon.
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