The following is an excerpt from the new book The Myth of the ADHD Child: 101 Ways to Improve Your Child’s Behavior and Attention Span without Drugs, Labels, or Coercion (TarcherPerigee, 2017), available for purchase from Amazon, IndieBound and Penguin:
The Big Payoff in Promoting ADHD Drugs
Drug companies give financial support, sometimes without public knowledge, to individuals and groups that are key players in the research, diagnosis, and treatment of ADHD. The parent advocacy group Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), for example, which was instrumental in helping get ADD (as it was then called) designated as a handicapping condition under federal disability laws in the 1990s, was secretly taking money from pharmaceutical companies for years before disclosing its financial connections after a 1995 PBS broadcast revealed its underhanded dealings with drug companies.[i] It now regularly reports the amount it receives each year from Big Pharma. In the 2008–2009 fiscal year, for example, it took in $1,174,626 from Eli Lilly, Johnson & Johnson’s McNeil division, Novartis, Shire US, and UCB, spending $330,000 on its annual conference, $114,950 on its twentieth anniversary gala, and $187,747 on a salary for its chief executive officer.[ii] Between 2006 and 2009, Shire alone paid CHADD $3 million to have CHADD’s bimonthly magazine, Attention, distributed to doctors’ offices nationwide.[iii]
The doctors who do the diagnosing and prescribing of ADHD and its many drugs are another key link in the marketing chain employed by big pharmaceutical firms. Drug companies typically hold “professional development” seminars for doctors where the benefits of the firm’s new products are touted. New York Times reporter Alan Schwarz described one such meeting sponsored by Shire to promote Adderall XR, in which a psychiatrist from Denver paid by the company to speak proceeded to give inaccurate information about ADHD and Adderall XR to the seventy-five doctors attending. According to Schwarz’s report, the doctor told his colleagues to educate their patients on the lifelong nature of the disorder, despite evidence that many, if not most, individuals cease to meet the criteria for ADHD after adolescence. He also claimed that stimulants were not drugs of abuse (despite the fact that they are restricted by the federal government because of their abuse potential), and that side effects of Adderall XR were “generally mild” despite clinical evidence of insomnia, significant appetite suppression, and mood swings.[iv]
Big Pharma also influences doctors’ decisions about ADHD drugs through the frequent contacts that physicians have with company sales representatives. One salesman interviewed in Schwarz’s report, Brian Lutz, a Shire representative who sold Adderall XR between 2004 and 2009, said he met individually every two weeks with around seventy psychiatrists in his Oakland, California, territory, adding up to about thirty to forty sessions with each psychiatrist each year. Lutz told Schwarz that if he was asked by a doctor about side effects or about potentials for abuse he downplayed them, referring the physicians to the small print on the drug’s box. While feeling that he never lied about the product to the doctors, he regretted his role in promoting the drugs, saying: “We sold these pills like they were cars, when we knew they weren’t just cars.”[v]
Even more troubling is evidence showing that the very scientists who have engaged in legitimating ADHD and its various drug treatments through their so-called objective research have themselves been subsidized by drug companies. In 2008, a Senate investigation revealed that Joseph Biederman, Timothy E. Wilens, and Thomas J. Spencer, three of the most prolific and highly respected researchers in the ADHD community, had been substantially subsidized by drug companies and failed to report much of their income.[vi] Big Pharma paid $1.6 million alone to Biederman in speaking and consulting fees. Their research was then used by the pharmaceutical companies in their marketing and promotional efforts. As Schwarz observed specifically in regard to Biederman’s research: “Those findings typically delivered three messages: The disorder was underdiagnosed; stimulants were effective and safe; and unmedicated ADHD led to significant risks for academic failure, drug dependence, car accidents and brushes with the law.”[vii] The three researchers were eventually punished by their institutions, Harvard Medical School and Massachusetts General Hospital, for violations of conflict of interest policies through their nondisclosures.[viii] Maintaining transparency regarding his own involvement with drug companies, Russell Barkley, arguably the single most respected and trusted researcher in the ADHD world and author of the best-selling book Taking Charge of ADHD, disclosed during a 2009 PowerPoint presentation his own financial relationships with Eli Lilly, Shire, Medice, McNeil, Janssen-Ortho, Janssen-Cilag, and Novartis.[ix] Finally, and perhaps most shocking of all, the very organization that has established the criteria for ADHD in its Diagnostic and Statistical Manual (DSM), the American Psychiatric Association, itself receives significant funding from drug companies.[x]
Excerpted with permission from The Myth of the ADHD Child: 101 Ways to Improve Your Child’s Behavior and Attention Span without Drugs, Labels, or Coercion, by Thomas Armstrong, Ph.D. © 2017 by Thomas Armstrong. TarcherPerigee, an imprint of Penguin Random House LLC. Available for purchase from Amazon and Indiebound.
[i] The PBS broadcast covering the links between CHADD and drug companies originally aired on October 13, 1995, and was part of John Merrow’s regularly featured segment “Learning Matters” on PBS NewsHour. It was titled “A.D.D.—A Dubious Diagnosis?” and produced by John Tulenko. The video can be accessed at learningmatters.tv/blog/documentaries/watch-add-a-dubious-diagnosis/640. A written transcript can be retrieved from add-adhd.org/ritalin_CHADD_A.D.D.html.
[ii] Figures on CHADD money from drug companies and expenditures on conference, gala, and CEO salary are taken from Pringle and Rosenberg, “Big Pharma’s Newest Money-Making Scheme: Adult ADHD.”
[iii] The $3 million from Shire pharmaceutical to fund CHADD’s monthly magazine is taken from Schwarz, “The Selling of Attention Deficit Disorder.”
[iv] The story on the professional development seminar for psychiatrists paid for Shire pharmaceuticals is told in Schwarz, “The Selling of Attention Deficit Disorder.”
[v] The account of ADHD drug representative Brian Lutz’s relations with Oakland-area psychiatrists is from Schwarz, “The Selling of Attention Deficit Disorder.”
[vi] The account of Biederman, Wilens, and Spencer’s failure to disclose support from ADHD drug companies is given in Gardiner Harris and Benedict Carey,” Researchers Fail to Reveal Full Drug Pay,” New York Times, June 8, 2008. Retrieved from nytimes.com/2008/06/08/us/08conflict.html.
[vii] Schwarz is quoted from his article, “The Selling of Attention Deficit Disorder.”
[viii] A report of disciplinary measures taken against ADHD researchers Biederman, Wilens, and Spencer is given in Xi Yu, “Three Professors Face Sanctions following Harvard Medical School Inquiry,” Harvard Crimson, July 2, 2011. Retrieved from thecrimson.com/article/2011/7/2/school-medical-harvard-investigation.
[ix] Drug company support disclosures are provided in a PowerPoint presentation by Russell A. Barkley titled “Deficient Emotional Self-Regulation Is a Core Component of ADHD: Evidence and Treatment Implications,” 2009. Retrieved from ccf.buffalo.edu/pdf/BarkleySlides_CCFSpeakerSeries0910.pdf.
[x] The American Psychiatric Association’s links to drug companies are reported in Schwarz, “The Selling of Attention Deficit Disorder.”