The Candor

Connecting Cultural Insensitivities with the Increasing Prevalence of ADHD

Omair Ali

Perspectives Editor

Attention Deficit Hypersensitivity Disorder, or ADHD, is a disorder that is “marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity” (National Institute of Mental Health). Diagnosing ADHD is a complicated matter that often begins early in childhood. A 2015 study indicated that “concern for inappropriate diagnosis of ADHD in children based on relative age and sex exists.” Per a 2012 population-based cohort study, children with ADHD are also at risk for future substance abuse. Thus, there are significant implications associated with the diagnosis and treatment of ADHD.

Although ADHD is not a contagious epidemic, it certainly has grown like one. A 2016 study indicates that the number of parent-reported diagnoses of children with ADHD had risen by 43% between 2003 and 2011. This alarming rise in incidence of ADHD should not be taken as a random phenomenon. Rather, the increase in ADHD diagnosis should be seen more as a product of two cultural insensitivities: unprincipled market behaviors and an unhealthy lust for achievement.

The Supply-Demand Seesaw of Culpability

The economy is heavily influenced by society’s culture. For instance, capitalism in America vastly depends on the consumer’s freedom to make choices, which is essentially a birthright. But to determine– and then provide– what consumers want requires marketing schemes that involve a degree of persuasion that often involves unethical practices. Within healthcare, marketing is a controversial matter that can give rise to nationwide dilemmas.

The trajectory of ADHD medication abuse is similar to the rise of OxyContin in the 1990s and 2000s. A 2012 American Journal of Public Health article highlights how marketing strategies that Purdue Pharma, OxyContin’s producer, established a vast web of support to promote its product. Misinformation convinced consumers that the drug was “less abusive” than other available pharmaceuticals, but the consequence on public health was a marked increase in OxyContin abuse that has contributed to today’s opioid crisis.

In a similar fashion, Shire, the producer of the ADHD medication Adderall, has played a role in promoting the drug in the market. The company had been in legal trouble for falsely marketing its pharmaceuticals. But now, with the rise of ADHD patients, prescription stimulants used to treat ADHD have become more prominent in the market, with the public health effect being increased abuse. Per a 2016 report, higher levels of Adderall abuse are prevalent among individuals who often are not diagnosed with ADHD.  But this comes as no surprise as college students are infamous for abusing Adderall as a  “study drug.” Truly, the consumer, like the supplier, also needs to play a more substantial role in regulating their behavior.

More Merit, More Problems

Cultures also tend to systematize values that they believe are essential. One example of this in American culture is the meritocracy. Merriam-Webster defines meritocracy is “a system in which the talented are chosen and moved ahead on the basis of their achievement.”

America’s cultural tendencies make it clear that those who embody achievement and success are given more attention than those who do not. This can be seen in educational policies, higher education, and companies that are partial to others based on scores, standards and prestige, all of which underscore merit. This meritocracy is also reinforced by individualism, which is the need to advance and protect our personal interests. Most importantly, the meritocracy based on merit leaves little opportunity for those who are unable to achieve.

Given the alarming statistics and these cultural values, perhaps the pressure to keep up with merit-based expectations has encouraged parents and children to try to pursue ADHD treatment plans in hopes of resolving learning difficulties. After all, many students that use prescription stimulants give the impression that they are an acceptable means of maintaining steady academic performance.

The Next Step? Rewriting our Cultural Obscenities

ADHD diagnoses have increased substantially among children over the past two decades.
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ADHD is a serious disorder that has garnered more attention over the years and has raised concerns about the way pharmaceutical companies, clinicians and even parents have approached this disorder. Many precautions related to the potential for substance abuse and side effects in long-term treatment of children were not taken into account as the incidence of ADHD skyrocketed during this decade and the 2000s.

Now, the idea is to change these cultural insensitivities, where needed, so that treatment strategies prone to long-term dependency and health effects do not threaten the well-being of both young adults and children that use these drugs primarily in academic settings.