WHAT HAPPENS TO MEDICATED ADHD PEOPLE IN THE LONG-TERM?

I’m a 46 year old originally Turkish information analyst with a Master's degree, who has also done freelance investigative journalism. I currently reside in the U.S. I started analyzing the long-term effects of ADHD medications after meeting a man whom we will call Tom. Tom told me that he had been prescribed aphetamines when he was only 5 years old. His mother told me that Tom’s school had forced her to keep her son medicated after Tom refused to quit playing pranks on teachers.

I witnessed the utterly degenerated state of Tom’s mental equilibrium as an adult. He had an unrealistically distorted body image and suffered from social anxiety as well as severe anxiety from his dread of the “end times.” He had a criminal record revealing his inability to control his temper. He exhibited bursts of excessive manic talkativeness alternating with periods of complete withdrawal. He experienced depression, demotivation, overwhelming fatigue and sleepiness despite taking about 120 mg of medication (three times the recommended daily dosage of Adderall for adults) most days of the month. In addition to his prescription, Tom was ordering amphetamines from a “Canadian Pharmacy.” I counted his pills daily in my efforts to verify his condition as I gathered information for the intervention I was planning. But this intervention did not go well as Tom persisted in denying his problem. Tom could not be helped, as he could not recall ever having energy and motivation without amphetamines and seemed incapable of imagining the possibility of this. He did not agree to go to rehab, instead choosing to stop speaking to me as well as to his mother, sister and other friends who also knew about his problem and were present at the intervention. Tom chose to alienate himself from his family and well-wishers.

I was at first convinced that Tom must be an advanced meth or coke addict. His condition was identical to people I had seen who were addicted to these substances at a rehab center where I used to volunteer (you will shortly read more on why I believe in helping addicts). After I learned Tom took amphetamines, a simple Internet search immediately revealed that my observations must be very similar to those of the Drug Enforcement Administration (DEA) which has placed ADHD drugs (amphetamine and methylphenidate) in the same category (Schedule II) as methamphetamine and cocaine.[1]

Would Tom have continued to benefit from his stimulants if he could have kept himself from taking more and more? I knew only too well that every addict starts out believing the answer is yes.

The popular practice of giving addictive stimulants to children was not around in Turkey at the time that I grew up there. None of my classmates had ADHD back then. The schools that I attended were filled with old school teachers who could either maintain discipline or lasted only a short time at their new jobs.

In addition to never having been forced to take behavior altering drugs, I have never tried any street drugs in my life, not even marijuana or cigarettes. I have been teased about this many times, having been called names like “goody goody” or “goody two shoes.” I have even been made fun of at a party in the U.S. after everyone suddenly took out joints “to freak me out” and burst out laughing. I remember the day I decided to strictly abstain from all addictive substances as a child after helplessly watching my father die of emphysema due to his inability to stop chain smoking. I used to cry wondering how dad appeared to not care about what he was putting me through, doing nothing as I watched him killing himself. I still can’t imagine how someone may come to love a harmful substance more than his daughter or more than his very own life. So anyone who wishes to may go ahead and laugh at the “fun” I’m missing.

You may have assumed I must be a biased woman who automatically put ADHD drugs next to tobacco. But I had originally honestly considered the possibility that Tom’s side effects may not be common, or that he was misdiagnosed and if he really had ADHD the drugs might have helped. I had expected my investigations to lead me to compelling scientific findings supporting the claim that ADHD drugs normalize the brain chemistry and neurotransmitter levels of people with an incurable brain disease. The advanced science might have failed to make sense to the people running the DEA who did not have high-level medical training. But then I noticed that the Food and Drug Administration (FDA) seemed to confirm the DEA’s conclusions. The FDA requires all amphetamine based ADHD medications such as Adderall, Vyvanse or Dexedrine to have black box warnings on their labels spelling out their high abuse potential, stating that this may lead to sudden death.[2] I knew that this was not an understatement, as I had seen Tom killing himself with Adderall. For the case of methylphenidate (Ritalin or Concerta), I saw that the International Narcotics Control Board (INCB), which oversees the implementation of the United Nations drug conventions, reports: “Methylphenidate, due to its high abuse potential, was one of the first substances to be placed under international control in Schedule II of the 1971 Convention on Psychotropic Substances.”[3] I found myself overwhelmingly concerned for not only one person, but for especially the countless children being robbed of their choice to live drug free lives like me. I lost sleep in my efforts to better understand if living on speed could really be helpful for those diagnosed with ADHD.

Black box warnings are the strictest drug label warnings of the FDA which “call attention to serious or life-threatening risks.”[4] But Internet searches nevertheless kept bringing up organizations or experts with impressive credentials referring to ADHD drugs as “the safest of all psychiatric medications”[5] or “safer than aspirin.”[6] I was temporarily puzzled by the way dangerous medications seemed to be sold like used cars. But I soon understood what is going on after reading a paper called “Key Opinion Leaders: Where They Come from and How That Affects the Drugs You Prescribe,” published in 2009 in Dermatologic Therapy.[7] This paper explains that the compromised laws permit scientists to accept not only research funding but also personal payments from the drug manufacturers. These personal payments often take the form of speaking fees, consulting fees or honoraria paid to influential experts to help promote treatments through seminars, conferences, online resources and other channels. These experts would often present materials provided by the drug companies that featured the biased results of studies conducted with drug industry funds. I verified the extent to which countless unwary MDs as well as the trusting public let themselves be educated by such thought leaders.

Congressional investigations had uncovered that some of the most influential ADHD researchers like Dr. Joseph Biederman had been stuffing his pockets with large amounts of undisclosed drug industry payments, violating both federal research rules and those of his university.[8] Biederman’s conduct seemed to be only the tip of the iceberg, as a 2008 paper in the British Medical Journal taught me.[9] As this paper explains, marketing drugs through drug company hired experts is so common that numerous independent firms have developed software-based solutions to help manage the key opinion leaders of the pharmaceutical industry. The paper quotes former drug industry sales representative Kimberly Elliott, who explains the extent to which drug companies rely on key opinion leaders. “There are a lot of physicians who don’t believe what we as drug representatives say. If we have a KOL [key opinion leader] stand in front of them and say the same thing, they believe it,” Elliott states. Simple Internet searches revealed the fact that companies offering key opinion leader management services had multiplied like fruit flies over the years. These companies include Veeva, KOL, Llc, OpenQ, CRMSolutions, Cravel Group, MedThinkConnect, SteepRock, Reltio, Genpact, and the list goes on to indicate the widespread popularity of using industry-paid influential medical experts to market treatments.

Continuing my research revealed the utter non-existence of legitimate science-based findings backing up the drug safety claims of ADHD mavens. In 2003, Americans had spent $2.4 billion dollars on ADHD medications[10] despite the absence of long-term studies about ADHD drugs up until that time.[11] The FDA currently states on drug labels that “the effectiveness of ADDERALL® for long-term use has not been systematically evaluated in controlled trials” (this label states it was revised in March 2007).[2] By 2011, the paid-off ADHD researchers had managed to create some junk science seemingly backing up their safety claims. The flawed and biased nature of these long-term studies was revealed by the Drug Effectiveness Review Project of Oregon State University (a project formed by the Medicaid agencies of 15 states and other organizations to determine the best drugs for Medicaid patients). In their 2011 report, the Drug Effectiveness Review Project announces the following about the long-term safety of ADHD drugs: “the overall body of evidence was poor quality due to a variety of flaws in design.”[12] At the beginning of this report, “poor quality” studies are defined as “trials that had a fatal flaw in one or more categories.” This statement is followed by the words: “a fatal flaw occurs when there is evidence of bias or confounding in the trial…” The same report contains the additional statement:

Longer-term studies indicated that although the evidence is somewhat mixed, efficacy benefits seen with immediate-release methylphenidate can be maintained over periods of up to 24 months, but that deterioration in benefit is seen with longer follow-up.[12]

Regarding the above conclusion, I would like to raise awareness of how far the American Psychiatric Association (APA) has gone to hide it from parents. APA is perhaps the world’s most influential psychiatric organization which defines all mental illness diagnostic criteria used by most prescribers in North America. I was appalled to discover how APA violates parents’ right to informed consent by grossly misrepresenting the results of a study called the “MTA Study” which represents the largest, longest-lasting and most significant randomized U.S. study on the long-term effects of stimulants. The MTA Study concludes:

Although the MTA data provided strong support for the acute reduction of symptoms with intensive medication management, these long-term follow-up data fail to provide support for long-term advantage of medication treatment beyond two years for the majority of children.[13]

The MTA study reports that benefits had deteriorated by the end of 8 years “despite a 41% increase in the average total daily dose” of medication.[13] But even though these results were published in 2011, they are not mentioned in the latest 2013 version of APA’s “ADHD Parents Medication Guide” which specifically states it was “Revised July 2013.”[14] This guide only lets parents know the “great” short-term (14 month long) results of the MTA study, drawing false conclusions from this. APA, which published this medication guide in partnership with the American Academy of Child and Adolescent Psychiatry (AACAP), misleads millions of parents as follows:

To help families make important decisions about treatment, the National Institute of Mental Health (NIMH) began a large treatment study in 1992 called the Multi-modal Treatment Study of Children with ADHD (or the MTA study). Data from this 14-month study showed that stimulant medication is most effective in treating the symptoms of ADHD, as long as it is administered in doses adjusted for each child to give the best response …[14]

Making it seem like the 8-year-long MTA study was concluded at the end of 14 months, the same medication guide goes on to announce the supposedly “great benefits and safety” of stimulants as follows:

The MTA study, along with many other large-scale treatment studies that have assessed the safety and effectiveness of ADHD medications, provides evidence that stimulant medication reduces hyperactivity and impulsivity, improves attention, and increases the ability to get along with others. For this reason, stimulant medications remain the medications of first choice for treating individuals with ADHD.[14]

Despite what actual science has shown, APA and AACAP make it clear how much they want stimulant medications to “remain the medications of first choice for treating individuals with ADHD.”[14] Further research led me to congressional investigations[15] and findings of analysts[16] which confirms that the American Psychiatric Association (APA) has been bought-out by the pharmaceutical industry. This, as I have documented in detail, is unfortunately not only the state of APA and AACAP, but almost all psychiatry.

I continued to investigate this subject for about three years, piecing together every bit of evidence I came across like a gargantuan jigsaw puzzle. I have still not been able to reach the limits of the ever-expanding cesspool of corruption that my investigations keep revealing. I have documented all of my findings with 550 saved electronic references readers may click onto, to instantly support every statement in my recent book “DOES YOUR DOCTOR KNOW THIS? - Shocking Evidence on ADHD Drugs” (currently being promoted for free). This book not only documents the fraud and actual long-term adverse effects of ADHD drugs, but also documents the unpromoted scientific evidence about effective drug-free approaches to eliminating ADHD symptoms and reversing the side effects of medications.

P.S.: My research ironically has revealed that amphetamines are more harmful and addictive than tobacco, cannabis or LSD, and that methylphenidate (Ritalin or Concerta) is more harmful than anabolic steroids or ecstasy. This has been determined by the peer-reviewed study “Development of a Rational Scale to Assess the Harm of Drugs of Potential Misuse,” published in The Lancet in March 2007.[17] [18] Such findings continue to be kept from parents as wealthy drug manufacturers only provide the funds to popularize the junk science helping sell more drugs.

REFERENCES:

1. DEA – United States Drug Enforcement Administration. Drug Scheduling [Internet]. No date [cited 2017 Jun 06]. Available from: https://www.dea.gov/druginfo/ds.shtml
Version saved at the time the book was researched:
http://adhddrugslongterm.com/References/DEA-Drug_Scheduling(2016-11-12_2-27-49PM).htm

2. U.S Food and Drug Administration. ADDERALL® (CII) [Internet]. c2013 [updated 2003 Mar; cited 2017 Jun 06]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf
Version saved at the time the book was researched:
http://adhddrugslongterm.com/References/Black_box_warning_for_amphetamines(2016-11-12_5-13-00PM).pdf

3. United Nations. INCB ANNUAL REPORT Background Note No.4. INCB Sees Continuing Risk in Stimulant Prescribed for Children [Internet]. [released 1997 Mar 4; cited 2017 Jun 06]. Available from https://www.incb.org/documents/Publications/PressRelease/PR1996/e_bn_04.pdf
Version saved at the time the book was researched:
http://adhddrugslongterm.com/References/INCB_Sees_Continuing_Risk_in_Stimulants(2016-11-12_4-52-50PM).pdf

4. U.S Food and Drug Administration. A guide to Drug Safety Terms at FDA [Internet]. [updated 2012 Nov; cited 2017 Jun 06]. Available from http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM107976.pdf
Version saved at the time the book was researched:
http://adhddrugslongterm.com/References/A_guide_to-drug_safety_terms(2016-11-12_5-15-50PM).pdf

5. McCarthy LF. Top 10 Questions About ADHD Medications for Children…Answered! [Internet]. ADDittude; c1998-2017 [cited 2017 Jun 06]. Available from: https://www.additudemag.com/top-10-questions-about-meds-answered/
Version saved at the time the book was researched:
http://adhddrugslongterm.com/References/ADHD_Medication_for_Children-Top_10_Questions_Answered(2016-11-12_5-10-23PM).htm

6. Hallowell E. Dr. Hallowell’s Response to NY Times Piece “Ritalin Gone Wrong.” [Internet]. ADDittude; c1994-2017 [cited 2017 Jun 06]. Available from: http://www.drhallowell.com/dr-hallowells-response-to-ny-times-piece-ritalin-gone-wrong/
Version saved at the time the book was researched:
http://adhddrugslongterm.com/References/ADHD_Medication-Long_Term_Effects_of_Ritalin_Debated(2016-11-13_6-02-35PM).htm

7. Meffert JJ. Key opinion leaders: where they come from and how that affects the drugs you prescribe. Dermatologic Therapy [Internet]. 2009 May/June [cited 2017 Jun 06];22(2):262–268. Available from: http://onlinelibrary.wiley.com/wol1/doi/10.1111/j.1529-8019.2009.01240.x/full

8. Theobald A. The incredibly Corrupt Practice sof Dr. Joseph Biederman – the Most Influential ADHDS Researcher [Internet]. Does Your Doctor Know This? 2017 May [cited 2017 Jun 06]. Available from: http://adhddrugslongterm.com/incredibly-corrupt-practices-dr-joseph-biederman-influential-adhd-researcher/

9. Moynihan R. Key opinion leaders: independent experts or drug representatives in disguise?. British Medical Journal [Internet]. 2008 June [cited 2017 Jun 06];336:1402. Available from: http://dx.doi.org/10.1136/bmj.39575.675787.651

10. Scheffler RM, Hinshaw SP, Modrek S, Levine P. The Global Market For ADHD Medications. Health Affairs [magazine online]. 2017 June [cited 2017 Jun 06]. Available from: http://content.healthaffairs.org/content/26/2/450.full.html
Version saved at the time the book was researched:
http://adhddrugslongterm.com/References/The_Global_Market_For_ADHD_Medications(2016-12-22_2-02-05PM).htm

11. Hechtman L, Greenfield B. Long-Term Use of Stimulants in Children with Attention Deficit Hyperactivity Disorder. Pediatric Drugs [Internet]. 2003 December [cited 2017 Jun 06]; 5(12):787-794. Available from: http://link.springer.com/article/10.2165/00148581-200305120-00002?view=classic
Version saved at the time the book was researched:
http://adhddrugslongterm.com/References/Long-Term_Use_of_Stimulants_in_Children_with_Attention_Deficit_Hyperactivity_Disorder-Springer(2016-11-13_12-44-16PM).html

12. McDonagh MS, Peterson K, Thakurta S, et al. Drug Class Review: Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder: Final Update 4 Report. Portland (OR): Oregon Health & Science University; [Internet]. 2011 Dec [cited 2017 Jun 06]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK84423/
Version saved at the time the book was researched:
http://adhddrugslongterm.com/References/Results-Drug_Class_Review-Pharmacologic_Treatments_for_Attention_Deficit_Hyperactivity_Disorder-NCBI_Bookshelf(2016-11-13_4-16-00PM).htm

13. Molina BSG, Hinshaw SP, Swanson JM, et al. The MTA at 8 Years: Prospective Follow-Up of Children Treated for Combined Type ADHD in a Multisite Study. Journal of the American Academy of Child and Adolescent Psychiatry [Internet]. 2009 May [cited 2017 Jun 06]; 48(5): 484–500. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063150/
Version saved at the time the book was researched:
http://adhddrugslongterm.com/References/The_MTA_at_8_Years-Prospective_Follow-Up_of_Children_Treated_for_Combined_Type_ADHD_in_a_Multisite_Study(2016-11-16_7-54-02PM).html

14. American Academy of Child & Adolescent Psychiatry and American Psychiatric Association. ADHD Parents Medication Guide [Internet]. c2013 [revised 2013 july; cited 2017 Jun 06]. Available from: http://www.aacap.org/App_Themes/AACAP/Docs/resource_centers/adhd/adhd_parents_medication_guide_201305.pdf
Version saved at the time the book was researched:
http://adhddrugslongterm.com/References/adhd_parents_medication_guide(2016-11-15_7-52-26PM).pdf

15. Carey B, Harris G. Psychiatric Group Faces Scrutiny Over Drug Industry Ties. The New York Times [newspaper online]. 2008 July [cited 2017 Jun 06]. Available from: http://www.nytimes.com/2008/07/12/washington/12psych.html
Version saved at the time the book was researched:
http://adhddrugslongterm.com/References/Psychiatric_Group_Faces_Scrutiny_Over_Drug_Industry_Ties-The_New_York_Times(2016-11-16_8-01-53PM).htm

16. Cosgrove L1, Bursztajn HJ, Krimsky S, et al. Conflicts of interest and disclosure in the American Psychiatric Association’s Clinical Practice Guidelines. Psychotherapy and Psychosomatics [Internet]. 2009 [cited 2017 Jun 06]; 78(4):228-32. Available from: https://doi.org/10.1159/000214444

17. Nutt D, King LA, Saulsbury W, et al. Development of a rational scale to assess the harm of drugs of potential misuse. The Lancet [Internet]. 2007 March [cited 2017 Jun 06];369(9566):1047–1053. Available from: http://dx.doi.org/10.1016/S0140-6736(07)60464-4

18. Bordern MJ. Drug Rankings by Harm [Internet]. [cited 2017 Jun 06]. Available from:http://drugwarfacts.org/cms/files/Drug-Rankings-by-Harm.pdf
Version saved at the time the book was researched:
http://adhddrugslongterm.com/References/Drug_Rankings_by_Harm(2016-11-13_2-12-08PM).pdf

One thought on “WHAT HAPPENS TO MEDICATED ADHD PEOPLE IN THE LONG-TERM?”

  1. Thankyou for your exhaustive research. As a mother of a son who I think is highly likely soon to be diagnosed with ADHD your research is backing up my gut feeling of saying no to medication. I will make my way through all your findings . Thanks again Katy .

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