Attention Deficit Disorder and the Drug Companies

The New York Times online has a long, vividly damning article about how the drug companies have sold Attention Deficit Disorder to doctors and patients with advertising that has drawn the censure of the Food and Drug Administration multiple times.  See the article at: http://www.nytimes.com/2013/12/15/health/the-selling-of-attention-deficit-disorder.html?nl=todaysheadlines&emc=edit_th_20131215&_r=0 

The story is an old one.  Attention Deficit Disorder (ADD) is a fairly common, difficult-to-diagnose mental disorder that affects many children and can persist through-out adulthood as well.  All the drugs currently available to treat ADD, except one, are also stimulants.  The most widely used is amphetamine, which is closely related to an illegal drug, methamphetamine; the only difference between the two, clinically, is that methamphetamine has a much longer duration of action.  Thus, ironically, the illegal drug is far more effective than the legal drug for the purpose.  Ritalin (methylphenidate) is also widely used and has similar side effects and risks, but it has a very short half life.  The only non-stimulant approved for use in ADD is a drug that is closely related to Prozac, that has similar effects and is not as popular.

The drug companies have exploited the fact that stimulants have a nonspecific activating effect in normal people that can improve concentration and mood; thus, people without ADD who are given the drugs notice a general improvement in their attitude even though they thought they were normal before.  Children (and adults) who are in competitive academic programs feel the need for stimulants to improve their ability to study, and doctors have been taught to fill that need with diagnoses.  The result of advertising and susceptibility is that the incidence of ADD has increased from about 3% to 15% and drug company profits on these drugs have increased from $1 billion a year to $9 billion a year.  There is a shortage of these drugs and the drug companies have been able to charge whatever the market will bear.

The answer to scandals of this nature is to increase the power of the Food and Drug Administration to control the drug companies, including their pricing strategies.  Advertising to consumers of prescription drugs must be stopped.  Payments by drug companies to practicing doctors must be stopped, particularly for giving lectures to fellow physicians.  Those who are appointed to the FDA must be committed civil servants.  Reforms that include control of drug company exploitation must be part of overall health care reform, which ultimately will include “health insurance for everyone” paid by progressive income taxes.  Only a truly dedicated, radical liberal politician can conceive, much less carry out, these reforms.