Over the past 15 years in America we have seen the rate of ADHD diagnosis increase by anywhere from 3%-5% per year (“Are ADHD Medications Overprescribed?”) and studies that show that 4% of American’s use these drugs without a prescription where America produces and consumes 90% of ADHD medication drugs (Sussman, Pentz, Spruijt-Metz, and Miller). When considering all of the statistics and trends, an on-going debate in American society is whether or not to increase the restrictions on the diagnosis and distribution in regards to ADHD, or attention deficit hyperactive disorder. ADHD is a clinical condition that is predicted to actually effect only 5% of children in the US (“Are ADHD Medications Overprescribed?”) that is characterized by poor attention spans, over activity, and impulsive behavior. While there are other methods for treatment, the most common is through the use of stimulant medication typically classified under amphetamines and methylphenidates (“ADHD Parents Guide to Medication”, 9) whose effects include increasing alertness, attention, and concentration in those who have the disorder (Keeler). However, while these drugs can be miracles for those who truly struggle with ADHD they can have very adverse effects on many factors. Therefore, I believe that the restrictions in relation to the diagnosis of ADHD and the distribution of the stimulant narcotic medication used to treat this condition should be even further increased due to the negative effects they can have on an individual’s health, the effects they can have on other parts of a user’s life, the fact that its production leads to increased black market activity, the increasing trends regarding diagnosis in recent years, and the effect this topic could have on society and culture. 

The first factor that will help explain why the restrictions regarding this medication should be increased is the amount of potential risk involved in taking said stimulant narcotic medications. For example, the side effects that can be caused by these types of drugs can sometimes be very dangerous and include irritability, nausea, insomnia, high blood pressure, irregular heartbeat, and decreased appetite (Sussman, Pentz, Spruijt-Metz, and Miller), (Hoyt), and (“ADHD Parents Guide to Medication”, 10). While some of these side effects don’t seem quite too harmful; such as nausea, headache, dry mouth, insomnia, or decreased appetite; when these effects are carefully examined many implications of such can be seen. As an illustration, first consider that increasing blood pressure and irregular heartbeats put the heart under quite a lot of stress. For an elderly individual or someone with heart complications this can lead to very serious problems such as increasing the risk for heart attacks and stroke. Along with this, given that amphetamine and methylphenidate medications are a treatment for a mental disorder, they often have an effect on other psychiatric conditions and can make symptoms of conditions like anxiety, depression, and motor tics much stronger (Sussman, Pentz, Spruijt-Metz, and Miller). Next let’s examine how the more common side effects can negatively affect a user. The fact that these medications have such a strong influence on the bodies sleep cycle and appetite can often times make for an unhealthy lifestyle as sleep is essential for proper functioning of bodily systems and decreased levels of appetite don’t allow for individuals on the medication to sense hunger and therefore proper nutrients are not obtained. Based on all of this, increasing the restrictions regarding ADHD medication would reduce the harm that can be caused by the use of these drugs as it would result in a lower amount of users in the population. 

Along with how ADHD medications can affect the health of an individual user, they can also have effects on many other parts of a person’s life. For instance, many people who use the drug without a prescription in order to help them focus while studying claim that after starting using the drug often for this purpose they have far more trouble concentrated than before they began doing so (Hoyt). This creates a huge problem for these students as it creates a need that they cannot fill most of the time considering that they were never actual diagnosed with the disorder and therefore don’t have full availability to the medication. This then turns these individuals to buy from the illicit market which, in turn, fuels the black market and puts them in danger as they are buying drugs that are illegal to them from possibly dangerous sources. In addition to that, in 2010 a Nation Survey on Drug Use and Health found that college students who abused Adderall or other forms of such were three time more likely to smoke marijuana, five times more likely to take pain medication for recreation use, and 90% reported frequent binge drinking (Keeler) along with how a study done in Addiction in 2005 found higher rates of ecstasy and cocaine use in this group as well (McCabe, Knight, Teter, and Wechsler, 96). While some may argue that this could simply be a correlation between users and their habits, let’s consider the fact that these ADHD medications are very strong form of stimulants whose effects are purposed to increase alertness and reduce tiredness in order to increase one’s ability to concentrate and focus. However, since many of the forms of these medications are extended release and work for long periods of time, students are often still experiencing the effects of the drug even after they have finished studying. As a result, these individuals may turn to other substances, specifically downers like alcohol and marijuana, in order to counteract the effects caused by ADHD medication such as insomnia and decreased appetite which is a dangerous game to play as simultaneously being under the influence of both uppers and downers can cause serious health issues. Therefore, it can be understood why the statistics regarding use of other drugs is a result of ADHD medication use itself and not simply a correlation along with how they can affect one’s life in ways other than health hazards which provides another example of the reasoning as to why policy must be changed. 

The solution to limiting the problems that occur as a result of use examined in the first two paragraphs in at least unperscribed individuals would be to eliminate the black market that these drugs are involved in. One of the biggest negative aspects of these drugs is how widely available they are to those without a prescription. For example, it is estimated that anywhere from 10% to 35% of college students are users of drugs like Adderall where one university that was included in the study saw as high as 80% of its upperclassmen abusing these medications (Hoyt)! Along with that, two separate studies found the percent of ADHD diagnosed students who had been asking about selling their medication was between 30%-40% (Keeler) in one study and 54% (Sussman, Pentz, Spruijt-Metz, and Miller) in the other. When looking at this data quantitatively, it very easy to see how big of a factor availability plays in the problem regarding unperscribed use of ADHD medications. In fact, the illicit use:medical use ratio of this class of drugs was found to be 2.45 where drugs used for sleeping, anxiety, and pain were all found to have levels of this ratio under 1.00 making ADHD drugs by far the most available to the average person (Sussman, Pentz, Spruijt-Metz, and Miller). As discussed in the previous paragraphs, contrary to popular belief, ADHD medications can have serious implications and adverse effects to not only one’s health but many aspects of one’s life when taken. Based on that, seeing how available the illicit black market makes amphetamine’s and methylphenidate’s it is honestly quite scary as it puts into perspective the number of American’s, specifically college students, that are at risk to experience these adverse effects where the only way to reduce this would be by the elimination or reduction of the black market which would be a product of increased regulation. 

While the elimination of ADHD medication’s black market would be nearly impossible based on the history regarding the war on drugs and the amount on money in this illegal industry, restrictions and limitation are essential in limiting the number of unperscribed users. While there are some limitations already in place regarding drugs of this class such as how the quantity of the drug being produced cannot exceed the estimate of the medication needed for medical and scientific use (“The International Drug Control Conventions, 41), how a manufacture must stay within the limit of production set by the DEA per month (ADHD Parents Medication Guide, 12), and how 21 states have monitoring systems for controlled substances (Sussman, Pentz, Spruijt-Metz, and Miller), there still needs to be an implementation of more regulation in order to truly reduce the black market activity and unperscribed use. There are many ways of going about this and methods that could be put in place in order to do so. First, the 29 states that currently don’t have a monitoring program for controlled substances could follow the first 21 states to do so by example and implement one in order to monitor diagnosed individuals as a measure to ensure they are not suppliers to the illicit market. Other possible methods could be for local city and county police to investigate and track locations of trafficking and sale and to police these areas more heavily, educating about and offering alternative methods of treatment, and the possibility of diverting them off the medication (Sussman, Pentz, Spruijt-Metz, and Miller). While all of these methods of regulation would definitely impact and reduce the black market trade, one method that I believe would work best would be to increase the complexity of the diagnosis process digging deeper into an individual’s life where doctors testing for ADHD would be required to ask extensive questioning about how people conduct themselves, their motivation and discipline levels, and other questions relating to true ADHD along with possibly implementing tests testing for other psychiatric disorders as these medications have bad interactions often times. As stated previously, no restriction can be put in place that would fully eliminate the black market trade of amphetamine and methylphenidate due to the knowledge the history of the war on drugs provided us with; however, the implementation of restrictions such as these would greatly reduce the availability of these drugs in those without a prescription which is important for the health and safety of those individuals. 

Perhaps the strongest factor influencing the need for increases in restriction’s regarding ADHD medication is the increasing trend of this condition being diagnosed in America. To put the trend that has been seen over the past 15 years into a quantitative value the rate of diagnosis has gone up 3%-5% not over that time but yearly, mostly due to incorrect analysis of the condition where it is predicted that 20% of the time ADHD in children is being mistaken for slower development (“Are ADHD Medications Overprescribed?”). Along with that, let’s consider both how it was estimated that between the years 1990 and 2000 the use of methylphenidate medication (not including amphetamine) increased by five times and how the USA is the number one manufacturing country of ADHD medications as it produces nearly 90% of them at 88% (Keeler). It is clear to see when examining all of these statistics that there is a problem within the culture of our society where we see past the true cause of someone’s struggle such as slower development and diagnose ADHD. While some believe that increasing restrictions is not a good idea as it deters those who need it from going through the process because of the difficulties involved and makes obtaining medication for those who truly need it much more difficult; however, based on the increasing trend of diagnosis the restrictions put in place would actually do exactly the opposite and allow for there to be more of this medicine available to those who need it. While this seems quite contradictory, let’s first consider that the reasoning behind ADHD individuals having trouble obtaining their medicine today is a result of shortages caused by the exponential growth of those with a prescription making producing enough medication difficult for manufactures with the current restrictions in place. The DEA regulates manufacturing by restricting the amount any given plant can produce each month, stopping production if the medication doesn’t meet quality standards, and limiting many essential ingredients that are used in generic versions of the product resulting in higher production rates of the more expensive name brand (ADHD Parents Medication Guide, 12). Be it that an individual’s pharmacy simply doesn’t have the medication, or that the person cannot afford the name brand, these restrictions often times are the cause of shortages because of how many more people need them every year. Based on this, how could adding more regulation possibly reduce shortages? To answer this, acknowledge how if the restrictions set in place were in regards to diagnosis of the condition rather than distribution of its medicine, where if doctors were to implement the process of diagnosis I described in the paragraph above, then we would not only see the increasing trend come to a halt, but also less individuals with a prescription for these types of drugs. In turn, this would cause the amount of this medication distributed to be reduced, the amount of legal available medication to be increased, and overall a decrease in shortages of the medication. Considering all of this, it is easy to see that medication shortages are a result of over-prescribing, rather than the current restrictions in place, and how increasing regulation would help make the medication more available to those who are truly in need of it. 

Together, we must come to understand the danger involved with the use of these types of medications, along with how the problems that are a product of inadequate regulation create a need for such. Based on the statistics regarding the trend of diagnosis, the fact that changing the diagnosis process would reduced shortages for those that truly struggle with the condition while simultaneously decreasing unneeded diagnosis, illicit use and trafficking, health issues, and other effects amphetamine and methylphenidate medications can have on an individual it is clear to see how America and our society as a whole needs to wake and understand the implications that are involved with the way we handle ADHD diagnosis and medication distribution. While this type of policy change can’t happen immediately, it needs to be soon if we are to move forward in the world of medicine and ensure that the next generation doesn’t follow the current trend and see even further false levels of diagnosis of ADHD. We as American’s need to come together as a whole and become educated on this subject in order to move the process of increasing regulation faster and be on our way to seeing a brighter, happier, healthier society as a whole. 
