In June 2012, Australia was before the United Nations Committee on the Rights of the Child (UN CRC) regarding the prescription of ADHD drugs to children.
The Committee expressed serious concern that current diagnosis procedure may not be adequate, resulting in significant increases and incorrect prescription of psycho-stimulants to children diagnosed with ADHD and ADD.1
They therefore recommended that Australia carefully monitor these prescriptions and take action to provide children diagnosed with ADHD and ADD, as well as their parents and teachers, with access to a wider range of alternatives including educational and social measures. Additionally, they suggested Australia undertake a detailed collection and analysis of exact numbers of people by substance-type and age who are taking such psycho-stimulant drugs to monitor possible abuse by children.1
Unfortunately, similar warnings and recommendations were made by the UN to Australia almost 7 years before when the Committee expressed concern at the information that “Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) was being mis-diagnosed and therefore psycho-stimulant drugs were being over-prescribed, despite the growing evidence of the harmful effects of these drugs.”2
Following that statement in September 2005, the CRC recommended further research be undertaken on the diagnosis and treatment of ADHD and ADD, including the negative effects of psycho-stimulants on the physical and psychological well-being of children, and that other forms of management and treatment are used as much as possible.2
Clearly these serious warnings and recommendations were not heeded as the UN has warned Australia and made recommendations again.
Prescriptions for government-funded ADHD drugs in Australia have increased from almost 233,000 in the 2004/05 (Australian Financial Year) to over 583,000 in 2011/12, a more than 150% increase in the period between these UN warnings.3
As a result, we as a country now find ourselves in the position where just for these government-funded ADHD drugs alone:
- Yearly prescriptions for ADHD drugs have risen from 16,559 in 1992/93 to 583,474 in 2011/12 (a 3424% increase in just 19 years)3
- Over 76,280 Australians were prescribed at least one ADHD drug in 2010 (a 28.7% increase from 2007).4 Australia the 3rd highest consumer of amphetamines in the world.5
- Over 68% (52,528) of Australians who took at least one subsidised ADHD drug in 2010 were children aged 16 or younger with 50% being children in the 12 to 16 year old band.
- Alarmingly 2,400 were children aged just 2 to 6 years of age.4 This is despite the fact the Australian government has not even authorised the use of such drugs for children under 6.6
It is not just the United Nations who is concerned about the mis-diagnosis of ADD/ADHD and over-prescription of these drugs. In a 2012 Medical Journal of Australia article, Fellows from the University of Queensland Centre for Clinical Research noted the increases in stimulant dispensing in Australia and commented “… regular users often develop acute tolerance to the subjective effects of stimulants, and often increase their dose, thereby increasing toxic side effects and the risks of misuse and dependence.”7
They also pointed out that mis-diagnosis, over-prescription, toxic side effects and dependence on these drugs are not the only issues requiring immediate attention in Australia. It is also a concern that people and in some cases children may be getting such stimulants from friends with a prescription and could be mis-using these drugs for non-medical purposes, creating additional social and health issues. In line with the UN’s recommendations, they suggested such drug use should be thoroughly investigated on a national level.8
With 5 deaths and 450 adverse drug reactions linked to these drugs in Australia, including suicidal and homicidal ideation, memory loss, major depression, delusions and hallucinations, convulsions, heart palpitations and many more reported through the Therapeutic Goods Administration (TGA) Database of Adverse Event Notifications (public database of reported side effects of drugs), it is imperative that parents are fully informed at time of prescribing of how the diagnosis is made including being informed that there are no tests to diagnose ADHD, all the potential side-effects and the alternatives that exist. Consent forms need to be implemented to ensure this occurs. With the increasing numbers of prescriptions and reported side-effects, it would be wise for the Australian Governments to take notice of and action on these UN warnings and quickly.
- Consideration of Reports Submitted by States Parties Under Article 44 of the Convention, Committee on the Rights of a Child, 60th Session, 29 May – 15 June 2012, Page 16.
- Consideration of Reports Submitted by States Parties Under Article 44 of the Convention, Committee on the Rights of a Child, 40th Session, 13 September – 30 September 2005, Page 10.
- Reports generated off the Medicare Australia website, https://www.medicareaustralia.gov.au/statistics/pbs_item.shtml & Pharmaceutical Benefits Scheme website, “Schedule of Pharmaceutical Benefits,” to obtain the codes for each drug to generate the reports on Medicare website: http://www.pbs.gov.au/browse/publications
- “Tables 1, Table 1b & 1C. Number of patients who had at least one prescription for a PBS/RPBS listed ADHD drug during the 2008 to 2010 calendar years, by age group and State/Territory,” Statistics obtained from Policy and Analysis Branch Pharmaceutical Benefits Division, 20 April, 2011.
- Part Two, Deuxième partie, Segunda parte, English Version, “Comments on the reported statistics on psychotropic substances,” p.33.
- Australian Government Department of Health and Ageing, Pharmaceutical Benefits Scheme website, “Authority Required” Warning: http://www.pbs.gov.au/medicine/item/3440C
- Jayne C. Lucke, Wayne D Hall, “Is the Non-Medical Use of Prescription Stimulants A Problem In Australia?,” Medical Journal of Australia, MJA 197 (3), p. 145, 6 August 2012.