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Do You Know Someone Taking Stimulants for ADHD?

The Netflix documentary Take Your Pills describes the use and overuse of stimulants on college campuses, professional playing fields and elsewhere in our society.
Young beautiful girl or woman take a pill or tablet with a glass of water near the window in white shirt and grey robe

Many of my fellow pharmacists have recently watched the popular Netflix documentary about Attention Deficit Hyperactivity Disorder drugs (stimulants) called Take Your Pills. I decided to see what the hype was about and watched it myself. I feel like it is very important and relevant in today’s world, and to many different demographics.

As a pharmacist, I have filled a lot of stimulant prescriptions for ADHD such as Adderall, Ritalin, Concerta, and Vyvanse (and their generics). Over the years, I have seen a shift to more and more young adults (as well as children) taking these medications, whereas in the past it was mostly children.

What Do People Say About Stimulants?

Take Your Pills opens with regular people talking about how they rely on their medications. “My mind came alive, my body felt alive.” “Side effects include being awesome at everything.” “Who takes Adderall? Half the kids in Palo Alto.”

College students tell us that they were advised by their parents to lock up their meds, and that almost everyone sells some of their medications. One college student explains that you want to be beautiful, skinny, and have amazing grades, and Adderall “sews it all up for you.” Another student shows viewers a public Facebook group where students buy and sell Adderall as if they were selling candy.

The documentary reports that America diagnoses more children with ADHD (11%) than any other country in the world.

ADHD is defined as “neurobehavioral condition that interferes with a person’s ability to pay attention and exercise age-appropriate inhibition.” (https://www.bbrfoundation.org/research/faq/frequently-asked-questions-about-attention-deficit-hyperactivity-disorder-adhd) This link provides a great resource to read more about the topic.

A Little History:

First studied in 1937, over the years Adderall increased in popularity, with such users as Andy Warhol, Jack Kerouac, and jazz singers. When soldiers in Vietnam became horribly addicted to stimulants, the Controlled Substances Act was created (https://www.dea.gov/druginfo/csa.shtml) which placed all regulated substances into one of five schedules, based on the substance’s medical use, potential for abuse, and safety or dependence liability.

Amphetamine (as well as other stimulants) was placed into Schedule 2, the most strictly regulated legal pharmaceutical class (https://www.dea.gov/druginfo/ds.shtml). Schedule 1 drugs have no currently accepted medical use and a high potential for abuse, such as heroin and LSD. Production of Adderall was also strictly limited – in 1969, 8 billion Adderall pills were produced, and by 1972, only 400 million were made.

Stimulants on the Playing Field:

When Eben Britton (former NFL player) developed a herniated disc, he worried that someone was always out there ready to take his job. When Britton reached his breaking point of exhaustion, a teammate gave him an Adderall and he felt alive and was able to react faster. Now, professional athletes must have documentation of their need for such medications, called a therapeutic use exemption (https://www.wada-ama.org/en/what-we-do/science-medical/therapeutic-use-exemptions).

Take Your Pills showed some eye-opening statistics on the prescribing of stimulants. In 1990, 600,000 children were taking stimulants, and by 2011 3.5 million were taking stimulants. One-third of children are diagnosed before age 6.

An interesting side note on the naming of the drug Ritalin is explained in the documentary – a scientist in Switzerland developed the drug to help his wife play tennis and keep her weight down. Her name was Rita, hence the name “Ritaline” – drug company Ciba later dropped the “e.”

How Much Do We Spend on Stimulants?

Stimulants are a $13 billion industry – the documentary explains that there are “big bucks” for doctors who file through patients quickly and give prescriptions. The United States is one of only two developed nations (New Zealand is the other) that allows for direct to consumer advertising of prescription drugs (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278148/).

The documentary suggests that with this direct to consumer advertising of drugs such as Adderall, parents feel more comfortable allowing their children to take these medications, as more and more parents are “seduced” by ads that promises better grades, etc.

Dr. Corey Hebert, “Physician for the People,” states that

“What you must do is make the correct diagnosis, do not over diagnose, and do not over medicate.”

If a child has ADHD, he says he does whatever it takes to help that patient, whether it involves therapy and/or medication.

What About Safety and Effectiveness?

Take Your Pills brings up safety risks – cardiovascular risks, risk of psychotic episodes even without a history, and risk of addiction which can bring a horrible fate.

There is an interesting study by Martha Farah at the University of Pennsylvania, which showed that there was no significant difference between Adderall and placebo in children without ADHD (https://www.thedailybeast.com/adderall-concentration-benefits-in-doubt-new-study). The only difference was a feeling of doing better, a feeling of having enhanced cognition.

Dr James Fadiman, a psychologist who has extensively researched psychedelics, speaks in the documentary of research that looks at micro doses of LSD (1/20th to 1/10th of a conventional dose) which produce zero psychedelic effects. Dr Fadiman speculates that this very low dose was under-researched, and if Sandoz had been more active in researching this, there would not have been a market for Ritalin.

Take Your Pills calls Adderall “the drug of our time.” Eben Britton, however, is happy to be on his next chapter and says, “it’s never so bad that you can’t climb out of the hole.” He credits meditation for helping with focus and clarity and is now writing about his experiences.

Parents speak out – they are hurting, they are crying. They are confused.

What Should Parents Do?

So, after watching this, what is one to do?

Let’s look at the side effects of one of these drugs, Adderall, directly from the package insert which is the prescribing information. (https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf) It starts off with a black box warning (the most serious kind of drug warning mandated by the FDA) about abuse, dependence, and that “MISUSE OF AMPHETAMINE MAY CAUSE SUDDEN DEATH AND SERIOUS CARDIOVASCULAR ADVERSE EVENTS.

The warnings section discusses risk of sudden death, strokes, heart attacks, even at usual doses. It also warns of psychotic episodes, possibility of aggression, and many other possible effects. It has a long list of drug interactions (another scary consideration where college kids are just taking these medications from their friends). In fact, I would recommend for anyone to thoroughly read this package insert.

When you talk to your kids about drugs, don’t forget to talk about stimulants. Make sure your children are familiar with the names of these medications, both brand and generic (there is a great chart here: http://www.emedexpert.com/lists/adhd.shtml). Just because they came out of a prescription bottle from a legitimate pharmacy for a legitimate patient does not mean they are safe or appropriate for someone else. It’s even against the law – these scheduled drugs are labeled “Caution: Federal law prohibits the transfer of this drug to any person other than the patient for whom it was prescribed” Look over the above package insert with them and point out the dangers. Knowledge is power, and students need to understand the dangers of sharing these medications.

Let Kids Be Themselves:

Try not to put excessive pressure on your children. Let them be who they are and do their best without feeling the need to resort to these drugs. Keep an open line of communication and talk about this often.

There are many people out there who are against these types of drugs altogether. As with many drugs, I think they have their place. And you can’t judge until you have walked in someone else’s shoes. If you think your child has ADHD, go to a doctor, and don’t be shy about getting a second opinion, especially when the conversation turns to medication. Despite all of the side effects that COULD occur, many children need these medications to function and with proper monitoring, most of these children do fine. I have personally spoken with many parents who have seen their child thrive from these medications, and under close monitoring, have not had any issues.

Giving your child a medication of this type is never a decision that is made lightly or easily, and risks versus benefits should always be weighed. When prescribed, these drugs are slowly increased to the lowest effective dose to minimize adverse effects.

Watching Take Your Pills was very eye-opening to me. There is so much focus lately on the opioid crisis that addiction to stimulants is often ignored, and this documentary was an important reminder.

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My neighbor has a young boy that is a holy terror and has been since a young age. Parents refuse to take him to a Dr. because someone told them “if parents were on DRUGS and they give their child meds for ADHD that child will turn to DRUGS as an adult” The mother would do anything not for that to happen.

I don’t know if this is a true statement or not, can’t find anything about it. I hate to see this child misbehaving and can’t keep up in school. He destroys everything he gets his hands on, lies so bad, mean to his sibling. Talks so loud you can’t stand it. But parent don’t think he has a problem. The list goes on and on.

As a retired teacher, I have seen the difference medication can make in a child with ADHD. I could tell when a child walked in the door first thing in the morning whether or not he (and it was usually a boy) had taken his medication. I also became aware of my own ADD when remembering school days when I did not pay attention in class and my grades suffered. I have found girls are more likely to have ADD and it is often overlooked as they are not disruptive.

They have difficulty understanding what was assigned and therefore difficulty beginning the assignment. Most experienced teachers know to be aware of this problem and discuss it with the the parents, as it will also be a problem at home. Medication should be considered for them as well.

My son had extreme ADHD as a preschooler, child and teen. He was very bright, which exacerbated the problem. He tested 12th. grade in Reading in first grade, 99th. percentile — so he was bored. He was rebellious and independent. He didn’t seek approval from anyone. Raising this kid was a nightmare. He did best when his teachers gave him short term goals and were consistent with discipline. Finally, at age 17, Ritalin was prescribed. He said, “My God! I can THINK. Mom, I can THINK for the first time in my life!” However, he only used it for 30 days. I asked him why he didn’t want to refill it and he said, “Do you know what one of these pills would sell for at school? I know I couldn’t resist the temptation. I don’t want to become a pusher, so no, I don’t want to refill it.” He began drinking a lot of black coffee and Mountain Dew. He’s a successful adult now, but his entire first 20 years was a continuous misery.

Haven’t seen the Netflix feature, but plan to watch it. I retired from a career in the pharmaceutical & biotech industries (research, teaching, clinical trials, health economics) and decided to take a “retirement job” in the world of retail pharmacy. What an eye opener. I was plunged into the abyss of patients taking too many drugs prescribed by too many practitioners and at too high a dose. Many of my patients are prescribed both uppers & downers together (ADHD drugs + benzodiazepines &/or narcotics). What kind of insanity is this??!!

The war on opioids should also be a war on these ill-used stimulants as well. Makes my “retirement job” one that should come with hazardous duty pay. Sign me “Disgruntled Clinical Pharmacist who put in a lot of years getting this education to get to this point of having to battle with patients about inappropriate therapy” Ridiculous.

Because our son was unable to stay focused in school, the school pressured us to get medical treatment for him. He was diagnosed with ADHD and the doctor prescribed Ritalin. He was started out on 5 mg and it worked for a while but then he stopped paying attention in school and his old symptoms returned so the doctor increased the Ritalin to 10 mg. That worked for a while and then we were back to where we started so the doctor increased it by 5 mg again.

That spiral continued until he was taking 25 mg. At that point, our dentist said our son had permanent gum damage and related it to the medication. That’s when we said, “This is not working!” We gradually took him off of it. We went through a horrendous adolescence with him that few people understand. He did not graduate from high school, but did take the GED and passed it the first time. He tried higher education but couldn’t stay focused. He used his skateboard and bicycle as transportation because he felt he wasn’t ready to drive until age 20.

Although he is in his 40s, he still uses his bicycle and skateboard. The good news is that he is still alive although several of his former friends are not. Like many with ADHD, he is extremely creative. He is a professional artist and works hard at it. From our experience, we learned that medication is not the answer. We tried the Feingold Diet for Hyperactive Children, but when he got to middle school, he stopped following it because, like most teenagers, he wanted to be like everyone else and eat what they ate.

If you research ADHD on the Web, you will find that ADHD occurs more frequently in males than in females. We noticed something was different about his behavior right from birth. One of the things we noticed was that, unlike most babies, he did not like to be held. He took two steps at 11 months and ran for the next 9 years.

It took us that long to get him to slow down and walk. We put him in a track club while he was still in elementary school so that he could work off some of his excess energy. While some studies include the low education level of parents as one of the contributing factors of his ADHD, that was not true for us since I had a bachelor’s degree and my husband had a master’s degree. I could write a book about this. Oh, wait; it looks like I just did!

My youngest child had a short attention spam (noticed for certain things, not for art). Today, he is a graphic designer. At the second grade, the school psychologist wanted me to tell his Dr. to place him under treatment. I decided no. The smartest thing I did in my life.

Anne in Wisconsin: Tell your daughter she needs to change doctors. Many adults have ADD and are helped by medication to live a more productive and satisfying life. I am 76 years old and was recently diagnosed with ADD. The medications have made a tremendous positive difference in my ability to concentrate–including a great improvement in my driving.

I’d like to hear more about adults in their 70’s who have ADD.

While I agree that advertising to the public of prescription drugs is a horrible idea and never should have been allowed, I can’t say I’ve seen a whole lot of advertising for drugs used for ADHD recently. Any doctor worth anything isn’t going to prescribe this stuff without a proper evaluation showing what specific symptoms of ADHD the person has.

My son couldn’t function without stimulents (which actually do the opposite in him), in a school setting. As an adult he no longer takes them, but they were necessary when he was young. He had every characteristic/symptom of ADHD and was literally overstimulated just walking into a Walmart. Abuse of a medication doesn’t mean it doesn’t have legitimate medical use.

I was 40 yrs. old when 1st diagnosed, my mother and I both cried because we now knew why I studied for mths. for the Realty Exam and then could not remember 1 answer. My friends were discussing what the 1st question was and I couldn’t remember the 1st question. I failed Physical Science in HS had to go to “summer school”, could not pass even algebra, anything w/several steps to it I had problems with. I know I would have had a successful life including marriage and maybe children.

I was scared to have children because I was scared I’d have one like I had heard myself described by others as a child and didn’t think I would be able to handle them. I don’t know how my poor mother did it. Medication for the 1st time felt like I had been blind and could now see clearly. I have a high IQ that’s why teachers and my parents did not understand me and I was punished constantly. I am writing a book.

My nephew, who is now in his 30s, has many long lasting problems from being on these drugs his entire life. He has tried desperately to get off of them and can’t.

There are some alternatives to drugs these days that teach kids how to focus by using brain training games and meditation. Neuroplus and Heartmath are two companies with promising products in this area. I am an angel investor and decided to invest in Neuroplus to help it get off the ground so that kids today don’t have to suffer the way my nephew has.

Poorly written article, i.e. A Little History: Adderall was first studied in 1937…Well, why, when and who was it created for?

Also, the broad statement “almost everyone sells some of their medications” does not explain what numerous sources the writer used to form this conclusion.

Finally, the writer of this article never states if they actually know someone with ADHD or ADD. Hey, there are many, many books actually written by people who treat and have ADHD which should provide an insight into the world and struggles which these people face.

In addition, there are support groups which may further assist the writer with loads of data. You know, anyone can find data to support a prejudice but a true researcher literally challenges themselves to research and disprove their own theory (prejudice). I’m shocked that this article is on this website! Mother, wife, and in-law of people w/ADHD

Giving kids speed before the age of six? We humans appear to be very broken.

No one was taking Adderall before 1996 when that brand name came out. Of course the real name Dextroamphetamine has been taken since WWII and Benzphetamine in inhalers since the 1930’s. It’s use in war on all sides is well documented and still used by our fighter pilots until very recently as “go pills”.

It’s use grew back then as a sort of cure all for mood and weight control. Then again effective antidepressants hadn’t been developed yet . Today the true problem isn’t the medications it’s the immense societal pressure to be thin, get good grades, and be the best athlete and on and on.

My daughter started Ritalin in preschool, recommended by a doctor. She took it throughout her school years. She graduated from college and continued on in post graduate school. It was a fantastic medicine for her. Not only did it help with her schooling, but she became a ranked tennis player. Doctors are now telling her that adults don’t have ADHD and they don’t want to prescribe it.

I worry every time she drives the car.☹️

Pam: Find another doctor. My daughter and her father both have adhd, and both are treated conservatively and effectively with Concerta. I and my daughter have Type 2 Bipolar, which comes along with concentration problems. So I, too, take a conservative dose of Concerta (I am an academic who must really concentrate tate to read, write, and teach). So whoever told you adults don’t have these problems is wrong.

When I was a kid I was put on Ritalin. This was in the 1970s. If memory serves, that was before they called it ADHD. All it did for me was make me sleepy. My mother took me off of it. Did I have focus issues? Heck, yeah! What I believe is that I was a kid who was in love with how things work, engines, electrical, all of it. If the curriculum had been that I would have been totally focused. But, it was the other things they needed me to learn and none of the things I wanted to learn. If I had been able to learn math as it applied to how an internal combustion engine worked I would have craved that knowledge. Maybe the problem is that we stuff all children into the same box and expect them to act like clones. The system is designed to clean the most chickens as quickly and cheaply as possible.

Back in those days they could not understand why I blew the IQ test away but couldn’t learn much in the classroom. I never really got the chance to really excel till I enlisted in the USAF, and they gave me some jets to work on. Then I graduated at the top of my class and loved every day of it. Drugs are not the answer for every kid.

As someone who has been diagnosed with ADHD, I appreciate how well balanced your article is. I belong to an online group, and there was quite a bit of debate over this documentary. Some were pretty outraged, feeling that once again they weren’t being understood for their condition or use of medication.

When I finally watched it, I had mixed feelings. I know the intent was to let people know how these medications are being overused and abused, and I can definitely agree. But it seemed as though they gave very little time to the people who had been diagnosed and prescribed. I got the feeling that like me, they were just as appalled by the wide use of stimulants just to get ahead academically or in the workplace. (Personally, I think that’s a problem in itself. Why do so many people feel so much pressure to perform/compete?)

The documentary hardly touched on the difference these drugs can make for someone who does have ADHD. And one of the things that happens to a lot of us, is too often doctors want to treat us with antidepressants alone or in addition to stimulants. I’m guessing it’s because dealing with ADHD can be exhausting and I know I often felt depressed. However, a relatively small dose of Adderall (I love the names!) made a big difference in that.

Most doctors start patients on a low dose. I started at 5 mg twice a day. Gradually I got to 10 mg, but I only take one in the morning after feeling like twice a day was too much. A lot of us struggle with finding the right medication and right dose, and I don’t think any of us are happy that we have to be on anything.

Recently I listened to a podcast that was about medication for ADHD, and I was shocked at some of the things people were saying. One woman talked about becoming psychotic and not being able to sleep for several days (that alone would make anyone psychotic). THEN she said she was taking something like 70 mg twice a day! That’s crazy, and I can’t imagine any doctor prescribing that much. There were some others who were definitely abusing their prescriptions, making it sound like it was the drug instead of the fact that their dose was too high, and they apparently weren’t working with their doctors.

There are always going to be people who abuse alcohol and drugs, and I definitely think we are having a crisis. I think it’s important to make people aware of the problems. But, it’s also important to support the people who need those drugs. We’re already struggling, trying to find ways to cope with a condition that impacts us daily. So, I only wish the documentary had been a little more balanced in that regard.

First d a other doctor. My daughter and her father both have adhd, and both are treated conservatively and effectively with Concerta. I and my daughter have Type 2 Bipolar, which comes along with concentration problems. So I, too, take a conservative dose of Concerta (I am an academic who must really concentrate tate to read, write, and teach). So whoever TD you ads do t have these problems is bunk.

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