A just-published study in the American Journal of Psychiatry has found that the prescribed use of stimulant medications to treat Attention Deficit Hyperactivity Disorder (ADHD) has increased at a steady rate from 1996 to 2008. While prescription use was the highest among 6-12-year-olds (rising from 4.2 percent in 1996 to 5.1 percent in 2008) prescription use grew the most among 13-18-year-olds, going from 2.3 percent in 1996 to 4.9 percent in 2008.
Benedetto Vitiello, M.D., of the National Institute of Mental Health (NIMH), comments that “This continuous increase among teens likely reflects a recent realization that ADHD often persists as children age. They do not always grow out of their symptoms” — that ADHD is not only a disorder of childhood, but one that can persist into adulthood and be lifelong (as my husband Jim Fisher a professor of American studies and theology, will tell you).
While ADHD is often treated with stimulants such as methylphenidate (e.g., Ritalin), amphetamines (e.g., Adderall) or other types of medications, its symptoms — difficulty focusing and controlling behavior, impulsivity and hyperactivity — can also be addressed through behavioral and others therapies. September is National ADHD Awareness Month; thanks to more awareness and understanding, students diagnosed with ADHD are seen as having difficulties learning and needing accommodations in school, rather than (as my husband was told in the 1970s) that they have “minimal brain damage.”
From 1987 to 1997, stimulant prescription use among children rose from 0.6 percent to 2.7 percent. The new study drew on data from the Health Resources and Services Administration’s National Survey of Children’s Health, which found that the percentage of children age 4-17 years diagnosed with ADHD rose from 7.8 percent in 2003 to 9.5 percent in 2007 to nearly 10 percent of children. Dr. Vitiello and Samuel Zuvekas Ph.D., of the Agency for Healthcare Research and Quality, looked at data from the Medical Expenditure Panel Survey, a nationally representative annual survey of U.S. households, to determine rates of stimulant use in children under 19 from 1996 – 2008. Here’s what they found:
Overall, prescription use among 6-12-year-olds was highest, going from 4.2 percent in 1996 to 5.1 percent in 2008. But the fastest growth of prescribed use occurred among 13-18-year-olds, going from 2.3 percent in 1996 to 4.9 percent in 2008.
Stimulant use remained very low among preschoolers, at 0.1 percent from 2004 onward; the rate actually decreased between 2002 and 2008suggesting that many still hesitate to use medications to treat ADHD in such young children.
The study also found that boys are prescribed stimulants three times as much as girls and that white children use the medications at higher rates than black or Latino/a children (4.4 percent in 2008 among whites, compared to 2.9 percent in blacks and 2.1 percent in Latino/as). Use of stimulants among racial and ethnic minorities is, though, on the rise, a figure that suggests that there is “more recognition of ADHD and acceptance of psychopharmacological treatment among these groups.”
I’ve become very aware of the challenges of living with ADHD in seeing my husband’s struggles. Despite this, he’s managed to write a number of books and much more. Even more, his ADHD has given him an intuitive connection to our severely autistic 14-year-old son Charlie. Exercise — long bike rides in particular — has become a key sort of “therapy” for both of them. Jim has always been one to choose walking up flights of stairs over taking the elevator; he finds that going for long walks helps “clear up” his thinking.
Dr. Vitiello, while noting that stimulant medications do work well to control the symptoms of ADHD, emphasizes they are only “one method of treatment for the condition.” Especially if ADHD is viewed as a condition that can and does persist past childhood and even into adulthood, we need to think of other ways to address its challenges other than medication.
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