8 Ways to Respond to Student ADHD Drug Abuse

Training about misuse of prescriptions and revised policies regarding diagnosis, treatment and drug diversion can help to address this issue.

High Rates of Childhood ADHD Forecast the Abuse

Many children and adults have used these drugs without abusing them or becoming physically addicted to them. However, the more a drug is prescribed, the more it will be diverted for abuse. Predictably, the ever-rising rates of ADHD diagnosis forecast the current ADHD drug abuse epidemic.

During the 1990s there was a 700% increase in the rate of ADHD diagnoses among school-age children. The children diagnosed in the 1990s have been growing up and showing up on college campuses with their ADHD medications in hand.

According to the latest figures from the Centers for Disease Control and Prevention (CDC), one in every 10 American children over the age of three has been diagnosed with ADHD. Before turning 18, nearly 14% will have been diagnosed. Most will be medicated for the condition.

Although ADHD drug abuse is a national epidemic, the magnitude of the problem varies across geographic regions of the country. At the state level, ADHD identification varies from a low of 5.6% in Nevada to a high of 15.6% in North Carolina. Within-state rates of ADHD diagnosis are even greater than between state differences.

Regardless of region, boys and white children have consistently been at least twice as likely as their peers to be diagnosed with ADHD. This means that up to 30% of American white boys in this country could be diagnosed with ADHD by the time they are 18.

The Diagnostic and Statistical Manual (DSM) is the definitive source for separating the sick from the well. However, over the past few years it has become public knowledge that the DSM (the psychiatric “bible”) promotes over-identification of ADHD.

As preposterous as it may seem to think about one out of every three white boys being diagnosed with ADHD, we already know this to be true in some communities.  As early as a decade ago, research had documented that ADHD had been diagnosed in 33% of white boys attending public elementary schools in southeastern Virginia. At the time, the Drug Enforcement Administration recognized the region as one of many identified “ADHD hot spots.” Colleges and universities that are located in “ADHD hot spots” may face the greatest levels of ADHD drug abuse.

Campus Clinician
s Face Diagnostic Conundrum

It is important to recognize that college clinicians (like all other clinicians) who diagnose ADHD are left to practice in the absence of sufficiently helpful clinical guidance. The Diagnostic and Statistical Manual (DSM) is the definitive source for separating the sick from the well. However, over the past few years it has become public knowledge that the DSM (the psychiatric “bible”) promotes over-identification of ADHD.

As detailed in popular books like Saving Normal (by a former head of the DSM Task Force) or The Book of Woe (by a therapist, journalist and DSM-insider),  the edition that was in use from 1994 to 2012 (DSM-IV) inflated the rate of ADHD by as much as 28%. The current version (DSM-5) is expected to make matters worse, so school administrators and safety officers will continue to be challenged to respond strategically to the fallout from the medicalization of what may be normal behavioral and academic challenges.

Schools Unwittingly Promoting Overuse of ADHD Drugs

Once the diagnosis of ADHD provided access to special education and other educational accommodations under the Individuals with Disabilities Act (IDEA legislation), pharmaceutical companies began providing K-12 school districts with free ADHD “educational” pamphlets to share with school personnel and parents. These pamphlets typically include scientifically unfounded or questionable statements that promote overuse of drug therapy. As more K-12 schools have ceased to distribute these pharmaceutical marketing materials, the industry has increased its effort to encourage ADHD diagnosis and drug treatment on college campuses.

College-based marketing efforts include the movie called ADD and Loving It – a movie produced and/or promoted by the leading industry-funded ADHD advocacy group called Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).

As described in The New York Times story about Richard Fee, Tidewater Community College hosted a free airing of ADD and Loving It, which included a follow-up discussion by a psychologist from the community. During the facilitated discussion, the Virginia Beach psychologist told the audience that there wasn’t much reason to be concerned about people using ADHD medications who do not actually have the disorder. Unbeknownst to the psychologist at the time, a New York Times reporter taped recorded his comments. The psychologist is on the national board of CHADD and Chair of its Public Policy Committee.

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