The rise of ADHD diagnoses and amphetamine prescriptions in Australia

Gone are the days when individuality was admired. Gone are the days when society valued our various strengths and weaknesses. Increasingly, the pressure is on us to possess the same attributes and skills. I am quite sure that I went to school with classmates who were daydreamers, fidgety, easily distracted, naughty and/or just not suited to academic pursuits. We were all different and, yet, those daydreamers, fidgeters, scamps and the rest of us grew up to pursue many different paths in life. Some of us succeeded and some of us did not. Such is life.

Needless to say, we baby-boomers (and our raggle-taggle bunches of classmates and friends) grew up in simpler times when our differences and idiosyncrasies were tolerated or embraced. If we were not academic, there was a smorgasbord of opportunities waiting for us in the world of work and little competition for them. How different it is today. Pressure is increasing for children to achieve high educational outcomes from an early age. Underachievement, for any reason, or unacceptable behaviour is no longer included under the umbrella of normal individual differences, such as being tall or having curly hair.

Under-achievement and bad behaviour have been pathologised. Tens of thousands of Australian children now have a diagnosis of ADHD (Attention Deficit Hyperactivity Disorder) and are taking medication to improve their learning and conduct. Similarly, given the prominence gained by ADHD on social media, a growing number of adults have discovered that their performance ability has been enhanced and their lives transformed when they, too, have a diagnosis of ADHD and are taking prescribed medication for it.

So, what is ADHD medication and how does it work? Medications prescribed for ADHD are central nervous system stimulants such as Adderall, Ritalin or Concerta. They all stem from the discovery of amphetamines in 1929. These drugs were used in the US for increasing pep and in Britain, it was noted that amphetamines made people feel confident, clever and witty. Amphetamines were first marketed to alleviate depression and hypochondria. For some time, they were also prescribed to assist with weight loss. During WWII, amphetamines were used to increase morale and aggression. They bolstered soldiers’ motivation to fight. German soldiers consumed 35 million methamphetamine tablets during the Blitzkreig and over the course of the war, the British military distributed 72 million amphetamine tablets.

Following the war, the Beat Generation decided taking amphetamines was essential to creativity. They were widely used, overused and abused by musicians, writers and artists and by the 1960s, they were just popular in mainstream society. By the end of the decade, 7 per cent of Americans were taking prescribed amphetamines or using them recreationally. To combat this epidemic of amphetamine (also known as speed or uppers) addiction, legislators moved to make amphetamines a controlled substance. Recreational use became illegal and strict prescription guidelines were applied.

As the legal supply of (prescription) amphetamines plummeted, pharmaceutical companies found themselves left with ‘a drug looking for a disease’. The coincidental emergence of ADHD (Attention Deficit Hyperactivity Disorder) offered them a remarkable opportunity. Fifty years later, amphetamines have a dominant place in the treatment of ADHD in children and increasingly, in adults, too. In Australia alone, 3.2 million prescriptions were written for ADHD medication (amphetamines, dexamphetamines and methylphenidates) in 2022.

Some fifty years after an epidemic of amphetamine addiction swept across the US, over 1.2 million scripts for this class of drug were dispensed in Australia for the treatment of ADHD, a condition diagnosed on a checklist of symptoms, observations and anecdotal reports.

Apparently, this is no cause for alarm. There’s no epidemic to worry about. There’s nothing to see here. The tabling of a Senate enquiry into the prevalence and treatment of ADHD has made recommendations that, if adopted, will further increase the market infiltration of prescribed amphetamines.

Anyone who has read Aldous Huxley’s Brave New World (where everyone takes the drug “soma”) or seen the television series Dope Sick starring Michael Keaton (about addiction to prescription medication) should be shaking their heads in disbelief! Do we really have such a need for speed or do we just want it?

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