For
readers of TIME.com: in my article, I make the statement that A
teenager in the United States is now nearly 14 times more likely to be on
medication for ADHD compared to a teenager in the United Kingdom. On this
page, I provide the basis for that statement.
In 2013,
the Centers for Disease Control (CDC) released their figures on the proportion
of American children who have been diagnosed with ADHD. Looking across the
entire United States, nearly 20% of American boys 14 to 17 years of age have
been diagnosed with ADHD, and 10% of American girls in the same age group. That
means that among high school kids in the United States, 15% have now been
diagnosed with ADHD.[1] The CDC estimates that 69%
of American kids who are diagnosed
with ADHD are also on medication for
ADHD.[2]
If we multiply 15% by 69% we get 10.3%. That means that about 103 out of every
1,000 American teenagers either are now taking, or have taken, medications for
ADHD.
A group
of British researchers recently released comparable data from a national survey
of 3,529,615 individuals across the United Kingdom. They found that among
teenagers in the United Kingdom, about 7 in 1,000 (7.4, to be precise) are now
taking, or have taken, medications for ADHD.[3]
Now we
are ready to do the comparison. In the United States, about 103 teenagers out
of every 1,000 are now taking, or have taken, medication for ADHD. In the
United Kingdom, the figure is 7.4 teenagers out of every 1,000. Comparing the
United States with the United Kingdom, the odds ratio is:
103 / 7.4 = 13.9
In other
words, the likelihood of being treated with medication for ADHD is nearly 14
times higher for teenagers in the
United States compared with teens in the UK.
For
younger children, the odds ratio is less dramatic. In the United States, among
children age 4 to 13, about 69 kids out of every 1,000 are now taking
medication for ADHD.[4] In the UK, among children
6 to 12 years of age, the figure is 9.2 kids out of every 1,000. So the odds
ratio, comparing the USA with the UK, is
69 / 9.2 = 7.5
The
likelihood of being treated with medication for ADHD is about 7.5 times higher
for elementary- and middle-school children in the United States compared with
elementary and middle-school children in the UK.[*]
Bottom line:
On this parameter, if you are a kid, living in the United States is a major
risk factor for being put on medication. And the risk increases as you move
from childhood into adolescence. You would be at much lower risk if you moved
to England, although rates of diagnosis of ADHD are on the rise in England as
well.[5]
I know
an American family who spent several years living in England. They had one son,
who was an average student: not great, but not terrible. When the family
returned home to the United States, the parents enrolled their son in the local
public school. Mom was startled by the continual drumbeat from teachers and
from the other parents: Maybe your son
has ADHD. Have you considered a trial of medication? She told me, ‘It was
weird, like everybody was in on this conspiracy to medicate my son. In England,
none of the kids is on medication. Or if they are, it is a secret. But I really
do not think many are. Here it seems like almost all the kids are on medication. Especially the boys.’
The above is adapted from my book The Collapse of Parenting, Basic Books,
2015, pp. 59 - 61.
[*] The age grouping is not precisely the same: 4 to 13 years of age in the US compared with 6 to 12 years of age in the UK. But it will suffice to give us an order-of-magnitude comparison.
[1]
Alan Schwarz and Sarah Cohen, A.D.H.D.
seen in 11% of U.S. children as diagnoses rise, New York Times, March 31, 2013.
[2]
In my first-hand experience as a prescribing physician in Maryland and in
Pennsylvania, the proportion is higher than 69%. In most cases in which I have
been involved, when a doctor diagnoses ADHD, the doctor also writes a
prescription for a medication. But we will accept the CDC estimate of 69%. Here
is the source for the figure of 69%: Centers for Disease Control and
Prevention, Attention-Deficit / Hyperactivity
Disorder (ADHD): Data & Statistics, November 13 2013, www.cdc.gov/ncbddd/adhd/data.html.
[3]
Suzanne McCarthy and colleagues, The epidemiology of pharmacologically treated
attention deficit hyperactivity disorder (ADHD) in children, adolescents and
adults in UK primary care, BMC
Pediatrics, volume 12, 2012, full text online at no charge at www.biomedcentral.com/1471-2431/12/78/.
[4]
According to the CDC data from March 2013, 10% of American children 4 to 13
years of age, or 100 out of every 1,000, have now been diagnosed with ADHD. The
CDC separately estimates that 69% of American children diagnosed with ADHD have
been prescribed medication for ADHD. 69% of 100 = 69 children out of every
1,000 have been prescribed medication for ADHD.
[5]
Peter Conrad and Meredith Bergey, The impending globalization
of ADHD: notes on the expansion and growth of a medicalized disorder, Social Science and Medicine, volume 122,
pp. 31 - 43, 2014.