Sudden drop in ADHD suggests ineffective prescription monitoring

A RECENT report has revealed over-prescription of Attention Deficit Hyperactivity Disorder (ADHD) medication was occurring in WA throughout the 1990s and early 2000s.

ADHD“If you want a quick way to calm children down, then ADHD drugs will do that”—Mr. Whitely. Image: Quijana Byrd

In his report, ‘The rise and fall of ADHD child prescribing in Western Australia: Lessons and implications’, published in the May edition of the Australian and New Zealand Journal of Psychiatry, WA politician and former school teacher Martin Whitely highlights the reasons behind the excessive number of children being prescribed stimulant medication and its long-term effects.

In 2000 the WA Health Department estimated between 85 and 90 per cent of the 20,648 West Australians on prescription stimulants were children and by 2003 ADHD prescriptions in WA were three and a half times the Australian average.

Mr Whitely believes this was due to ineffective monitoring of stimulant prescribers—only infrequent prescribers were required to obtain approval for each stimulant prescription but  ‘block authorisation’ was given to those who prescribed often.

In 2003 block authorisation was abolished and there was a 60–70 per cent decrease in the number of children on ADHD drugs—making Perth the only ADHD hot spot to ever experience such a massive decline in child prescribing rates.

Mr Whitely says the ADHD label is “a useless and meaningless diagnosis” and the main reason for the over-prescription of ADHD medication was convenience.

“If you want a quick way to calm children down, then ADHD drugs will do that— they have a short term effect of making everyone more compliant, regardless of whether they have ADHD or not,” he says.

Mr Whitely says children on prescription ADHD medication, such as amphetamines were being exposed to potential long-term effects, highlighted in the Raine Study (a study of WA children’s health and wellbeing that began in 1989).

The results, published early last year, suggest two significant findings: the consistent use of stimulant medication was associated with higher diastolic blood pressure (which is an indicator of cardiovascular disease) and long-term impairment of educational performance in school children. The results also demonstrated depression was marginally worse.

“ADHD students that were never medicated did better at school but those that were medicated were failing,” Mr Whitely says.

“The main reason for prescribing drugs to children with ADHD is to help them learn, however, this evidence suggests the opposite is happening.”

Today, WA ADHD child prescribing rates are 4 per cent below the national per capita average but Mr Whitely believes more can be done to limit the number of children on prescription medication.

He says before prescribing a child stimulant medication, it was important to assess the reasoning behind a child’s behaviour, such parenting, other health problems, and lack of sleep.

“We need to stop looking for quick fix solutions because we find children annoying.

“The idea that you should give amphetamines to children that are distractible is simply wrong.”