ADHD and the rise in stimulant use among children

Attention-deficit/hyperactivity disorder (ADHD) holds the distinction of being the most extensively studied pediatric mental disorder and one of the most controversial, in part because it is also the most commonly diagnosed mental disorder among minors. Currently, almost 8% of youth aged 4 to 17 years have a diagnosis of ADHD, and approximately 4.5% both have the diagnosis and are using a stimulant (methylphenidate or amphetamine) as treatment for the disorder. Yet a diagnosis of ADHD is not simply a private medical finding; it carries with it a host of policy ramifications. The enduring controversy over ADHD in the public arena therefore reflects the discomfort over what happens when science is translated into policies and rules that govern how children will be treated medically, educationally, and legally. This article (1) summarizes the existing knowledge of ADHD, (2) provides the relevant history and trends, (3) explains the controversy, (4) discusses what is and is not unique about ADHD and stimulant pharmacotherapy, (5) outlines future directions of research, and (6) concludes with a brief analysis of how two North Carolina counties have established community protocols that have improved the screening, treatment, and societal consensus over ADHD and stimulants.