For decades, David Martin struggled with time management and procrastination, but he wasn’t sure why.
In college, he noticed that his grades were better during shorter, semester-long courses than in year-long classes. And when he reached 40, he even let his household bills pile up for months, not because he couldn’t pay them, but because he simply didn’t pay them on time.
Then, almost a decade ago, when he was 46, the Toronto resident was diagnosed with attention deficit hyperactivity disorder, ADHD, and began taking medications that he now says changed his life.
Soon, Martin, now 57, began keeping track of bills, remembering important dates, and was finally able to manage his time.
“They changed different aspects of my life,” he said. “Because I wasn’t procrastinating.”
ADHD is often identified in a person’s childhood, when parents or teachers notice problems such as inattention, hyperactivity or impulsive behavior, but Canadian doctors and mental health professionals say more and more adults are being diagnosed as well. , sometimes even when they are 40 years old. 50 and beyond.
New data provided to Breaking: from British Columbia suggests the rate of ADHD medication use among adults has also increased dramatically.
Figures show total ADHD medication use among British Columbia adults has increased at a CAGR of 17 per cent since 2004, from one user per 1,000 adults to 16.5 users per 1,000 adults in 2022 .
Obtained from the BC Ministry of Health, the data was released on tuesday by the University of British Columbia Therapeutics Initiative, an organization that provides Canadian physicians, nurse practitioners, pharmacists and other health care professionals with independent, evidence-based information on health care interventions.
Medical experts who spoke to Breaking: say the trend across the country is likely similar and could be improving the lives of many Canadians. Others, however, warn that it is a double-edged sword.
Commonly Diagnosed Condition
ADHD is known as one of the most common neurodevelopmental disorders, affecting millions of people in North America. A 2022 review of Canadian research suggests that approximately three percent of adults may have ADHD, with a higher prevalence among children.
The condition is often treated with medications, therapy, behavioral changes, or a combination.
Megan Rafuse, a registered social worker, psychotherapist and CEO of online therapy practice Shift Collab, said she struggled with completing assignments, concentrating in class and finishing projects during college. She was not diagnosed with ADHD until she was in her early 20s.
Rafuse began taking medication as part of his treatment plan. She now credits him with helping her develop habits that allowed her to pursue a career in psychotherapy.
“If we need glasses to help us see, we wear them,” he said. “Medications work the same way: We take medications to improve the functioning of our brain so we can go out and be our best productive selves in the world.”
While many patients experience success stories, Victoria-based family physician Dr Josh Levin said higher rates of ADHD medication use in adults have a dark side that isn’t always talked about.
“I’m a little concerned that … we might be overdiagnosing ADHD and that might be an unnecessary medicalization of people,” she told Breaking:. “And then we end up treating them with medications that they may not get much benefit from and, in fact, may be harmed by the side effects that we might expect from the medications.”
Risks of ADHD Medications
In his own practice, Levin said he has treated patients who have developed heart conditions caused by ADHD medications, some of which fall into the category of stimulant medications, including amphetamines and methylphenidate, which are known to rev up the systems. of the body.
Common brand-name stimulant medications used for ADHD include Concerta, Ritalin, and Vyvanse, and the websites for each describe the potential risks of these medications.
Vyvanse, for example, one of the newer options for treating ADHD, can cause serious side effects, including psychiatric problems and heart-related problems such as sudden death, heart attack, or stroke. Its website notes that it also has “high potential for abuse” and “may cause physical and psychological dependence.”
Dr. Elia Abi-Jaoude, a researcher and assistant professor in the department of psychiatry at the University of Toronto, said stimulant medications can also suppress a person’s appetite or interfere with sleep, which can actually make the ADHD is more difficult to control.
He emphasized that the worst side effects associated with these drugs are still quite rare (and may be more difficult to study), but “when we talk about increased use of these drugs at a population level, then these things become especially salient.”
ADHD symptoms fall on a spectrum, Levin said, adding that there is growing acceptance of that range among the psychiatric community. But he also questioned where doctors should draw the line.
“As doctors, we should make a diagnosis based solely on what we see in a patient in front of us,” Levin said. “But of course we are human beings, so we are subject to biases.”
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Private clinics focused on ADHD.
Levin pointed to the rise of private clinics focused on psychology, an emerging trend where patients can pay for evaluations specifically to see if they have ADHD.
“When we’re in a clinic where the patient is paying us to look for something, I think that changes our thinking a little bit and we’re more likely to see what the patient is looking for,” he said. saying. “And this kind of raises the concern about finding diagnoses.”
Some clinics focus solely on ADHD, while others offer evaluations for a variety of psychological problems, charge patients hundreds to thousands of dollars for services, and often have minimal or no wait times.
One such clinic, the Adult ADHD Centre, operates across Canada. He charges $300 for evaluations and says his team has performed more than 20,000 to date. According to the center’s websiteThey are “very similar” to those usually carried out in the public system.
Doctors in Quebec warn that ADHD medications are being overprescribed to teenagers, twice as much as in any other province, leading to potentially harmful long-term effects.
Dr. Gurdeep Parhar, the centre’s medical director, told Breaking: there was a need across the country for a focused practice like theirs.
“We kind of learned that there weren’t many places that adults with ADHD could go for an evaluation,” he said. “Children could go to pediatricians and family doctors, but adults just had nowhere to go. And part of that is because there weren’t many doctors and people aware that adults could get ADHD.”
He also noted that a “good percentage” of those evaluated by his team don’t actually end up diagnosed with ADHD.
Given the long wait times for psychiatric care in Canada and limited access to family doctors, private ADHD clinics may be filling a gap. (Nova Scotia, for example, is even paying private psychologists to conduct autism and ADHD assessments to address the provincial lag among children.)
But several medical experts who spoke to Breaking: also questioned why there appears to be such a high level of demand for ADHD assessments.
Growing awareness through social media
Growing awareness, driven in part by social media, could be contributing to increased interest in this condition among the public. For example, ADHD-related videos, quizzes, and promotional posts are now regularly found on platforms such as Instagram and TikTok.
Rafuse, a psychotherapist, said greater awareness of neurodiversity (the term increasingly used to describe the different ways people’s brains work) can be beneficial.
“Suddenly, as a society, we are being more open about our struggles, what the symptoms look like and how they manifest,” she said.
But others warn that the trend could lead to unnecessary diagnoses, misinformation about how ADHD actually presents in people, and increased interest in medications that not everyone necessarily needs.
In a study published in 2022, a research team led by Abi-Jaoude analyzed the 100 most popular ADHD videos uploaded to TikTok and found that just over half were misleading. Notably, none of the videos asked viewers to seek an actual medical, psychiatric, or psychological evaluation before attributing their symptoms to ADHD.
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While the full picture behind rising rates of ADHD medication use in adults remains unclear, some emphasize that the stories of patients whose lives have changed for the better should not be clouded by concerns about certain medications.
“Quite effective and quite safe”
“ADHD medications should not be excluded for any reason,” Parhar said. “They are quite effective and quite safe.”
Martin, the Toronto resident who was diagnosed with ADHD at age 46, currently takes Vyvanse once a day to manage his condition.
The only thing he regrets now is not having received a diagnosis sooner. A failed math course in college, for example, prevented him from pursuing his goal of a career in computer science.
“If I had been diagnosed earlier, maybe I wouldn’t regret it,” he said.
“Believe [medication] “It’s giving people the opportunity to live the life they maybe wanted.”
