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Comment by TeMPOraL | Hacker News Reader

Amphetamines aren't magic. There are qualitative differences in response between people with and without ADHD, that manifest across the board, not just on few school metrics - and a psychiatrist will be able to see them.

The "young unruly boys without enough PE" is a well-known trope, and modern school is very much kid torture - but I'm not willing to say yet that we're medicating children too much, when the world is only slowly waking up to the fact that we've been underdiagnosing ADHD by at least factor of 2 - this stereotype of unruly boys means the Primarily Inattentive subtype of ADHD is being frequently ignored (vs. the Primarily Hyperactive that creates all the stereotypes), that girls suffering from ADHD are not being diagnosed, not to mention adults.

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> There are qualitative differences in response between people with and without ADHD, that manifest across the board, not just on few school metrics - and a psychiatrist will be able to see them.

I was under the impression that this "it works differently on people with ADHD" thing was essentially a pleasant myth. If you've got solid citations that stimulants do somehow work differently on people with ADHD I'd be interested in reading them. My understanding was that the effect is broadly similar, with the only meaningful distinction being that ADHD-diagnosed individuals have been judged as needing those effects, and others have not.

"By high school, nearly 20% of all boys will have been diagnosed with ADHD."

Either 1. we are medicate children too much and schooling is very screwed up or 2. 20% of boys defective to extent that they require amphetamines. I am not see third option. I am not believe 20% of boys defective to such extent. So I believe we are medicate children too much.

[0]: https://www.esquire.com/news-politics/a32858/drugging-of-the...

Well, yes. About ~10% of US kids.

How about 3: schooling is increasingly good at exacerbating symptoms of a problem that's considered to be strongly genetic[0] (a point curiously omitted in the article you linked) and widespread in the population. And the numbers seem less surprising if you consider that adult life is also good at making the symptoms apparent - except we brush them away with labels like "lazy", "unorganized", "chronic procrastinator", "rude", etc. and let people figure out coping mechanisms on their own, which often include substance abuse, or on the lighter end, self-medicating with coffee and cigarettes.

[0] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3245028/#__sec1... points to "strong genetic influence on ADHD with estimated heritability ranging from 75% to 91%".

20% is how many boys that age were ever diagnosed with ADHD. 89% of children ever diagnosed have a current diagnosis. Only 62% of children with a current diagnosis take any medication.[1] So much fewer than 20% take a specific medication probably.

Almost 40% of boys that age need vision correction.[2]

[1] https://www.tandfonline.com/doi/full/10.1080/15374416.2017.1...

[2] https://www.cdc.gov/mmwr/volumes/66/wr/mm6644a12.htm?s_cid=m...

Which are absolutely insane numbers compared to very similar societies all around the world. I doubt there is some sort of truly unique illness doing rounds only in America.

America isn't an extreme outlier. And most of the variation around the world can be explained by different diagnostic criteria.[1] Look for numbers around the world to jump as countries adopt ICD-11.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994964/

84% of total world wide ADHD meds are eaten in the USA. There is a difference between identifying symptoms and thinking stimulants are the answer or just not paying any attention. Just like in Europe the medical consensus is that people have to learn to live with pain rather eating oxy's. It doesnt meant the doctors pain didn't exist in their patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261411/

I know you don't intend it this way, but it does come across as cruel when confronted with realities.

> 84% of total world wide ADHD meds are eaten in the USA.

That's of course because US is ahead of the curve in medicine.

> Just like in Europe the medical consensus is that people have to learn to live with pain rather eating oxy's.

This isn't a medical consensus. We just don't push opioids for everything so early. We start with paracetamol and ibuprofen, upgrade to ketoprofen and other NSAIDs in more specialized or severe cases, and continue as needed. But living with pain is not an acceptable answer here either.

Stimulant meds work very well on ADHD and are very safe, both short and long-term; it's a much better story than say SSRIs and depression. The main problem here is the combination of stigma (oh no, amphetamines!) and fears of abuse by people not suffering from ADHD (oh yes, amphetamines!) - both of which are in large part fueled by the US War on Drugs, the unending source of pathologies and suffering worldwide.

Stimulants also work very well on people without ADHD, so why not give them to everyone!?

It seems crazy that we've made it this far as a species without medication; so why should it be required now? Maybe the issue isn't the children, but the environment they are in?

Because 50 years ago:

- teachers had a lot more options when it came to disciplining kids

- many left school for work at age 15 - 16

Do you want the good old times back?

(Another thing is many countries have changed the curriculum to be even more heavy on theory than it used to be. That I would like to change, both for the kids and for future employers: broad practical experience probably increases someones chances in engineering and probably other disciplines as well.)

Says in the article 7 times more likely to get adhd meds in the US than UK. America is wealthy but these numbers are way off compared to similarly developed nation.

Could you point out where the article claims that? It's padded extensively with selective and often irrelevant factoids and speculation about ADHD diagnosis, recreational drug use, etc.

> the US (<5% of the world’s population) was responsible for > 92% of the world spending on these agents [35].

92% of spending doesn't imply 84% of consumption. The same drugs cost more there than the rest of the world. And new drugs start there often.

Given the opiate situation, I have no doubt there is a massive kickback scheme going on over emotional conformity drugs

The United States most definitely has a unique illness. It’s convinced the masses freedom is being tethered to corporatism.

We need a less militaristic and autocratic 1984

“40 hours a week for deflated earnings is freedom. Quarterly gains for the aristocracy is how we beat ‘them’.”

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