America’s ADHD Crisis Made Worse by Telehealth

America is facing a deficit of ADHD medications due to overdiagnosis of the condition. It’s important to note that not all mental health disorders should be treated with pharmacological drugs. Painkiller addiction help and suboxone program can provide assistance to individuals struggling with addiction. These programs can be especially important given the ongoing opioid epidemic in the US. Mental health diagnoses can be difficult, especially for milder cases such as excessive stress, fear, or worries. This highlights the need for increased mental health awareness and support. Unlike physical ailments, where the diagnosis is often made based on lab report confirmation, mental ailments diagnosis is based on a doctor’s assessment. That is why in recent years subject of the medicalization of human emotions has also been raised. Many health experts fear overdiagnosing mental health issues is becoming a significant problem in the US. Unfortunately, this also means excessive use of pharmacological therapy to manage mental health disorders.


Moreover, if some conditions are diagnosed, it does not necessarily mean that they can or should always be treated with pharmacological drugs. Unfortunately, however, it appears that Americans are obsessed with pharmacological drugs, so much so that it is causing a shortage of some medications like Adderall and amphetamines for ADHD treatment. When it comes to ADHD (attention deficit hyperactivity disorder), there are significant concerns regarding overdiagnosis. The US has already emerged as the world capital of ADHD. CDC data suggests that there are more than 6 million children in the US living with the condition, and almost close to 80% of them receive drug therapy. Yes, these numbers are massive, especially considering that drugs have limited benefits in managing the condition.


Researchers say there is an urgent need to understand the cause of overdiagnosis in the US. The condition has become so severe that it is even causing a shortage of drugs to treat it. Many healthcare experts believe that this may be due to poorly defined ADHD diagnostic criteria in the US. For example, European diagnostic criteria for the condition are far more stringent. As a result, a child may show many more symptoms than in the US to be diagnosed with ADHD. Thus, any child is much more likely to be diagnosed with the conditions in the US.


The final result of this has been a continuous rise in the prescription of drugs like Adderall. It is the most commonly prescribed drug to treat ADHD, and its prescriptions have risen almost twice in the last ten years. The prescriptions have gone up so fast that it has even created drug shortages. However, there is one more worrisome trend, and that is the emergence of telehealth. Studies show that the rise of telehealth services has considerably fueled this growth in Adderall prescription. In addition, pandemic-era changes in the regulations have only increased the prescription of controlled substances like amphetamines, which is also the main ingredient in Adderall.


The debate regarding the misuse of overprescription of stimulants like Adderall to treat ADHD in the US is quite old. However, here again, experts say that the US approach to prescribing stimulants is quite different from European nations. In European countries, stimulants are regarded as a last resort, while in the US, these drugs are accepted as a first-line treatment or treatment of choice. Proponents of using stimulants for managing ADHD say that these medications have proven safety records. In addition, they do not cause dependence and are not addictive. However, opponents of this approach say that getting a prescription for ADHD is too easy, and thus it can be used as a loophole to access stimulants, resulting in their abuse. It appears that certain legal changes have fueled Adderall prescription in the pandemic era. Earlier, one could not get an Adderall prescription through telemedicine platforms. However, the US government has allowed the remote prescription of such controlled substances due to the pandemic. Of course, there are other reasons too for the shortage of these drugs. For example, some manufacturers have to reduce the production of these drugs on instruction by the US government.


By Gurpreet Singh Padda, MD, MBA, MHP

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