Regarding the comment: “Most experts put the estimates of U.S. adults with ADHD at 10 percent and even as high as 16 percent. The 4 percent figure was based on the current DSM criteria, which was developed with young boys in mind, not adults of both genders.” –

This is not correct. MOST experts do not put the rate at 10-15 percent. I was not citing my own estimates but that based upon the most rigorous studies to date and the one cited by most experts. The criteria for ADHD in the Diagnostic and Statistical Manual for Mental Disorders (DSM) published by the American Psychiatric Association are THE accepted, official definition of ADHD. So saying there is 10-16 percent rate of adult ADHD if you don’t use DSM criteria is like saying the rate of high blood pressure published by the American Heart Association is incorrect because they use the expert consensus cutoff of 120/80, but some experts think the AHA cutoff is too high and it that it should actually be 115/75 (classifying more people as having high blood pressure). Again, DSM criteria are the official definition of ADHD. This has nothing to do with my opinion. The DSM is periodically revised and criteria for diseases are modified based upon the newest information. Regardless of whether the dissenting experts are correct or not, until their views are accepted and integrated into the DSM, the current criteria remain the official benchmark for determining prevalence. So 4.5 percent is the best estimate we have based upon the DSM criteria.

Regarding this comment: “Amphetamine class stimulants such as Adderall actually CAN be addicting and are often abused.” –

Yes, I never said they cannot be addicting. Only that they very rarely cause addiction (i.e., produce a craving for more and severe physical reaction or withdrawal when stopped). If you want to know whether they are highly addicting, try finding a parent who will tell you that their child can hardly wait for their next dose or are always wanting to take more than they are prescribed. You will find the opposite, parents typically have to remind and badger their child to take the medication (what child wants to take pills every day!).
Regarding abuse, this is not the same as addiction. These drugs are indeed highly “abused,” meaning they are frequently not used as prescribed. This is mostly because people who don’t have ADHD (e.g., college students, truck drivers) obtain them and use them to get the same benefits they provide ADHD patients (increased concentration, counteracting fatigue, etc.), so they can enhance and extend their cognitive performance later and longer. This is NOT the same as addiction.

Dizfriz

I would just point out a few clarifications.

The 4 percent figure for adults with ADHD is extremely conservative; most experts put the estimates of U.S. adults with ADHD at 10 percent and even as high as 16 percent. The 4 percent figure was based on the current DSM criteria, which was developed with young boys in mind, not adults of both genders.

Longitudinal research by Barkley et al and other research teams shows that ADHD is largely persistent into adulthood — as much as 90 percent.

Amphetamine class stimulants such as Adderall actually CAN be addicting and are often abused, including by adults with ADHD whose treatment is not well-managed by physicians or the patients themselves. Modern delivery systems of decades-old medications have mitigated the potential for abuse and provided smoother, more sustained delivery for longer periods of time. The newer delivery systems include Concerta, Vyvanse, and a skin patch called Daytrana. In general, leading experts consider the newer delivery systems vastly superior to the older medications such as immediate release Adderall and Ritalin. In my work as an advocate, author, and speaker in this field, I have repeatedly seen the improved benefits of these medications over the older choices.

ADHD treatment is complex, especially when the diagnosis comes later in life. Careful attention must be paid not only to getting the medication right (there are many individual reactions and 75% of adults with ADHD have a co-occurring condition) but to revising one's attitudes and coping strategies.

Thank you,

Gina Pera, author and former long-time San Diego resident
Is It You, Me, or Adult A.D.D.? http://www.adhdrollercoaster.org