December 14th, 2011 by Dr. Val Jones in Expert Interviews, Health Policy, Research
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It is estimated that as many as 10 million U.S. adults have ADHD (Attention-Deficit/Hyperactivity Disorder). A recent research study (publication-pending) suggests that the economic burden of ADHD on America could be as high as $250 billion annually. I attended a recent briefing on Capitol Hill and interviewed one of the study’s co-authors: Tufts economist, Dr. Peter Neumann as well as congressman (and psychologist) Tim Murphy about ADHD in America.
I learned from Dr. Neumann that cost these high cost estimates are most strongly influenced by reduced productivity in adult workers with ADHD rather than direct costs of treating children with the disorder. Productivity costs include absenteeism, and reduced work output due to difficulty focusing. Dr. Neumann explained that ADHD has many “spill over effects” in that it impacts the educational system, the justice system, the healthcare system, and our work environments. Please check out our interview video for the full story.
Congressman Tim Murphy is a clinical psychologist with three decades of experience in treating people with ADHD. He is also Co-chair of the Mental Health Caucus and GOP Doctors Caucus where he regularly works to raise awareness of healthcare accessibility needs. I had the chance to interview him also at the event.
I learned from Rep. Murphy that the costs of ADHD multiply when patients are untreated. Getting the correct diagnosis is critical, because impulsivity and problems with focusing are not always caused by ADHD. These symptoms can be caused by lead poisoning, damage to the limbic system of the brain, metabolic disorders, or even sleep apnea. Children who are inattentive should not be put on medications for ADHD without first confirming the diagnosis by ruling out other possible causes.
Rep. Murphy recommends a team approach to the management and treatment of ADHD and he believes that costs related to ADHD are escalating because some physicians are not managing children holistically, but resorting to prescribing medications without involving counselors and family directly. He sees lack of health insurance coverage for behavioral health services as a threat to comprehensive and effective ADHD treatment.
Please watch the video for the full interview with congressman Murphy.
*Please note that the panel event, and Better Health’s participation, was made possible by a grant from Shire Pharmaceuticals.
December 8th, 2011 by SteveSimmonsMD in Expert Interviews, Opinion, Video
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Today, most- if not all- Doctor’s offices are strained by the shortage of some prescription medication or vaccine. A month ago, President Obama signed his executive order, directing the FDA to take steps to reduce drug shortages as the White House stated that drug shortages have nearly tripled over the past five years reaching the stunning number of 178 in 2010. These shortages make regular news: Cancer patients without the chemotherapy needed to keep them alive, antibiotics unavailable to treat life-threatening infections, or intravenous nutrition to support the critically ill fighting to live while medical teams and families search for elusive remedies.
As this new reality plays out in hospitals and homes the media is provided a steady stream of drama for our morning paper or evening news. Meanwhile, time and focus is repeatedly stolen from physicians, patients, and parents in a myriad of ways. Currently, my medical practice- in primary care Internal Medicine- has been negatively affected by the shortage of Adderall, a medication used to treat Attention Deficit Hyperactivity Disorder (ADHD). What this medical condition may lack in dramatic news-worthiness it more than makes up for in sheer numbers with an estimated 4.5 million Americans living with this condition today.
I had my first inkling several months ago of the affect the Adderall shortage would have on my practice after one of my patients called frustrated that their pharmacy did not have their Adderall at the prescribed dosage. By calling several pharmacies I was able to find their medication at a smaller dose. Advising my patient to “double-up” I wrote another prescription and had to direct my patient to return to my office to pick up the rewritten prescription- a time-consuming process that doctors and patients can ill afford to repeat on a regular basis.
Unfortunately, this scenario -initially thought an exception- has now become the rule monopolizing my own time while draining the daily resources of my staff, nurse, and medical partner. Most ironically though, Read more »
September 15th, 2010 by Dr. Val Jones in Announcements, Better Health Network, Celebrity Interviews, Expert Interviews, Medblogger Shout Outs
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Attention-deficit/hyperactivity disorder (ADHD) is probably overdiagnosed by physicians. In the lay public, the term is often used jokingly to describe the common feeling of distraction we experience in a world filled with interruptions. With a constant stream of text messages, Facebook updates, TV commercials, and fast-paced Twittering, there’s little wonder that we all feel frazzled at times.
But the occasional experience of jangled nerves is not a proper basis for a diagnosis of ADHD. Unfortunately, there has been great confusion between the actual disorder, and its misuse as a label for simply feeling distracted.
So to help set the record straight and to tease out fact from fiction, I’ll be attending a forum on Capitol Hill with my co-bloggers Dr. Kevin Pho and Dr. Rob Lamberts.
If you’re in the DC area, please come and join us in person. If you’d like to view some of the event via the Internet, we’ll be conducting live interviews with the speakers on Ustream. You can join the conversation by asking your questions in real time in the chat room starting at 2:00PM (EST) on Thursday, September 16, 2010. Please save the Ustream link to join the conversation: http://www.ustream.tv/channel/fact-or-fiction-adhd-in-america. Read more »
May 7th, 2009 by Jon LaPook, M.D. in Better Health Network, Video
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This week’s episode of CBS DOC DOT COM took me to a college campus where I got schooled by two students about the widespread use of ADHD (Attention Deficit Hyperactivity Disorder) meds – by kids without a diagnosis of the condition – to study, stay attentive, and sometimes just to feel good. A 2005 Web survey found that 5% of US undergraduates reported having used stimulants over the previous year for non-medical reasons. But the real number may be much higher, especially if you listen to the students I interviewed with Dr. William Fisher, a psychiatrist at Columbia University Medical Center.
Features of ADHD include inattention, hyperactivity, and impulsiveness. A national survey in 2003 reported that about 4.4 million children in the US have been diagnosed with ADHD and 56 percent take medication to treat it. It’s estimated that about one to two thirds of the children with ADHD continue to have symptoms in adult life.
ADHD medication was in the news last week with a report that medication use in elementary school children improved math and reading scores. The gains – equal to about a fifth of a school year in math and a third of a school year in reading – still left the treated children lagging behind kids without the disorder. The study fans an ongoing debate on who should receive medications such as Adderall and Ritalin. These medications – along with behavioral/psychological therapy and educational interventions – help patients with ADHD; but they’re also being used by students and adults who have not been diagnosed with the disorder.
These drugs have potentially serious side-effects such as high blood pressure, irregular heart beat, and dependency. Doctors prescribing them for patients with ADHD should be carefully weighing the risks and benefits. People taking them on their own are rolling the dice with their health. No matter what you may feel philosophically about using these stimulants, the risk-benefit of their use in patients without ADHD has simply not been established.
I feel strongly that ADHD medications should only be used under the guidance of a physician. But that’s apparently often not the case. In today’s segment, we explore this issue further. Why do people without ADHD take stimulants? How do they start? How does it make them feel? Is society’s metronome pulsing so much faster today that people feel pressured to take drugs just to keep up? Click here for a fascinating related article which appeared recently in The New Yorker.
Click here to see a video on this topic.
