The 50-year campaign to market ADHD drugs has paid off.

December 14, 2013 4:21 PM

A.D.H.D.: the pharmaceutical campaign's influences and consequences. "Adults searching for information on A.D.H.D. encounter websites with short quizzes that can encourage normal people to think they might have it. Many such tests are sponsored by drug companies in ways hidden or easily missed. " And more!
posted by DMelanogaster (19 comments total)

This feels like another recycled Times article topic supporting the idea that ADHD is a myth and that people who use Adderall are just lazy drug abusers. I have a few friends who take meds for ADHD and it's helped them. They aren't suddenly geniuses with an unfair advantage. To my knowledge, they get meds in therapeutic doses and don't abuse them. They're pretty normal people and they aren't Jessie Spano on caffeine pills.
posted by discopolo at 4:33 PM on December 14, 2013 [9 favorites]

I'm just going to say this and then leave the thread: I was not a believer in ADHD for many years. This past spring, after years of struggles, my son was diagnosed. By extension, so was I. The medication has made a big difference for both of us.

The medication route isn't for everyone and I have no doubts that there are people out there abusing them and also that there are people taking them who shouldn't be (I think there are many other medications that the same can be said of). That being said, for some of us they have been an incredible benefit and I am suddenly very tired of these articles that question the
disability and the use of medications to assist with it.
posted by nubs at 4:51 PM on December 14, 2013 [7 favorites]

Yeah, I have to also post a disclaimer: I used to not believe in ADHD. But the intense vilification of people who use those drugs and benefit a little from them made me change my mind. My ex-boyfriend was also not a believer in ADHD but even when I was with him, I always thought he could benefit from an evaluation for it. He didn't even see how he was self-sabotaging by not being able to focus.

If anything, it seems underdiagnosed in a lot of adults.
posted by discopolo at 4:57 PM on December 14, 2013

I am suddenly very tired of these articles that question the
disability and the use of medications to assist with it.

You should maybe read the article. That's not what it's about. It's about questionable marketing practices and the fact that drug companies are downplaying the risks of amphetamines in order to peddle more hard drugs to people who probably don't need them.
posted by dortmunder at 5:01 PM on December 14, 2013 [5 favorites]

After years of coping with ADHD via adrenaline and novelty and various other coping mechanisms (and failing at times), I decided that in my 40s I was getting too old for that shit, and got a prescription. I've now been at my current company for over three years, which is in fact a record for my adult life. I'm sure it's abused by some people, but I get pretty bored with it's all an EEEEEVIL plot by Big Pharma.
posted by tavella at 5:04 PM on December 14, 2013 [4 favorites]

If you're inclined to believe the conspiracy that Big Pharma is calling the shots the medical world, this article will push all the right buttons.

But the bottom line in the article seems to be that the evils are proven by the fact that pharmaceutical companies have the gall to actually sell their products. There's some handwaving about over diagnosing ADHD, but it doesn't really come out and say that is actually the case. And that yes, these stimulants can be abused. Which seems like a weak angle to plug, as there are many prescription drugs that can be abused. Which is why they're prescription drugs.
posted by 2N2222 at 5:07 PM on December 14, 2013 [2 favorites]

I absolutely believe I have ADHD (and have been diagnosed with it) but none of the commercial medicines available seem to help me without intolerable side effects, so I have mixed feelings on this.
posted by saulgoodman at 5:20 PM on December 14, 2013

For all the article hints at stimulant abuse and under warned dangers... It never actually describes any dangers of long term stimulant usage with an ADHD diagnosis. Plenty of other drugs are designed to be taken over the course of a lifetime, if stimulants are somehow different or there are known long term dangers - they should actually describe them rather than just hint that "people stay on these drugs without knowing the risks!"

A lot of blather about how no one talks about the risks or side effects only to never mention a risk or a side effect.
posted by sonika at 5:21 PM on December 14, 2013

Buzzfeed: 25 Things Only People With ADHD understand
posted by humanfont at 5:21 PM on December 14, 2013 [1 favorite]

Honestly this is one of the problems I have with turning everything into a moral issue and a statement of character. Like imagine if we thought using antibiotics was a crutch and a plot by Big Pharma so people stumbled around with infections and oozing wounds because ANTIBIOTICS ARE A CONSPIRACY YOU'VE GOT TO TOUGHEN UP AND GET THROUGH IT.

I mean it's possible that while maybe overused these drugs do genuinely benefit an enormous number of people and make it possible to function within the bounds of our society but that's crazytalk.
posted by Ghostride The Whip at 5:21 PM on December 14, 2013 [2 favorites]

Laser-guided articles posted on MetaFilter like this are designed to stir up controversy. You can't talk about "overprescription" of medicine in general or the insidious effect effect of "profit making" when it comes to the r&d of different categories of more important (yeah i said it) medication like antibiotics --- without offending someone's child. I don't know what the deal is with the NYT but they seem to like to publish the same type of article over and over again, which seems designed to ruffle feathers rather than get us anywhere in terms of public debate.
posted by phaedon at 5:34 PM on December 14, 2013

It is possible for a given class of drugs to be absolutely efficacious and beneficial for some people AND for the companies that make those drugs to possibly overstep in their marketing leading to the drugs being prescribed to other people who don't need them.

The way that the pharma market is set up, drug companies absolutely have incentives to invest lots of money to find good, effective treatments. But once those good, effective treatments are found and proven, those same drug companies have incentives to convince as many people (and their doctors) as possible the patient is part of the group that will be better off with the drug than without.

This is why we have regulation (which I think for pharma/med devices works pretty well, most of the time).
posted by sparklemotion at 5:36 PM on December 14, 2013 [5 favorites]

I am so sick of seeing this nonsense show up every few months on the blue. We wouldn't tolerate posts suggesting that homosexuality or being transgendered were just made up. I doubt posts spouting anti-vax nonsense would linger on the fpp. Yet those us with ADHD have to endure this shit over and over again. Adderall fixed in days what years of beating and berating did nothing to help. These fpps are like getting beaten up again. In conclusion fuck you.
posted by humanfont at 5:39 PM on December 14, 2013 [2 favorites]

We just had this conversation in mid October; do we really need to have it again?
posted by mygothlaundry at 5:40 PM on December 14, 2013 [2 favorites]

But the bottom line in the article seems to be that the evils are provenby the fact that pharmaceutical companies have the gall to actually sell their products.

Until relatively recently, it was illegal for pharmaceutical companies to market to the public. Of course, I can't prove that their modern blitzkrieg of marketing has any effect on what drugs get made our how much they cost, my marketing degree tells me otherwise. Profit motive and health care make extremely uncomfortable bedfellows, in my book.
posted by Benny Andajetz at 5:41 PM on December 14, 2013 [1 favorite]

As someone with a shiny new ADHD diagnosis, a very small dose of stimulants has pretty dramatically turned my life around in a period of 2 months or so. So, I can't think of much I give less of a shit about, than whether someone thinks I'm "cheating" or something.

People really need to understand that stimulants don't give ADHD people superhuman focus, they give them normal focus, the kind of focus most people take for granted. I wasn't able to focus on anything - even the things I enjoyed. I'd get distracted during sex, when watching movies, when reading a book, when riding my bike. It's not that I wasn't able to focus on work and drudgery, it's that I couldn't focus on anything at all.

So, basically, fuck everyone and their ignorant opinions; I need to get back to studying.
posted by downing street memo at 5:42 PM on December 14, 2013

I'm sympathetic to ADHD. I'm sure that many lives are made better by these medications. I'm also aware that speed helps just about everyone focus better.

I'm not trying to pick a fight or denigrate anyone; I just lived through the era when Dexedrine was free for the asking at the university clinic.
posted by Benny Andajetz at 5:47 PM on December 14, 2013

I'd go with Sparklemotion on this one. I don't highly doubt the statistics of prevalence; something that comes to mind was all the people who came out of the woodwork when the first Tourette's foundation was put together. They didn't just suddenly come into existence; it was just that there was no firm category to link them together. This category has come together well for ADHD now, and people are going to think about it.

At the same time, pharmaceutical companies are renowned for this sort of thing, focus is a perennial issue, and their overstepping advertising bounds doesn't seem unlikely either. It'd be easy to hit both appropriate and inappropriate diagnoses.
posted by solarion at 5:50 PM on December 14, 2013 [1 favorite]

It's so strange to me that the question is always "Are psych meds overprescribed or underprescribed?" Because the truth is, it's both at once. There are a ton of people with serious psychiatric problems who aren't getting the meds they need, and there are a ton of people who are taking meds unnecessarily.

There's a tremendous amount of demographic variation, too, and much of it is race- and class-linked.

I used to look around at my friends and say "This overprescription talk is bullshit. Everyone I know on psych meds was seriously suffering before they got their prescription. None of those people are pawns of the pharmaceutical industry. If anything, a lot of them put off getting care for too long because they were scared of being manipulated by the industry."

But then I started to learn that there are populations where this stuff is clearly massively overprescribed, and where the perverse incentives leading to that overprescription are strikingly obvious. When a state passes a law penalizing schools for low test scores, their rate of ADHD diagnosis goes up dramatically. Psychiatric disorders of all kinds are prescribed at higher rates among foster kids than among non-foster kids, even when you control for other relevant variables. So there's all these kids at failing schools and/or in foster care who are getting psychiatric diagnoses foisted off on them for pretty blatantly cynical reasons — not even to give the kids themselves an unfair advantage, but just to make their test scores reflect better on their school, or to help their parents get extra resources out of the foster care system.

(And at the other end of the spectrum, poor and minority adults are getting far too little psychiatric care — because they're underinsured, because they don't have family or community support and managing a psych diagnosis is hard, or just because doctors treat them like drug-seeking criminals when they try to get help.)

Okay, fine, so things are already horribly skewed in a way that most articles like this don't recognize. So then the question of advertising comes up — and the fact is, that has a disproportionate effect on poor and underprivileged people too. Look: I'm safe from the pernicious effects of advertising. I know how to read the introduction and conclusion to an article in a medical journal if I have to; and if I don't feel like bothering, I've been taught to assess the reliability of pop-science-type sources, so I can read those without falling for marketing bullshit. I can afford to see a psychiatrist with a stellar reputation even though he doesn't take Medicare. I can afford to see a really great therapist too, even though she doesn't take any insurance at all, and that serves as a reality check on my psych diagnoses. I can advocate for myself with my psychiatrist — and when I do he thinks "Hey, she knows what she's talking about, maybe I'll consider her suggestion" rather than "Oh god, she's probably some sort of drug-seeking criminal, I should refuse to treat her." I can afford brand-name medication. There are dozens of factors that lead me to get good, evidence based medical care, when other people really are stuck taking the first med that pops into their overworked GP's mind, or the thing he's got extras of in the back of the sample cabinet.

So of course I'm not taking my meds just because of an ad campaign, or a shitty provision in No Child Left Behind, or a dreadful loophole in the foster care regulations. But a lot of other people sure are. And talking about this stuff without talking about that difference, and the economic and social and legal forces that lead to it, is utter bullshit.
posted by Now there are two. There are two _______. at 5:50 PM on December 14, 2013 [4 favorites]