Adolescents Misuse ADHD Medications Due to Doctors’ Over-Prescribing
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The last twenty years have been burdened by a growing epidemic of Attention-Deficit Hyperactivity Disorder in children and adolescents. Without using proper Diagnostic procedures, physicians are frequently prescribing ADHD medication to patients who demonstrate symptoms of inattention. The increased number of diagnoses is causing individuals illicitly to use ADHD medication like Ritalin and Adderall, which puts them at risk for addiction. Many experts, including David Stein, Ph.D., believe that ADHD is a fabricated disorder and medication is unnecessary for the treatment of inattention and hyperactivity in children and adolescents [6].
ADHD drugs can cause depression and violence in users, and students often become dependent on the medication because they are “given in dosages that would satisfy a street addict” [6]. As some doctors fail to employ correct methods during the diagnostic process, many children who do not need the psychiatric drugs are taking them and running the risk of misuse and addiction to the stimulants. Like Stein, experts Bruce Wiseman of the Citizens Commission on Human Rights and Dr. Keith Conners of the Duke University Medical Center believe that ADHD is overdiagnosed. Research shows that college students illicitly use and abuse the drugs to maintain desired grade levels, and that students also take the drugs socially – they like to get high without an academic motive [12]. In dissimilarity, Rachel Klein, Director of Research Training at the Modern York University Child Study Center, is convinced that ADHD is underdiagnosed and that children do not receive adequate treatment for the disorder [27]. Studies also show that students do not abuse the drugs in certain areas of the country [23]. The Food and Drug Administration should regulate the frequency of doctors’s prescriptions of ADHD medication to children and adolescents, in order to prevent the misuse of and addition to the drugs. HISTORY AND BACKGROUND INFORMTAION The number of ADHD diagnoses in children ages three to 17 rose from 3.3 million in 1997 to 4.4 million in 2002 [30]. This may be in part to the numerous U.S. schools that have required children to take Ritalin or Adderall to improve their classroom behaviors in recent years [21]. In 2002, The House Committee on Government Reform found that parents were having to choose between keeping their children in school or putting them on potentially dangerous medication – if parents refused to feed their children the drugs, the students were expelled from school [21]. Attention-Deficit Hyperactivity Disorder is so widely diagnosed that school officials bewitch they understand the medical needs of their students, when certified physicians are the only qualified individuals to boom medication. The actions taken by school personnel in various cities across the nation has generated the need for the limitation of ADHD drug prescriptions in children and adolescents. While the House Committee on Education and the Workforce imposed an act in 2003 to abolish the requirement of Ritalin use in our nation’s schools [21], there are calm students who take ADHD medication at school and who are extremely likely to sell or trade their prescription drugs with their peers [11]. A study conducted in various middle and high schools in Detroit, Michigan in May of 2002 found that 23.3% of students who took prescription medication were asked to sell or trade their drugs within a one-week period [11]. The contemplate also reports that non-medical stimulant expend in high school students rose significantly from the early 1990s to the late 1990s, and that the increase in illicit drug use is due to the overprescribing of stimulant medication [11]. The illicit and medical use of stimulants like Ritalin and Adderall has caused numerous violent outbreaks among students in schools across the United States. Kip Kinkle, the notorious 15-year-old boy from Springfeild, Oregon who killed his parents and opened fire in his school, was taking Ritalin at the time of the atrocity [31]. Countless other school shootings, including the 1999 Columbine shooting, have been committed by students taking ADHD drugs [31]. There are also several cases of rapes, stabbings and suicides – all caused by stimulant medication. Bruce Wiseman of the Citizen’s Commission on Human Rights claims that “psychiatric drugs are a cause of violence and suicide and are the current denominator in the killings and acts of senseless violence occurring in our nation’s schools” [31]. The failure to diagnose patients properly and the abundance of psychiatric drugs in schools and has led to an outbreak in school violence. These recurring, brutal behaviors are a major factor in the need for the regulation of doctors’s prescriptions of ADHD medication. The ADHD drug Adderall is so dangerous that Health Canada removed it from the Canadian market in February of 2005 [25]. Health Canada ordered Adderall’s manufacturer, Biochem, to end manufacturing the drug, as it was linked to several cases of stroke, heart malfunction and death in users [25]. Many of the complications and sudden deaths occurred in children who were taking proper doses of the drug, which proves that the dangers of Adderall do not apply solely to addicts [25]. While the Canadian government did not advise users to stop taking their prescriptions once the drug was removed from the market, officials strongly suggested that consumers meet with their doctors to discuss their health and the personal risks that Adderall presents [25]. Before Health Canada’s realization that Adderall and Ritalin were wicked to ADHD sufferers, the Clinton administration declared that more research was needed in order to identify whether or not the drugs were dangerous and if they were being used and prescribed correctly [2]. In 2000, the Clinton administration decided to “improve the care of children with emotional and behavioral disorders” by initiating four federal programs: The FDA develop the appropriate dosages of ADHD drugs for children through extensive research; The National Institute of Mental Health distribute five million dollars to research regarding ADHD drug use in preschool children; The National Institute of Mental Health help parents sight information on superior treatment methods for their children; and the Office of the Surgeon General, the FDA and NIMH hold a national meeting concerning treatment strategies for ADHD and mentally ill children [2]. While several institutional and governmental organizations set aside large amounts of money to research treatment methods for ADHD and other mental health disorders, Ron Paul of the United States House of Representatives does not think such extensive research is necessary, as the definition of “mental health” is too vague [24]. On January 4, 2005, Paul issued a bill stating that there would be no federal funding for mental health screening programs, as the programs are often invalid and mental disorders are much harder to diagnose than biological, identifiable medical illnesses [24]. Paul’s decision to propose this law was also based on events from the 1998 National Institutes of Health Consensus Conference, in which experts admitted that ADHD has not been recognized as a brain disorder, that a single test does not exist for detecting ADHD, and that the causes of ADHD are unknown, even after years of investigation [24]. It is useless to spend millions of U.S. dollars on mental health screening when even professionals argue that diagnosing mental illnesses like ADHD is subjective and incredibly difficult. Currently, diagnoses for Attention-Deficit Hyperactivity Disorder are regulated by the subjective use of the Diagnostic and Statistical Manual of Mental Disorders (fourth ed.), parent and teacher rating scales, clinical interviews, child self-reports and observational methods. Not all of these procedures are edifying, but the most commonly archaic and trusted diagnostic method is the DSM-IV checklist [13]. The checklist has two columns: inattention, which includes a list of nine symptoms; and hyperactivity/impulsivity, which includes seven symptoms. A child is usually diagnosed with ADHD if he or she displays six or more symptoms in either or both of the categories, if he or she has shown symptoms since before age seven, and if the symptoms have demonstrated considerable impairment in two or more situations [13]. This checklist, just as the other diagnostic methods, is open to interpretation and can be biased, depending on who is performing the examination. The current diagnostic process is not regulated strictly enough with personal checklists and parent observations; the hastily, impersonal evaluation results in an abundance of ADHD-diagnosed children and an excessive amount of stimulant drugs circulating in schools. ISSUES Subtopic I: The Risks and Benefits of ADHD Medication Attention-Deficit Hyperactivity Disorder has many negative effects on those it encompasses, especially high-school adolescents. Studies show that severe inattention and hyperactivity symptoms in children often lead to substance exhaust and abuse in adolescents, as well as affiliation with deviant peer groups in high school [14]. Children and adolescents diagnosed with ADHD often have poor academic, behavioral and social skills and have troubled relationships with their friends [14]. A study conducted in 2006 found that children with serious ADHD symptoms have a significantly higher chance of using and abusing illegal substances in their teenage years [14]. However, ADHD medications like Ritalin and Adderall attend abnormal, inattentive and hyperactive children feel accepted and avoid substance abuse. Without medication, these children would be even more shunned by their classmates and would have to turn to drugs, alcohol and deviant peers for acceptance. Kris White, the mother of two ADHD-diagnosed boys, is aware of the substance abuse problem among attention-deficit adolescents in their cry for help in coping with their disorder [35]. She says she began talking with her sons about alcohol, marijuana and cocaine when they were young, and “medicating them helped in keeping them from falling into this trap” [35]. Jane Leavy is also the mother of a boy with ADHD and believes that medication has improved her son’s temperament and character [3]. According to Leavy, the first seven years of her son’s life were difficult, as he struggled with the fact that he was different and was performing poorly in school. His parents told him he was brilliant, but Leavy explains that he didn’t have a way to present his skills in the classroom and became extremely frustrated. He even transferred to a Special school to improve his grades and his self-esteem, but nothing worked until he was finally diagnosed with Attention-Deficit Hyperactivity Disorder and put on Ritalin when he was seven years old [3]. Leavy asserts that Rialin pushes her son to perform academically and socially – the medication helps him “be his best self” [3]. Alyson Smith, a third grade teacher at Greenway Elementary School in Beaverton, Oregon, also believes that ADHD medication makes a Huge difference in the students who truly need it. She remarks, “I can totally tell when they don’t take their medicine, because they tear my classroom apart” [34]. When her inattentive students do not take their medication, they are unfocused, unsocial, and unable to learn in the classroom. The drugs make all the difference in their characters. While many parents and teachers trust Ritalin is the perfect remedy for their children’s poor academic performances, misconduct and inattentive behaviors, others feel the drug is detrimental to ADHD sufferers. Ritalin is one of four Schedule II drugs; it is in the same category as opium, morphine and cocaine [6]. According to psychologist David Stein, Schedule II drugs possess a great potential for addiction and only have some medical uses [6]. Ritalin has been proven to expressionless the growth of children’s bodies and damage children’s developing brains when they go on and off the drug, as most Ritalin users do [6]. Studies show that Schedule II stimulants like Ritalin and Adderall also hinder the development of internal and external sexual organs, as well as the female menstrual cycle [6]. Recent research suggests that Schedule II stimulants may damage the immune system too, which conflicts with taking Ritalin in the first place, as Ritalin is meant to improve one’s health [6]. Ritalin is a dangerous stimulant, and the complications associated with Ritalin and related drugs have led to death in several individuals in the United States. In February of 2006, the Food and Drug Administration committee recognized the growing trend of death in Ritalin users and the harmfulness of the drug and decided to take action. It voted to recommend adding a “black box” warning to ADHD drugs because of current cases of heart problems, strokes and hypertension in individuals taking the drugs [4]. Previously, the FDA committee voted unanimously to recommend a medication guide for all ADHD drugs, but the FDA foolishly refused both of the panel’s suggestions [4]. Members of the committee agreed that it is rank for the FDA to ignore the harmful risks and side effects of the stimulants and let doctors go on prescribing it unknowingly [4]. With the rise in ADHD diagnoses and the increased prescriptions of ADHD drugs, we can expect the number of addictions, deaths and health problems in Ritalin users to also rise. Many U.S. citizens and organizations assume that Ritalin is a mild, safe substance and that drugging our nation’s children is completely ordinary. However, they are unaware that the United States is the only country in the world that feeds stimulants to its children [30]. The International Narcotics Control Board addressed this issue in 1996, expressing its concern about the dangerous side effects of the drugs, which, in addition to heart problems and stroke, include agitation, irritability, anger and mania, according to recent examinations by the FDA [30]. Children who take the drugs also have a higher risk of developing the mental disorder psychosis, an illness in which patients are unable to make distinctions between real objects and events and illusions [30]. Between the years 2000 and 2005, there were 1,000 accounts of psychosis in individuals taking Ritalin [30]. There are many more side effects of Ritalin than the standard, well known risks of heart malfunction and hypertension. The additional risks are ones that are unfamiliar to the public and need to be addressed in order to preserve the health and safety of ADHD sufferers. The medical and sociological risks associated with Ritalin and other ADHD medications outweigh the potential benefits of the drugs. According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, Ritalin users often have thoughts of suicide after coming off the medication [31]. It is pointless to medicate individuals if they end up killing themselves when missing a couple days of their prescription. Users who take prescription stimulant drugs non-medically have a higher chance of suicide and health risks, because they do not follow physician’s directions and usually take improper doses of the drug. If there were less prescription stimulants floating around in schools and on the streets, there would be fewer health failures and deaths. Ultimately, a human’s life is more valuable than an ADHD prescription. Subtopic II: The Roles of Parenting and the Environment in ADHD Some studies present evidence that Attention-Deficit Hyperactivity Disorder is genetic, and therefore requires medication for treatment. A twin and family study conducted this year in Australia suggests that ADHD is a “highly heritable disorder” and that its comorbidities Oppositional Defiant Disorder, Conduct Disorder and Reading Disorder all have “strong genetic components” [16]. The researchers examined 2,040 families with twins, and they dilapidated the Australian Twin Behavior Rating Scale and a Reading Disability questionnaire to determine that ADHD is hereditary and that it is genetically linked to Reading Disorder. A similar study performed in the 1990s also found that Reading Disorder is strongly related to ADHD, and that Reading Disorder and ADHD should be viewed as two variations of the same disorder [17]. As Reading Disorder is a clinically confirmed illness and most people believe that the disorder is legitimate, these studies validate the existence of ADHD because they prove that the two disorders share many of the same genes [16]. Some people, though, do not need these studies to persuade them that ADHD is genetic. Kris White has two sons who have been diagnosed with ADHD and a husband who also displays symptoms of the disorder [35]. She watches her husband struggle with the same disorganization and inattention problems that her sons have and is positive that the disorder is hereditary [35]. Her continuous efforts to motive and organize her sons through behavior modification and at-home treatment strategies were unsuccessful, and her sons’s behaviors and academic performances did not improve until they were put on medication [35]. White also asserts that a child’s parents and his or her environment do not cause Attention-Deficit Hyperactivity Disorder, but she admits that the school system and the stress of home and work add to the severity of symptoms. Dr. Lianne Lennert, a clinical psychologist in Beaverton, Oregon, agrees with White. She argues that “our culture is pretty screwed up in the expectations we have for young children. The conception that for the first fifteen years of life we should be able to sit in a chair and do paperwork eight to ten hours a day is ludicrous” [33]. While Lennert acknowledges that a child’s environment intensifies symptoms of ADHD, she is certain that the disorder is genetic, as recent brain-imaging technology has allowed researchers to understanding patterns in the brain’s fiber tracts that indicate attention-deficits in individuals; the research also suggests that medication improves the fiber tracts [33]. Dr. Lennert states that counseling alone cannot cure ADHD, as the disorder is extremely complex and is “not a specific diagnosis. It is a variety of things that all have a similar pattern.” She believes medication is vital in treating ADHD. Contrary to Lennert’s beliefs, the National Mental Health Association is concerned with the number of children taking ADHD drugs and feels that all elementary and secondary teachers should receive behavior management training, social skills training, and instruction in a number of other areas to better treat ADHD children in the classroom [22]. Children’s environments and the people they associate with play a big role in their ADHD symptoms, and teachers need to know how to help ADHD children when medication does not succeed. When teachers learn how to work with inattentive and hyperactive children, students are able to function better in the classroom and do not need medication to thrive. A study conducted in Reno, Nevada found that ADHD students are qualified of using self-managed inspect skills to improve their behaviors in the classroom, and that external rewards from their teachers better motivate them [18]. The National Research Center on the Gifted and Talented also believes that school systems should implement special assistance for children with ADHD by means of the Individuals with Disabilities Education Act so students have an alternative to drugs [20]. Parents and doctors must also be more active in appropriately assisting ADHD children, as a pill should not be the only means of treatment for ADHD patients [8]. These outside environmental aids have effectively improved the behaviors of students with ADHD, which proves that the disorder is not hereditary and can be treated with drug-free counseling. Additional evidence regarding parenting techniques also suggests that the disorder is not genetic. According to recent studies, parents have the capability of preventing ADHD in their children if they work to explore their children’s behaviors and temperaments early in infancy [5]. Without early intervention, 80 percent of defiant babies become hyperactive and resistant in childhood and increase their risk of developing ADHD [5]. These studies suggest that ADHD is not genetic because parents have the power to prevent the disorder in their children. Another way that parents can prevent the disorder is to properly nourish their kids, as malnutrition has been proven to generate symptoms of ADHD [10]. 16-double blind studies confirmed that food dyes heighten ADHD symptoms in children [10]. A healthy diet that avoids food dyes can assist in preventing inattention and hyperactivity without the use of drugs. A child’s environment plays a larger role than genetics in the development of ADHD, as there is not enough distinguished evidence to suggest that the disorder is purely hereditary. In the mid-1990s, the FDA, DEA and the manufacturer of Ritalin admitted to neurologist Fred Baughman that “no objective validation of the diagnosis of ADHD exists” [9]. Stein agrees with this conclusion, as he has “cured” several ADHD-diagnosed children with simple drug-free programs, including his own Caregiver’s Skills Program [6]. As the disorder lacks a valid diagnosis and has been cured in numerous cases without drugs, it is clearly triggered by environmental factors and not genetic material. Subtopic III: The Role of Drug Companies Each year, drug companies allocate millions of dollars for research, drug samples and advertising, which creates anger and annoyance in many doctors and drug consumers. However, most of the time this money simply goes toward the development of new products [28]. This research funding allows pharmaceutical industries to produce improved medications and reach the health of individuals. Without obliging funding for research or the development of new products, our nation would be less strong and healthy. Many drug companies do not have bad intentions; they simply wish to improve the public’s well being. Still, there are those who maintain that the drug industry’s objectives are immoral. In 2001 and 2002, five class actions in which plaintiffs “alleged that APA and Novartis engaged in an illegal conspiracy to boost the sales of Novartis’s Ritalin brand of methylphenidate” withdrew before they went to court [29]. The plaintiffs were certain that the company was not funding for research, but bribing doctors and the Children and Adults with Attention-Deficit Hyperactivity Disorder advocacy group to advertise Ritalin [29]. They withdrew from the case due to lack of sufficient evidence [29]. It was inappropriate to file the lawsuits because the plaintiffs had no proof of this “conspiracy,” which furthermore supports the idea that drug companies are only funding for research to assist consumers in their medical needs. While drug companies distribute a large amount of money each year for research and development, they often fund programs that conduct favorable outcomes for their drugs. Former official of the U.S. Drug Enforcement Agency Gene Haislip believes that ADHD researchers who are funded by large pharmaceutical companies collaborate to produce outcomes that are beneficial to the companies, and that ADHD advocacy groups are pushing the prescription of ADHD medication to children in exchange for money from drug companies [28]. Dr. Lennert claims she has attended informational meetings with prestigious physicians and witnessed bribes and gifts from drug company representatives [33]. Although Lennert is an advocate for ADHD medication, she believes that pharmaceutical companies market their drugs unethically [33]. For many drug industries, more money and time is spent on marketing drugs than on research and development. In 2001, Novartis, which manufactures a perform of Ritalin, spent 36 percent of its total returns on marketing, and only five percent on administration [7]. Direct-to-Consumer advertising is a considerable component of marketing in the drug industry, but the ads are often misleading and cannot be prevented by the FDA, as there are thousands of drug commercials each year and an insufficient number of FDA officials to review and modify each advertisement [7]. The information portrayed misleads doctors and consumers and tricks them into prescribing or using possibly harmful drugs. Direct-to-Consumer ads are illegal in every country and should also be prohibited in the United States [7]. There is significant evidence to suggest that drug companies bribe doctors to prescribe their drugs and illicitly market their products to consumers. Drug representatives regularly take doctors out to fancy dinners to discuss certain medications, offer them expensive gifts, and leave them bags full of assorted drug samples [7]. This behavior is immoral and detrimental to thousands of individuals who trust and rely on their doctors to provide them with immense care. While the pharmaceutical industry consists of businesses that need to compose money (just like every other U.S. business), it is crossing the line in falsely advertising to doctors and consumers. The bribery and marketing tactics contribute to the widespread of ADHD stimulant prescriptions, which lead to health problems and deaths in thousands of children and adolescents. DISCUSSION Students with Attention-Deficit Hyperactivity Disorder are often characterized as unimaginative, unintelligent and unmotivated, when they may be gifted students in disguise [19]. This declare is not often debated by others but has a immense impact on the decision to limit the frequency of ADHD drug prescriptions. Many ADHD students are not able to express their creativity and originality because our school system is based on a traditional model in which students are required to sit at their desks for a large portion of the day. Medication is often the only draw that facilitates conformity and allows students to feel accepted in a conventional school system, but it suppresses children’s creativity and prohibits them from expressing their factual ideas and characters [1]. Our nation’s future needs the creative minds of ADHD individuals that are not masked by stimulants. Our culture assumes that higher levels of inattention and hyperactivity require higher doses of ADHD drugs, but studies show that smaller doses of medication are more effective than larger ones [15]. This issue is not widely recognized or debated either, but it should be considered in an effort to prevent drug misuse and addiction. Patients who do not need high doses of stimulants should not be prescribed high doses, because bigger quantities of the drugs are not capable for most ADHD sufferers and they contribute to illicit drug use and addiction. The issue of underground selling and trading of prescription stimulants is not taken seriously enough and has a major impact on students’s physical and mental health. Georgetown students report that taking ADHD drugs is the only method to cope with the demands of college life [12]. Many students who retract Ritalin non-medically use them when studying for tests or writing long essays and admit it is extremely easy to obtain the drug [12]. Students who previously had taken the stimulants strictly as a studying technique are now using them socially [12]. It is dangerous to take the drugs non-medically because there is a higher risk for addiction and other heath problems, as illicit drug users consume the medication in infamous quantities without physicians’s guidelines [12]. STAKEHOLDERS’ SUGGESTIONS Psychologist Lianne Lennert asserts that psychologists, parents and teachers are more qualified than the Food and Drug Administration to regulate the frequency of ADHD drug prescriptions, because they are the people who are around the affected children and are knowledgeable of each case [33]. Doctor’s do not know each of their patients personally enough to continuously originate accurate diagnoses, and they often give prescriptions without adequate observation and understanding of their patients’s behaviors and temperaments. Doctors are also often influenced by drug companies and cannot always be trusted. Lennert argues that the FDA has no way of forecasting who should receive medication and who should be turned away, because there is no clinical test to determine if the disorder even exists [33]. Therefore, patients will not be averted from medication if they visit the doctor and believe to have ADHD. A child’s parents, teachers and counselors know him or her better than doctors do and should be the ones to settle whether or not medication is necessary. Lennert asserts that the decision is in the hands of those who are best equipped [33]. Alyson Smith agrees with Lennert’s argument but also believes that doctors should be held accountable for their wrongdoings [34]. She asserts that strict standards, guidelines and tests for doctors should be set and followed when prescribing ADHD medication, and physicians should be liable for any events that occur due to their prescribing psychiatric drugs without following the set standards [34]. Smith believes that students who meet the requirements for the disorder should receive medication to help them be successful, but there should be follow-up appointments after the diagnoses [34]. These follow-ups will allow physicians, parents and children an opportunity to evaluate the medication and switch medication if needed, as some children have serious side effects to certain drugs. The only flaw in Smith’s suggestion is that there is no arrangement to guarantee that every doctor who misdiagnoses a child will be held accountable, unless the patient or parent knows the specific, appropriate diagnostic process and can recognize when the physician does not follow formal procedure. RECOMMENDATIONS The frequency of ADHD prescriptions should be regulated, but the FDA cannot grunt who should receive medication and who shouldn’t, as there are no chemical or blood tests to identify the disorder. So, to regulate the prescriptions given out, individuals with symptoms should undergo a number of treatment strategies before seeing a doctor and concluding immediately that they have ADHD. Such “pre-referral intervention” strategies may include school daily represent cards and at-home parent training [32]. Many conditions including restlessness, irritability and chaotic households can cause symptoms that are similar to those of ADHD, but without intervention before seeing a doctor, the patient will most likely be misdiagnosed and prescribed unsafe stimulants to treat a disorder that is not present. With less frequent visits to the doctor, not as many children and adolescents will be prescribed ADHD medication, and there will be less misuse and addiction to the drugs. However, school teachers may not have time during their hectic days to fill out individual report cards each afternoon, and parents may be too busy to undergo 12-week treatment programs with their children. It is common for ADHD children to have single parents whose schedules are too demanding with work and running their households to implement time-consuming intervention programs into their lives. But if parents and teachers can take the time to help their children with inattention and behavioral problems, the benefits will outweigh the disadvantages. If the majority of these problems can be treated without drugs, students will be happier, healthier, and less dependent on drugs in the future. Many lives will be saved, as there will be fewer drug addicts and suicides. Also, the classroom will be overflowing with creativity, which is what our world needs in its future leaders. CONCLUSIONS More and more frequently, physicians have been prescribing dangerous stimulants to patients that display symptoms of inattention and hyperactivity without using adequate diagnostic procedures. The rise in the prescribing of ADHD medication has lead to health problems in many consumers, as well as misuse and addiction in legal and illegal drug users. To come to my conclusions, I researched the prevalence in ADHD among our nation’s children, the risks and benefits associated with ADHD medications and effective methods for treating the disorder. I examined the roles that parenting, the environment and genetics play in the development of ADHD. I also considered ways that the frequency of Ritalin and Adderall prescriptions could be regulated and whether or not regulation was is feasible. ADHD diagnoses must be regulated because many physicians do not follow correct procedures, which are necessary to one’s health [26], and end up misdiagnosing their patients. To limit the number of misdiagnoses and stimulant prescriptions, school personnel should avoid instantly referring their inattentive students to subjective doctors and instead recommend effective, at-home treatment strategies for parents to exhaust to improve their children’s behaviors and temperaments. In addition, parents should not jump to conclusions, immediately rushing their children to the doctor when they notice signs of inattention and impulsivity – they should first take the time to work with their children in a drug-free manner. Implementing at-home treatment strategies prior to doctor visits will reduce ADHD symptoms in children and end the epidemic that has consumed our country. WORKS CITED [1] Elias, Marilyn. “Number of Adults on ADHD Doubles.” 14 Sept. 2005. USA Today. 2006. Gannett Co. Inc. 4 April 2006 -09-14-adhd-drugs-usage_x.htm> [2] McCarthy, Michael. “NEWS USA to Improve Care of Children with ADHD.” The Lancet 335 (2000):1161-1163. The Lancet. 2006. 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