It’s that time again: A feeding frenzy on ADHD and the medications used to treat it. Because nothing sells like ADHD hysteria! This latest salvo in the anti-ADHD wars comes from Netflix, Take Your Pills.
Nobody has time for this nonsense. You surely have better things to do than read this post. I am immersed in developing online training for Adult ADHD-Focused Couple Therapy.
Yet, we all have a lot to lose by failing to speak up. The blogosphere and the clickbait-o-sphere are brimming with praise for Take Your Pills.
Please: Do not imagine that ADHD treatment is a given.
Look at many other Western countries, where adult ADHD is not even on the radar (often, pridefully so), especially in single-payer national healthcare systems. The U.S. could devolve to that, too, if disinformation campaigns sway public opinion.
Thank You For Sharing
The film’s clear aim is to provoke, to further confuse a largely science-illiterate public. “Driving us back into the closet,” says my friend Meg, age 40 and diagnosed at 35.
Moreover, this “Adderall epidemic!!! and ADHD over-diagnosis!!!” theme constantly rears its ugly head. In this post, I shed light on the reality.
The producers and Netflix call it a documentary. Yet that would imply balanced reportage. There is none in Take Your Pills. Most legitimate documentaries don’t shovel shame and stigma on people burdened enough. (A professional documentary critic agrees; see below.)
“I agree with some of it,” a young woman with ADHD responded to my Facebook post. No, I am sorry but it doesn’t work that way. You cannot cherrypick edible fruit from a toxic tree.
Sure, the filmmakers toss in a smidgeon of valid points. That serves to ensnare people ignorant to the complexities on this topic.
But therein lies the trap: the filmmakers’ vainglorious claims of addressing “an important societal issue” amount to nothing more than a transparent and treacherous Trojan Horse.
Their true agenda is clear: No more ADHD diagnoses and no more medications.
This Post Covers These Points:
Yes, this post is long. But I want to cover as much territory as possible, and I am short on time.
Here are the highlights:
1. The producers are Maria Shriver and daughter Christina Schwarzenegger.
Christina was diagnosed with ADHD at age 6. Neither one seems to know a thing about ADHD. Except for having it. What else do they have? Gobs of money, access, and an ax to grind.
2. You can watch a video interview, below, where they clearly reveal their ignorance.
3. Contrary to popular belief in the ADHD community, “Neurotypicals” are not the enemy of ADHD awareness and legitimacy.
In my observation, it is a subset of people with ADHD who pose the biggest threat.
4. Professional documentary critic Christopher Campbell, an ADHD skeptic until his son was diagnosed, takes this film to task. Excerpt and link below.
5. A list of points about the complexities of “stimulant abuse”—including the fact that most of the people “abusing stimulants” probably have ADHD.
6. Two studies examining the “diversion” problem (diversion is when a prescribed medication is used by someone other than the patient for whom it is prescribed)
7. I provide several links to substantiate or expand my points. I hope they don’t distract you! Maybe try reading the post fully and then going back to the links.
Still Curious? Watch This Interview Instead
So, before you take the bait and watch it on Netflix, please think about the consequences. Every time we “vote” for skewed ADHD propaganda, in a film or newspaper, we say, “Give us more of this, please.”
(I’m convinced that the New York Times has been tapping into public hysteria about ADHD for years—simply because it drives web traffic like little else. That’s why I don’t share the links. And, rest, assured, Alan Schwarz, the former New York Times sports reporter who campaigned on the paper’s front page for a Pulitzer on the backs of people with ADHD, figures prominently in this film. I’ve heard he is now a high school math teacher. Don’t know who he is? Read these posts: Dr. Thomas E. Brown Responds to NYT’s Alan Schwarz and The Truth Behind “10,000 Toddlers Medicated for ADHD)
Hey, but don’t take my word for it! Check the videotaped interview below. It will tell you all you need to know about the filmmakers’ agenda. Shriver and Schwarzenegger are interviewed by Kara Swisher (wearing sunglasses).
Did She Actually Say That?
A friend watched it and said, “Did that woman actually say, ‘Why does a 16-year-old need executive function?’ Good lord!”
Why yes. Yes, she did.
Swisher also proudly disclosed that she “declined” suggestions of ADHD medication for her school-age son. Instead, she let him run around outside.
And. Then. This. Wait for it.
“Well, he’s just not going to do well in school. He’s a tall rich white man in America. I think he’ll be fine.”
Let that sink in a minute.
I’ve seen that attitude dominate in San Francisco, where Swisher lives. It’s a city is known for its high rates of substance abuse. Meth, opiates, and cocaine are the drugs of choice (if you don’t count startups and IPOs), according to The Most Commonly Used Drugs in San Francisco. In a future post, I share research showing the reduced risk of developing a substance use disorder among children treated early for ADHD.
“NeuroTypicals” Aren’t The Enemy
Let’s be very clear: “Neurotypicals” didn’t bring us this film. That’s the word commonly used to describe folks who don’t have ADHD and are blamed for ADHD denialism. “They don’t understand what it’s like to live with ADHD,” some will complain.
Here’s a little secret: In my long experience and close observation, no one publicly denies or obfuscates the facts around ADHD more than someone who has ADHD, is “in denial,” is narcissistic—and has something to sell.
The producers are Maria Shriver and her daughter, Christina Schwarzenegger. Reportedly diagnosed with ADHD in childhood, Schwarzenegger reports taking Adderall through high school and college. It’s a bit confusing, but it seems the only reason she quit was that her liver enzymes were elevated. “And no one told me this could happen!” With all that Shriver/Schwarzenegger money, her parents a broadcaster and a one-time governor, no one ever even asked about this?
Anyway, according to them, everybody is abusing Adderall on college campuses. Everybody. How do they know this? Unclear. But one gets the feeling that, whatever lip service to ADHD’s legitimacy they might give elsewhere, any use of a stimulant is an illegitimate use in their eyes.
Is Everybody Abusing Adderall? Truly?
Shriver particularly points to the dangers of more young women taking stimulant medications—”cause they want to do start-ups.” Yet, my female friends with ADHD work as teachers, nurses, therapists, and every other occupation. Consider this post from the aforementioned Meg: On Trying to Swim Blind: ADHD and Medication
Where Meg writes poetically of horizons expanding and clarity sharpening when she is diagnosed and begins stimulant medication, Shriver sees only disaster and addiction. A national calamity.
Sneak Preview Highlights:
Here are some interview highlights:
—Schwarzenegger claims she was diagnosed at age 6
In my experience, only the most severe cases of ADHD in girls are diagnosed that young.
—Shriver says her daughter was a “creative learner”
“But teachers will come to you and say ‘medication’ and I said ‘no no no.’ But there is a lot of pressure when the child falling behind.”
In other words, all the usual tropes….” schools are not designed for creative learners.”
And the world is designed for “creative learners”? Only if you are rich and privileged—and not so severely impaired by ADHD that you end up broke, addicted, and in jail.
Ah, but no, Schwarzenegger did avail herself of a stimulant.
—By the first year of high school, Schwarzenegger was taking Adderall
She is careful to stipulate: This happened “only after extensive testing.”
Then onto college, where she discovered the “Adderall epidemic.” She attended the highly competitive and costly Georgetown University. Was that the best choice for someone who had a long history of struggling in school? Who was allegedly a “creative learner”?
—Christina reports a hard time “getting off” of Adderall
Schwarzenegger reports trouble functioning after stopping the medication. Shriver views that as proof of stimulants’ addictiveness.
But wait. As one friend with ADHD points out, “Well, duh, when you stop the medication, ADHD symptoms return. Maybe you forgot what that was like!”
For a vivid example of an unplanned medication “holiday,” check out Katy Rollins’ essay, ADHD Drug Holiday—Or Horror?
I just have to wonder why, with all their money and access, the Schwarzenegger-Shrivers settled for Adderall, that most problematic of stimulants. It works best for a minority of people. But for most, it causes more problems than it solves. Did the family do no research? Sure seems that way.
He Watched It So You Don’t Have To
Christopher Campbell is a freelance film editor and critic and the founder of the documentary review site Nonfics.
At The Thrillist website, he opens his incisive review of Take Your Pills (Side Effects of Netflix’s New Doc “Take Your Pills” Include Rage and Misinformation) this way:
One of my favorite jokes is about a man goes to the doctor seeking “smart pills,” only to walk out with a sample of what turns out to be rabbit droppings.
When he returns to the doc and points out that the “pills” are actually poop, the doc says, “See, you’re getting smarter already!”
Netflix’s new documentary Take Your Pills is the 90-minute equivalent of the “smart pills.”
This From A Reformed ADHD Skeptic
Here’s the part where I explain my anger. I don’t like to be so subjective in my criticism of films, but Take Your Pills hit me on a very personal matter.
My entire life, I’ve been skeptical of pharmaceutical drugs to a point of great opposition. Then I became a father of a son with ADHD, which not only crippled his learning but was also affecting others in his school and recreational activities.
Only after much convincing and research did I give in to the idea of medication. Even then, there was a trial and error process with the various prescription stimulants and doses, genetic testing to pinpoint the best combination of drugs and vitamins, and constant counsel with his pediatrician and teacher. For my developing son, and for this diligent parent, the meds are necessary.
Dear Netflix, This is Why I Take My Pills
Also, consider this excerpt from an excellent opinion piece by Metro News writer James Woods: Take Your Pills: Dear Netflix, this why I take my pills:
Throughout the film, I found only a handful of the descriptions to be relatable.
I have never felt my medication ‘kick in’ for example, nor have I used it to ‘get through the day’, and I certainly haven’t felt ‘powerful’ because of taking my medication.
The film also fails to show the impact ADHD can have on a person’s life and even the economy.
In my experience, it caused me to spend my school years feeling stupid, my late teens feeling crazy and often lazy. It was the source of two major breakdowns, which saw me drop out of university and quit a job I loved.
It dictated my life for many years, and now with an understanding and treatment, I dictate my own life.
Remember: I Coined the Term “Madderall”
No one need school me on Adderall. I sounded the early warnings: Sloppy prescribers who irrationally favored Adderall risked creating a backlash against ADHD. I hate that I was right—and continue to be. The prescribers are not learning. It is a shameful phenomenon.
I wrote years ago about the complexities in this blog’s all-time most popular post: The Tragic Truth of Adderall, or Madderall.
The fact that people abuse stimulants is no front-page story. The fact that humans seek stimulation in all forms is no state secret. How many physicians have I met who joked, “If not for cocaine/Benzedrine/Fill-In-The-Blank, I’d never have made it through med school.”
I finally had to post on my Quora profile: “Please don’t ask me questions about how to abuse medications. Thanks.” It’s not just Adderall they are seeking. There’s Modafinil and many I’ve never heard of. These misguided and desperate-sounding people are looking for anything to make them “smarter”. But don’t be distracted: It’s not just Adderall that Shriver and Schwarzenegger are castigating. They very clearly put all stimulants in the same scary category, along with the very diagnosis of ADHD.
So yes, we have some big problems with competent treatment for ADHD, just as we do for almost all psychiatric conditions, not to mention the rest of medicine.
But does that mean that all of these people allegedly seeking to “score” Adderall don’t have ADHD? No, it doesn’t.
Think about it: Who is most likely to want a “shortcut” to focus?
I’ll share research on that in a minute.
But what does this alleged “Adderall epidemic” have to do with ADHD? Where are the numbers? Which research are they citing? Oh, they just asked Alan Schwarz. He’s a high school math teacher. He should know.
Now for the Bullet Points and Two Studies
Just before Take Your Pill’s launch, a British newspaper reporter asked to interview me on the topic of Adderall. At the last minute, the editor decided to drop the story (good editorial judgment!) and so the interview was canceled.
Not to let several hours work go to waste, I’m sharing here.
1. The Film’s Creators Lack focus—and Neuroscience
- Is the focus an alleged increase in so-called “performance drug” usage?
- Is it the “abuse” of stimulant medications? If so, how do they define abuse? What research do they cite?
- Did they vet experts for competence—or for suiting their bias?
- Do they include among the alleged abusers those people with ADHD who cannot afford or find a psychiatrist to treat their ADHD—so they obtain stimulants not prescribed for them?
- Do they include college students and young adults in their first jobs trying to keep up despite clear ADHD challenges—but not wanting to endure the stigma of ADHD and a legitimately prescribed medication for it? (In other words, it’s more acceptable to take a “performance enhancer” than to cop to a highly stigmatized diagnosis.)
- What is their proof that stimulant medications truly work as a “performance drug”? In fact, if people who do not have ADHD take Adderall, in particular, the result is more likely an over-focus. It confers, at most, improved facility with memorizing dates—but risks missing the larger details of the subject they are studying.
- Do they include caffeine in this “performance drug” usage? Caffeine is a readily available drug that is being massively abused today. Strong coffee. Red Bull. Caffeine pills. Many caffeine abusers, in fact, have ADHD (diagnosed or not) and are “self-medicating.”
- Some caffeine abusers end up in emergency rooms. According to a 2013 story in The Atlantic, How Much Caffeine Before I End Up in the E.R.?: “In 2005, fewer than 2,000 trips to hospital emergency departments involved energy drinks. By 2011, that number was over 20,000. If energy drinks are safe, why are they sending us to the hospital?” 20,000 ER visits from caffeine!!! Where’s that documentary? And that study was published 13 years ago!
2. Fake News Sells
It’s easy to exploit public ignorance and preconceptions. Especially with “fake news” about ADHD.
The very word “stimulant” strikes the average person as wildly inappropriate for a child or adult who is already “nervous” or “wired.” That’s because most people do not understand the nature of ADHD’s brain-based challenges and how the medications work to mitigate them. This ignorance makes them vulnerable to exploitive “fake news.”
ADHD is No “Controversy” in the international scientific community.
3. Reasons for the “Non-Medical Use of Prescription Stimulants”
- Instead of “abuse,” the more accurate term is “non-medical use of prescription stimulants (NPS)” And there are diverse potential explanations for this.
- In a sense, the very choice to abuse Adderall reflects the user’s poor judgment, poor planning, and overconfidence that taking “speed” will magically negate the adverse effects of such. There is nothing “smart” about that.
- I suspect that the majority of the people “abusing” Adderall, in fact, do have ADHD. See research below.
- As previously mentioned, it’s simply more acceptable to take a “performance enhancer” or to even “abuse” a drug than it is to acknowledge both a deficit and a disorder.
- Moreover, there are barriers to treatment for many people with ADHD—access, cost, location, time. Every day, I help clients identify local ADHD-savvy mental-health professionals. In some areas, it’s simply impossible. Even if you have lots of money.
4. Most Adults Are Not Diagnosed, Thus More Vulnerable to “Self-medicating”
Of the roughly 10 to 30 million adults in the U.S. thought to be on the “ADHD spectrum” (that is, having ADHD to an extreme or mild degree), only 10% are diagnosed, according to the most recent research. Fewer still are in treatment.
These people are more vulnerable to a long list of poor life outcomes, including unemployment, low education, bankruptcy, absentee parenting, substance abuse, on the job and auto accidents, incarceration, and even earlier death. This is not a topic suitable for self-serving skewering.
5. Adderall Is An Older, Typically More Problematic Stimulant
- Adderall is an older and in many ways outmoded stimulant. FDA approved Adderall in 1996, only two years after Adult ADHD was made an official diagnosis.
- It releases quickly into the system and ends quickly. But it has a more complicated “mechanism of action” than most stimulants; it is four mixed amphetamine salts, not one, as with Dexedrine or Vyvanse. This means that Adderall might work best for a small subset of people with ADHD. Yet, for many others, it causes more problems than it solves.
- Since 1996, many other formulations in the two classes of stimulant (amphetamine and methylphenidate) have been made available. This allows individuals to find a formulation and dosage that works best for them. Most of the newer stimulant choices allow a longer, more sustained, and smoother delivery, in contrast to Adderall’s quick-release and quick-stop. (It is stereotypical for Adderall patients to depend on cannabis to reduce ADHD-fueled irritability and sleeplessness.)
- Whatever the particular issues with Adderall, this film is not drilling down into that. It is using “Adderall Abuse!” as its war cry, but it is including all the stimulants on its banner. (In an interview, Shriver alludes to more “natural” approaches, including a “creative” school and meditation.)
6. Competent Psychiatric Treatment Is Difficult to Find
In a very real sense, Adderall is “abused” by some physicians who prescribe it for legitimate ADHD. That is because they prescribe it sloppily, without follow up and tracking of symptoms over time. (I hear the stories every day….lives flying off the rails.) But the same is true for all the stimulant medications, not to mention most psychiatric medications in general.
7. That Doesn’t Mean We Focus Only On Negatives
If we fail to clearly separate all these issues, we do a shameless disservice to the millions who truly suffer from poorly managed ADHD—and the millions whose lives have been elevated and even saved with diagnosis and treatment.
2012 Study in the Journal of Attention Disorders
Surveyed 10,000 U.S. adults about using stimulant medication when they did not have ADHD:
Non-Medical Use and Diversion of ADHD Stimulants Among U.S. Adults Age 18-49
Just 8% of these adults reported ever having used such an ADHD stimulant for non-medical purposes in their lifetime.
- Compare that to the rate of non-medical use of pain medications, such as opioids, which was done 4 times more often than that seen for ADHD stimulants. Notice that only 1-2 people per 100,000 engaged in such behavior for any given ADHD stimulant.
- Other research shows that stimulant misuse on college campuses specifically occurs in just 2-3% of students—a figure far, far below the use and misuse of alcohol, marijuana, and club drugs.
- Increasingly, research shows that youth treated early for their attention deficit hyperactivity disorder are less likely than others with the condition treated later in life (or not at all) to start smoking or to abuse alcohol or drugs. Also from this paper:
- Research with college student samples has shown that the most frequently reported reason for NPS is to purportedly improve concentration so as to enhance academic performance
- Yet the academic motives for NPS contrast with a pattern of other associated behaviors that would appear to impede nonmedical users’ of prescription stimulants academic performance, such as spending less time studying, skipping more classes, and spending more time socializing than their counterparts
2012 Paper in the Journal Addictive Behaviors
Dispelling the myth of “smart drugs”: Cannabis and alcohol use problems predict nonmedical use of prescription stimulants for studying
This study tested the hypothesis that college students’ substance use problems would predict increases in skipping classes and declining academic performance, and that nonmedical use of prescription stimulants (NPS) for studying would occur in association with this decline.…Although additional research is needed to investigate causal pathways, these results suggest that nonmedical users of prescription stimulants could benefit from a comprehensive drug and alcohol assessment to possibly mitigate future academic declines.
Nonmedical prescription stimulant use (NPS) for studying among 984 college students.
- Four-year trajectories of cannabis/alcohol use problems, skipping class, GPA.
- Increasing cannabis use problems predicted declining GPA via skipping class.
- Indirect path: cannabis trajectory to skipping trajectory to GPA trajectory to NPS.
- Results were similar for separate models on alcohol and cannabis use problems.
There Is More—Much More!
But we’ll save it for a future post!
As always, I welcome your opinion.