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ADHD medication debate reignites -

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ADHD medication debate reignites

Broadcast: 16/02/2010

Reporter: Mike Sexton

It is estimated that more than 350,000 Australian children and adolescents have ADHD, which is
treated in a variety of ways, including by prescription stimulants, to help children focus and
interact socially. But many people oppose such medication and the debate about the treatment of
ADHD is about to be further stoked with the release of a long-term health study in Western
Australia tomorrow.


KERRY O'BRIEN, PRESENTER: The treatment of attention deficit and hyperactivity disorder has long
been controversial. It's estimated that more than 350,000 Australian children and adolescents have
ADHD, which is treated in a variety of ways, including by prescription stimulants to help children
focus and interact socially.

But there are many who oppose such medication, arguing it's dangerous for children.

This heated debate is about to be further stoked with the release tomorrow of a long-term health
study in Western Australia.

The 7.30 Report has been given exclusive access to the University of Western Australia study that
suggests the use of stimulant medication for children doesn't help them academically while also
harming them physically.

Mike Sexton reports on a case of complex arguments and polarised debate.

MIKE SEXTON, REPORTER: For people with Attention Deficit and Hyperactivity Disorder each day is
filled with distractions, interruptions and impulsive behaviour. Specialists believe the condition
affects the part of the brain involving self-control and one way of treating it is by using
stimulants that help the person cut through distractions and focus.

pay attention in the class. University students are able to attend their lectures and focus on the
lecturer as opposed to the 200 children - students being rowdy around them.

MIKE SEXTON: But the benefits of using amphetamines or other stimulants to treat ADHD is disputed.
and leading the charge is a former teacher turned Western Australian Labor MP Martin Whitely.

MARTIN WHITELY, WA LABOR MP: I saw a lot of boys in my classroom that were very heavily medicated
and frankly they were compliant, they were very easy to control, but they weren't switched on to
learning, they weren't interacting with their peers, and that really sort of generated an interest
in the issue.

MIKE SEXTON: Nowhere is the debate over the use of ADHD medication fiercer than in Western
Australia. During the 1990s, medication rates soared, and according to the Medical Journal of
Australia, by 2000 more than 20,000 West Australians were using stimulants, a prescription rate
that ranked amongst the highest in the world. But for the past 20 years in WA, authorities have
conducted one of the most thorough medical surveys in the world that sheds significant new light on
the issue.

LOU LANDAU, UNI. OF WA: The study itself was not designed for ADHD, but at the same time there was
a need to look at the long-term effects of management of ADHD.

MIKE SEXTON: In 1989 almost 3,000 women agreed to be part of research on ultrasound imaging. After
birth the families continued allowing data to be collected. So over two decades, this long-term
health study has amassed information on a generation of West Australians, including those diagnosed
with ADHD, some of whom were medicated and some of whom weren't. The results show those using drugs
did not improve academically.

(male voiceover): "The finding that stimulant medication use increased the odds of below age level
academic achievement by a factor of 10 times strongly suggests that medication may not result in
any long-term academic gains (as rated bay classroom teacher) and at worst, may result in poorer
teacher-rated academic performance."

LOU LANDAU: It tells the doctors that if you're going to use stimulant medication, you do need to
be aware that you need to look at the risks against the benefits. Now we know there are some
short-term impacts which may help the child, but long-term they're not likely to result in
significant improvement.

MIKE SEXTON: In addition to the academic performance, the report suggests long-term health

(male voiceover): "It was found that those who had consistently received medication at all time
points had a significantly higher mean diastolic blood pressure than those who had not consistently
received medication in the past."

LOU LANDAU: Stimulant medication short-term does increase the blood pressure, but of more concern
is the fact that those that had had stimulant medication in the past, even if they weren't
currently having it, still had blood pressures which were even higher.

MIKE SEXTON: The survey conclusions haven't changed the views of those who believe medication is a
legitimate part of the treatment of ADHD.

MICHELLE TONER: It was a parent survey and that's all it was. I think that there are other studies
that have been very carefully controlled that have showed some increases in children's academic
studies, and certainly my own PhD research showed medication a very valuable part of the treatment
- it's not the whole treatment - a very valuable part of the treatment for my university students
with ADHD.

MIKE SEXTON: Michelle Toner is President of a self-help group for those with learning and attention
disorders and sits on a WA ministerial committee on ADHD.

MICHELLE TONER: People need to be aware that there is often a lot of hysteria around ADHD
medications that is not always founded. Children with ADHD are treated by specialists, not GPs;
they have a specialist treating their medication and ADHD medications are very well controlled.

MIKE SEXTON: Martin Whitely sits on the same ministerial committee as Michelle Toner, but disagrees
strongly with her views.

MARTIN WHITELY: It should end the ADHD debate. We should stop the use of stimulants for ADHD in
children. But it won't, because frankly there's too many powerful vested interests that'll continue
to push it.

GRAHAM JACOBS, WA MINISTER FOR MENTAL HEALTH: I would not say that we ban all medication for ADHD.
I think it can be an important contribution to the treatment, but this study shows some of the
consequences and that makes us aware.

MIKE SEXTON: Martin Whitely believes the results in the west should be noted by the Federal
Government, because currently there are no national guidelines for the use of drugs in treating
ADHD. Late last year a set of new draft guidelines was released by Health Minister Nicola Roxon,
but they are yet to be approved because they relied heavily on studies conducted by American child
psychologist Joseph Biederman, who's currently under investigation for alleged conflict of interest
after reportedly receiving more than $2 million from drug companies.

MARTIN WHITELY: Governments, when they have concerns about ADHD over-prescribing and misdiagnosis,
they go back for advice to the ADHD industry, the very people that have actually led to the problem
in the first place. And Nicola Roxon has made the same mistake that Tony Abbott made when he was
Health Minister. They need to stop talking to the ADHD industry, they need to start talking to
people that don't have a pre-determined position on the issue.

MIKE SEXTON: While there's been no comment today from the Federal Health Minister, Western
Australia's Minister for Mental Health says the study is contributing to a change in thinking.

GRAHAM JACOBS: It's my intention to submit this report to the federal minister. I think there are
some things to learn from us nationally about policy moving forward in the prescription of
medication to ADHD. I think it's an important work.

MIKE SEXTON: Professor Lou Landau concedes the data won't end the debate, but sees it as vital
information for parents and doctors deciding how to treat children.

LOU LANDAU: Their decision will now be made with better information as to the benefits and the
risks, and so will help in making the right decision for that child.

KERRY O'BRIEN: Mike Sexton with that report.