Tuesday, December 17, 2013

The Times reports

that the overbearing direct marketing of ADHD medications to neurotic parents and clueless doctors is the reason for the jump in ADHD diagnoses over the past 20 years. The Times also seems to think that ADHD drugmakers are the only ones guilty of such a thing, and no other drugs for any other malady, disorder or issue have ever been over-aggressively marketed to the public. Also, the Times thinks that the only parents or kids worth asking about the subject are the ones who disagreed with the diagnosis and hated the drugs in the first place.

But really, the Times says, it's a real disorder. Really, we believe that, we swear. Sort of.

The article I'm talking about is of course this one, from Sunday. I quote:

Few dispute that classic A.D.H.D., historically estimated to affect 5 percent of children, is a legitimate disability that impedes success at school, work and personal life. Medication often assuages the severe impulsiveness and inability to concentrate, allowing a person’s underlying drive and intelligence to emerge. 

But even some of the field’s longtime advocates say the zeal to find and treat every A.D.H.D. child has led to too many people with scant symptoms receiving the diagnosis and medication. The disorder is now the second most frequent long-term diagnosis made in children, narrowly trailing asthma, according to a New York Times analysis of C.D.C. data. 

Behind that growth has been drug company marketing that has stretched the image of classic A.D.H.D. to include relatively normal behavior like carelessness and impatience, and has often overstated the pills’ benefits. Advertising on television and in popular magazines like People and Good Housekeeping has cast common childhood forgetfulness and poor grades as grounds for medication that, among other benefits, can result in “schoolwork that matches his intelligence” and ease family tension. 

I can't really speak to the advertising, because I tend to ignore advertisements, except when I'm mocking them out of sheer exasperation (I'm looking at you, giant-bow-wearing Lexus one-percenter car ads). I didn't seek treatment for my kid because an ad told me he would get better grades. I sought treatment because it was the only way he was ever going to function in a group setting. Or possibly in any setting.
It's entirely possible ADHD is overdiagnosed. I guess it's possible some people would rather get their medical info from a magazine ad than from a doctor. It's also possible that certain doctors are diagnosing without the proper medical experience or knowledge and are using the medications as the first treatment option, not the last resort. Just saying. 

Believe me, I am in no way defending the drug companies and their massive marketing budgets. I don't much like that either. I also don't like all the other medication ads I see on a regular basis, in magazines or on TV. Judging from the ads during football games, football fans all have erectile dysfunction; judging from the ads in the magazines I read, all women interested in entertainment news are severely depressed. Also, all watchers of WE tv and Lifetime have weight issues, and all watchers of, well, anything have insomnia. 

I would be perfectly in favor of all drug ads going away; for one thing, they're insulting. For another, they're inaccurate. Of course they're inaccurate. They're selling something. Even cereal ads make misleading or false claims to make the sale. Medication, naturally, being of greater concern than Frosted Mini Wheats.

The Times again:

Companies even try to speak to youngsters directly. Shire — the longtime market leader, with several A.D.H.D. medications including Adderall — recently subsidized 50,000 copies of a comic book that tries to demystify the disorder and uses superheroes to tell children, “Medicines may make it easier to pay attention and control your behavior!”

Profits for the A.D.H.D. drug industry have soared. Sales of stimulant medication in 2012 were nearly $9 billion, more than five times the $1.7 billion a decade before, according to the data company IMS Health. 

Yeah, I've got a bunch of books that try to "demystify the disorder." "Shelley the Hyperactive Turtle." "Cory Stories." "Eddie Enough." Pretty good books. In all of them, the main character, at some point, begins taking medication. I don't love that, if only because people can and do manage without it. But all the kids I know with ADHD take something or other, because they needed to, or because their parents tried every other option first and decided this had to be the next step. Like us. So honestly, if that's in the books, so be it. Those books don't appear to have been subsidized by any drug companies, dear Times -- is that all right by you?
Believe me, if a kid has ADHD, they know they're different. They know they have trouble with things their friends can do with no problem. If the best way to explain to that kid what's going on is to use a book, or a comic book, is that really so objectionable?

When federal guidelines were loosened in the late 1990s to allow the marketing of controlled substances like stimulants directly to the public, pharmaceutical companies began targeting perhaps the most impressionable consumers of all: parents, specifically mothers.

Says you.

A.D.H.D. patient advocates often say that many parents resist having their child evaluated because of the stigma of mental illness and the perceived risks of medication. To combat this, groups have published lists of “Famous People With A.D.H.D.” to reassure parents of the good company their children could join with a diagnosis. One, in circulation since the mid-1990s and now posted on the psychcentral.com information portal beside two ads for Strattera, includes Thomas Edison, Abraham Lincoln, Galileo and Socrates.

The idea of unleashing children’s potential is attractive to teachers and school administrators, who can be lured by A.D.H.D. drugs’ ability to subdue some of their most rambunctious and underachieving students. Some have provided parents with pamphlets to explain the disorder and the promise of stimulants. 

(OK, seriously, Psychcentral, you can't diagnose someone a century or two after they're dead. You couldn't just go with Michael Phelps or Ty Pennington or Jeff Kinney? People who are still living?)

Also, teachers and school administrators should not be advising medication, because that is out of their area of expertise, and they could be courting legal trouble. It just figures the only parents the Times could find to talk to for this article are parents whose school officials acted inappropriately.

Insurance plans, increasingly reluctant to pay for specialists like psychiatrists, are leaving many A.D.H.D. evaluations to primary-care physicians with little to no training in the disorder. If those doctors choose to learn about the diagnostic process, they can turn to web-based continuing-education courses, programs often subsidized by drug companies. 

Soooo, maybe the answer is that insurance plans should provide coverage for psychiatrist visits? Oh wait, that doesn't come up again, because the point of the article is to rail against the drug companies. 

Look, I'm not necessarily saying the article is bad. It's just, if the only time you're going to write about ADHD is because college kids are abusing the drugs and dying, or because the drug companies have played hardball in selling their products, you're still implying the disorder isn't real. Especially if you don't talk to a single parent of an ADHDer, or adult ADHDer, who has good things to say about medication.

I'm all for enforcing truth in advertising, but can't we also have some actual truth?

1 comment:

  1. Girl, I would not wipe my ass with The Times. Just stop reading them.