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The High Cost of AD/HD
Carol E. Watkins, M.D. and Glenn Brynes, Ph.D., M.D.


A study published in 2001 in JAMA, The Journal of the American Medical Association, indicated that children with AD/HD were more likely to need medical care.

The investigators followed the medical histories of more than 4000 children for nine years. The median medical costs for the non-AD/HD children was $1944 as compared to $4306 for the AD/HD group. The AD/HD children had higher rates of accidents and medical illnesses than the children without AD/HD.

The AD/HD children were more likely to end up in an emergency room with an injury. They had more visits to their primary care doctors and to hospital clinics. They had more infections, asthma, and interpersonal problems.

It is interesting to note that the study did not count mental health visits or prescription drug costs. If these had been factored in, the cost difference might have been much higher.

Past reports have noted that adults and children with AD/HD are more likely to experience bone fractures, car accidents, and chronic medical conditions.

What can we learn from this data? Parents and teachers should be alert for situations that might put an AD/HD child at risk for injury. The very child who runs out to skateboard without helmet and knee pads is actually the child who most needs these safety devices. Childproofing should extend well beyond the baby years.

If your children are more likely to need emergency services, ask your child’s doctor about your local emergency rooms. Some emergency rooms are better than others at handling a young hyperactive child. Some hospitals have separate emergency areas for children and adolescents with doctors and nurses who specialize in treating children. Some may even provide a staff member to help with an active sibling while the parent is comforting the injured child. Other emergency rooms lack pediatric specialists and leave the parent and children to fend for themselves in an open noisy area with dangerous (but fascinating) medical devices all around.

Families affected by AD/HD must have access to insurance and adequate medical care. Those who are unable get insurance should get documentation of the child’s medical and psychiatric conditions and talk to their doctor about whether the child might qualify for one of the “gray zone” insurance programs.

Health care practitioners should screen AD/HD children carefully for non-psychiatric illnesses and spend time educating parents.


Read our other articles on Attention Deficit/Hyperactivity Disorder in Children and Adults

Dealing with Stimulant Side Effectsnew_icon.gif (152 bytes)

Women with Attention Deficit Disorder: How ADD can affect your home.

Adult Attention Deficit Disorder: Diagnosis, Accommodation and Mastery

The Gifted Student with ADD: Between Two Worlds

Adult ADHD: It Rarely Travels Alone

Stimulant Medications for Children and Adults

Non-Stimulant Medication for Children and Adolescents

New Medications for Adults with AD/HD 

Gardening Tips for People with AD/HD 

ADHD and Medication: the Basics  

When a Grandchild Has ADHD

Helping Your Child Succeed in School

Coping Styles in ADD Adults

Girls, Women and Attention Deficit Disorder

Practical Hints for Raising and Educating an ADHD Child

Taking Your ADD To College

Marriage, Family and the Adult with ADHD

When Your Mom Has ADD!

Neurobiological Diagnosis and Personal Responsibility: How Does Morality Fit in with ADD?

Gifted Women

Attention Deficit Disorder in Adults (Adult ADD)

Attention Deficit Disorder in Children and Adolescents

How Computers Can Help Individuals with ADD

Book Reviews: Attention Deficit Hyperactivity Disorder

View slides from our presentation on AD/HD in Adults

Links related to ADHD

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AD/HD and Medication: The Basics

There has been controversy about the use of medications to treat both children and adults with Attention Deficit Disorder There have been articles debating whether Ritalin is over or under prescribed. When people ask me about this, I tell them that I can only answer for the children and adults that I have evaluated or treated. Yes, there probably are some individuals who have received medication when some other treatment might have been better. On the other hand, there are probably others who were not been diagnosed for years and could have benefited from medication. Finally, even if someone has attention deficit disorder (ADHD) and is on medication, is it the best medication, dosage and timing?

Medication can be quite helpful if prescribed in the right context. First the individual needs a thorough evaluation. If medication is prescribed, it should be followed closely. Small changes in timing and size of doses can make a difference.

Although Ritalin is the best known medication for ADHD, there are a number of other useful medications. For individuals who have an incomplete response to one medication, the doctor can often work with the patient to find another medication or combination that does control symptoms. Some of the secondary medications may require closer monitoring during the initial phase of treatment.

Sometimes medication failure is due to lack of communication between patient and doctor. (and sometimes school) The doctor, patient and family should be clear about exactly which symptoms they expect the medication to treat. Patients should ask questions. They should inform the doctor if there are side effects or if the medication does not seem to be working.

If medication is still not working as expected, it may be time to re-evaluate the diagnosis. Individuals with ADHD may also have other disorders at the same time. Anxiety and depression may superficially resemble ADHD. Occasionally a medical illness may masquerade as a psychiatric condition.

Medication can only take the individual part of the way to recovery. Therapy, community support, coaching and the individuals own determination are important parts of treatment.


Carol Watkins, MD


Northern County Psychiatric Associates 

Our practice has experience in the treatment of Attention Deficit disorder (ADD or ADHD), Depression, Separation Anxiety Disorder, Obsessive-Compulsive Disorder, and other psychiatric conditions. We are located in Northern Baltimore County and serve the Baltimore County, Carroll County and Harford County areas in Maryland. Since we are near the Pennsylvania border, we also serve the York County area.   Our services include psychotherapy, psychiatric evaluations, medication management, and family therapy. We treat children, adults, and the elderly.

Carol Watkins, MD
Northern County Psychiatric Associates
Lutherville and Monkton
Baltimore County, Maryland
Phone: 410-329-2028
Web Site

Copyright 2006  Northern County Psychiatric Associates
Last modified: October 13, 2007


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