Monday, December 16th, 2013
The rising number of diagnoses with attention deficit hyperactivity disorder (ADHD), particularly among kids, has been paired, logically, with a sharp rise in the number of prescription drugs distributed to treat the condition. But some medical experts, even longtime advocates for better diagnostic tools and more aggressive treatment, are questioning whether drug companies have played fair with their marketing tactics. More from NBC News:
The rise of A.D.H.D. diagnoses and prescriptions for stimulants over the years coincided with a remarkably successful two-decade campaign by pharmaceutical companies to publicize the syndrome and promote the pills to doctors, educators and parents. With the children’s market booming, the industry is now employing similar marketing techniques as it focuses on adult A.D.H.D., which could become even more profitable.
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.
A 2002 ad for Adderall showed a mother playing with her son and saying, “Thanks for taking out the garbage.”
The Food and Drug Administration has cited every major A.D.H.D. drug — stimulants like Adderall, Concerta, Focalin and Vyvanse, and nonstimulants like Intuniv and Strattera — for false and misleading advertising since 2000, some multiple times.
Sources of information that would seem neutral also delivered messages from the pharmaceutical industry. Doctors paid by drug companies have published research and delivered presentations that encourage physicians to make diagnoses more often that discredit growing concerns about overdiagnosis.
Many doctors have portrayed the medications as benign — “safer than aspirin,” some say — even though they can have significant side effects and are regulated in the same class as morphine and oxycodone because of their potential for abuse and addiction. Patient advocacy groups tried to get the government to loosen regulation of stimulants while having sizable portions of their operating budgets covered by pharmaceutical interests.
Image: Prescription pills, via Shutterstock
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Friday, October 11th, 2013
The overuse–and, in the case of using it to treat the common cold, the improper use–of antibiotic drugs is a problem in most of the developed world. Health experts in the U.S. and overseas worry that over-prescription is resulting in a growing number of antibiotic-resistant strains of bacterial illnesses. To combat the problem and raise awareness, researchers in England are experimenting with having children share the message “Take care, not antibiotics” with each other. More from Reuters:
Starting in January, 13-year-olds at the eighth-grade level in England’s schools will be teaching peers and younger kids about microbes, proper hygiene and why antibiotic overuse is a bad thing. Researchers hope to implement a nation-wide program in September 2014.
“The idea is that the kids will go back home and tell their parents what they’ve learned,” said lead researcher Donna Lecky of Public Health England in the United Kingdom.
To counter a worrisome increase in antibiotic-resistant diseases, the European Centre for Disease Prevention and Control (ECDC) in 2008 designated November 18 as European Antibiotic Awareness Day.
In 2010, 24 European Union states, plus Norway and Iceland, reported their most recent antibiotics use to the ECDC. Overall, numbers of antibiotic doses decreased or stabilized in 15 countries and increased in 11 since the last survey in 2009.
The same report stated that the most commonly prescribed antibiotics in community health clinics, not including hospitals, were drugs in the penicillin family, another category known as macrolides and tetracyclines.
Image: Child with a cold, via Shutterstock
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Tuesday, June 4th, 2013
As more and more American adults take medications for conditions ranging from diabetes to depression to high blood pressure, medical experts are seeing a rise in the number of children who are becoming poisoned by ingesting those medications, usually by accident but occasionally on purpose. NBC News has more:
“We felt like we were seeing so many children with poisonings related to prescription drugs,” says Burghardt, an emergency room doctor at Boston Children’s Hospital. Other studies had shown a 36 percent increase between 2001 and 2008 in the number of kids hospitalized after taking prescription drugs meant for someone else.
The team used statistics from the National Poison Data System, and compared them to data on prescriptions written for adults using the National Ambulatory Medical Care Surveys for 2000 through 2009.
“Increasing rates of adult drug prescriptions are strongly associated with increases in drug exposures and poisonings among children and appear to be a direct cause of exposures and poisonings,” they wrote in a report published in the journal Pediatrics.
Over that time, 38,485 children took diabetes drugs that lower blood sugar; 39,693 took cholesterol-lowering medications; 49,075 took blood pressure drugs called beta-blockers, which slow heart rate, and 62,416 took opioid painkillers. Kids 5 and younger were by far the most likely to be poisoned, but 2,330 teens were treated for opioid poisoning, and they very likely took the drugs on purpose, Burghardt says.
Burghardt’s team only looked at those four drug classes, as they were the most commonly involved in poisonings.
Image: Prescription pill bottles, via Shutterstock
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Friday, May 31st, 2013
Stimulant medications that are prescribed for attention deficit hyperactivity disorder (ADHD) are not predictors of later drug abuse by children, a new report based on more than 20 years of previous research has found. The news will come as a relief to parents who might have concerns about their pediatricians’ ADHD treatment plan. The New York Times has more:
The paper, written by three researchers at the University of California, Los Angeles, examined data from 15 previous studies on the subject and determined that, on average, medications like Adderall and Ritalin had no effect one way or the other on whether children abused alcohol, marijuana, nicotine or cocaine later in life.
A 2003 study in the journal Pediatrics had concluded that the introduction of stimulant medication to children with A.D.H.D. reduced the risk of such abuse later in life, a finding that has been repeated by doctors and pharmaceutical companies not only to assuage parents’ fears of medication but also to suggest that the pills would protect their children from later harm.
“I always doubted the whole ‘protection’ argument, and I wasn’t the only one, but that message was really out there,” said Liz Jorgensen, an adolescent addiction specialist at Insight Counseling in Ridgefield, Conn. “Hopefully, this message will be heard loud and clear.”
The study comes amid growing concern about the persistent rise in A.D.H.D. diagnoses and prescriptions for medication among children. A recent New York Times analysis of data collected by the Centers for Disease Control and Prevention found that 11 percent of all children ages 4 through 17 — 6.4 million over all — had received a diagnosis of A.D.H.D. from a medical professional. The diagnosis rate rose to 19 percent for boys of high school age.
Stimulant medication is by far the most prevalent treatment for childhood A.D.H.D., with the vast majority of children at least trying medication and about 60 percent of them staying on it long term. Stimulants can drastically improve the lives of children with severe A.D.H.D. but are also increasingly abused by high school and college students for their jolts of focus toward schoolwork.
Side effects can include appetite and growth suppression, sleep disturbance and occasionally psychosis, especially when the stimulants are abused.
The paper released Wednesday in the journal JAMA Psychiatry analyzed data from studies conducted from 1980 to 2012, and included more than 2,500 children with A.D.H.D. from the United States, Canada and Germany. They were followed from an average age of 8 into young adulthood.
Image: Prescription medications, via Shutterstock
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Thursday, April 25th, 2013
Pregnant women who use an anti-epilepsy drug called valproate have babies that are 5 times more likely to be diagnosed with an autism spectrum disorder (ASD), according to a new study published in the April 24 issue of the Journal of the American Medical Association. More from CBS News:
“This is an important risk factor and one that can be avoided or at least the risk reduced in women who don’t need to take this and can take another drug,” Dr. Kimford Meador, a professor of neurology at Emory University in Atlanta, said to Businessweek. Meador wrote an accompanying editorial published in the same journal issue. “This is the strongest evidence to date that there is a link between fetal exposure and childhood autism or autism spectrum disorder.”
The Centers for Disease Control and Prevention now estimates that 1 in 50 school age children may have an autism spectrum disorder (ASD). ASDs are a group of developmental brain disorders that affect social, communication and behavioral development. The disorders can range in severity from people with milder symptoms — called Asperger syndrome — to those with autistic disorder or “classic” autism.
Researchers looked at 665,615 babies born in Denmark between 1996 and 2006. The children were followed for an average of 8.8 years. Out of the group, 5,437 were diagnosed with an autism spectrum disorder, and 2,067 were diagnosed with childhood autism specifically.
The researchers found that mothers of 2,644 children took anti-epileptic drugs during pregnancy, with 508 specifically taking valproate. They determined that valproate was linked to an absolute risk of 4.42 percent for an ASD and 2.5 percent for childhood autism.
For women who had epilepsy who did not take valproate, the absolute risk of having a child with an ASD was 2.44 percent, with 1.2 percent receiving a diagnosis of childhood autism.
In January 2013, a British study of 415 children also linked autism to mothers taking valproate. Those results were published in the Journal of Neurology, Neurosurgery & Psychiatry.
“Women for whom valproate is a treatment option should discuss the risks and benefits of this drug with their doctor prior to pregnancy, to ensure that their health and that of the potential child is optimized,” Rebecca Bromley, a clinical psychologist and research associate at the University of Liverpool who led the British study, told HealthDay.
Image: Pregnant woman, via Shutterstock
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