The High Cost of ADHD

 

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

 

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