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Misdiagnosis of ADHD Can Be Fatal

by sjbit (follow)
The U.S. Department of Health and Human Services declared an opioid epidemic – OxyContin, Vicodin, fentanyl, heroin – but as bad as the problem is, it’s not the only danger out there. For young people, stimulants – often prescribed for attention deficit hyperactivity disorder (ADHD) or taken as a study aid by students – also are a problem.

“Prescription amphetamines and other stimulants used without medical direction have constituted the second most widely used class of illicit drugs used by teens,” according to the latest Monitoring the Future study.

The most commonly prescribed and abused of these drugs are amphetamines/dextroamphetamines – Adderall, Dexedrine – and methylphenidates – Ritalin or, in extended release form, Concerta. Overdose symptoms include confusion, hallucinations, vomiting, agitation, tremors, muscle twitching, seizure (convulsions), blurred vision, confusion, hallucinations, fainting, sweating and a quickened heartbeat.

According to the Drug Enforcement Administration’s Drug Abuse Warning Network, “In 2004, just two ADHD drugs played a role in 10,800 cases of emergency department visits. By 2011, the figure for those two drugs jumped to 42,000, a nearly fourfold increase in less than a decade.”

Why the increase? Well, on an episode of South Park, it was a ploy by local doctors and pharmacists to drive up the value of their shares in an ADHD drug company. (Children who were bored and couldn’t answer trivial questions about The Great Gatsby after an adult read it to them were diagnosed with ADHD.) Alan Schwarz makes a similar but serious claim in his recent book, ADHD Nation: Children, Doctors, Big Pharma, and the Making of an American Epidemic.

On the other hand, diagnosing ADHD is difficult and takes time. There are two main types of ADHD – inattentive and hyperactive, plus a combination of the two – and the American Psychological Association’s latest Diagnostic and Statistical Manual of Mental Disorders (DSM-V) lists nine potential symptoms for each. At least six are supposed to be required for an official ADHD diagnosis. For the sake of a quiet life, doctors and parents may choose to err on the side of medication.

The good news is “Their use has fallen considerably, however. In 2016, 3.5 percent, 6.1 percent and 6.7 percent of 8th, 10th and 12th, respectively, say they have used any in the prior 12 months—down from recent peak levels of 9 percent, 12 percent and 11 percent, respectively, reached during the last half of the 1990s.”

That’s little comfort if your children are among the misdiagnosed. While “Researchers at Princeton University found children and teens with ADHD who received medication were 7.3 percent less likely to have a substance use disorder” than those with ADHD who didn’t receive medication, a University of Michigan study found that those who took medication when they didn’t have ADHD were more likely to develop a substance use disorder. This includes taking someone else’s prescription.

The studies don’t specify which substance, but even if it’s the same ADHD drugs, Adderall or Concerta overdose symptoms can be severe, even fatal, especially if you have glaucoma, high blood pressure, heart problems or a history of “sudden death” in your family.

Even when they do have ADHD, those who use Ritalin or Concerta “may have lower bone density than their peers who do not take these medications,” according to an Endocrine Society study. That doesn’t mean they can’t take stimulants, but they should have their bone health monitored during and after. A proper ADHD diagnosis takes time and can be difficult, but it’s vital.

BIO: Stephen Bitsoli writes about addiction and related matters. A journalist for more than 20 years, and a lifelong avid reader, Stephen loves learning and sharing what he’s learned.
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