The history of ADHD policy and regulation nationally from 1992 to 2012, in WA from 1993 to 2011 and in NSW from 2007 to 2011 is that regulatory capture occurred in the majority of policy development and regulatory processes. These ‘captured’ processes have been associated with subsequent ADHD child pharmaceuticalization. Conversely the only ADHD-critic dominated process identified occurred in WA in 2002 and was associated with subsequent ADHD child de-pharmaceuticalization. The findings of this thesis are consistent with Abraham’s assertion that regulatory capture is a significant driver of pharmaceuticalization.

PDF of full thesis available at Martin Whitely PhD Thesis Copy – ADHD and Regulatory Capture in Australia PDF

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“Personalities, rhetoric and charisma are driving the direction of mental health rather than science and evidence.” (Martin Whitely MLA, Parliament of Western Australia, 25 September 2012)

Related Media

Sue Dunlevy, News Limited Sunday papers, 7 October 2012, Doubts cast on youth mental health program. Available at  http://www.news.com.au/national/doubts-cast-on-youth-mental-health-program/story-fndo4eg9-1226489760605

Also see Patrick McGorry’s ‘Ultra High Risk of Psychosis’ training DVD fails the common sense test http://speedupsitstill.com/patrick-mcgorrys-ultra-high-risk-psychosis-theory-fails-common-sense-test

MARTIN WHITELY (Trancript of speech in the Legislative Assembly, Parliament of Western Australia, 25 September 2012): I want to use this opportunity to talk about some very serious concerns I have about the direction of the mental health policy in Australia. My basic contention is that personalities, rhetoric and charisma are driving the direction of mental health rather than science and evidence.

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A review of the medical records of 937,943 Canadian children showed that children born in December, the last month of their school year intake, were much more likely to be diagnosed and medicated for ADHD than their classmates born in January.

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The world’s most popular independent online news service, The Huffington Post, recently published two significant blogs suggesting that Western Australia and France offer lessons on how to tackle the global ADHD epidemic.

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“Currently there are some isolated measures designed to help doctors and pharmacists suspicious of doctor shoppers but clearly they are inadequate. What is needed is a comprehensive, easy to use, ‘real time’ system of sharing information before prescriptions are dispensed. The Commonwealth and State governments may need to co-operate and remove privacy restrictions so that pharmacists can share information about what abuse-able drugs have been dispensed to individuals presenting prescription in their pharmacies. This change and a modest investment by government in the software needed to allow the ‘real time’ sharing of information between pharmacists, will shut off the pipeline of abuse-able prescription drugs that is fuelling this misery.”

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By Martin Whitely

Perth’s ADHD generation, those diagnosed and ‘medicated’ in the 1990’s and early 2000’s, are now young adults. They were prescribed ADHD amphetamines (primarily dexamphetamine) at approximately three times the rate of their eastern states contemporaries[1] and old habits die hard. Many of Perth’s twenty to early thirty-somethings have grown to love their ‘dexies’, particularly with a drink or fifteen, on their weekend benders. With dexies on board they drink longer and harder, with the loss of inhibition and impaired judgement from alcohol but without the drowsiness. Some also use dexies as a substitute for sleep, to either get up for work after a hard night of partying, or to cram for exams or tight work deadlines.

Part of the problem is that whilst methamphetamine is illegal in Australia and therefore understood to be harmful, it’s difficult to get Perth’s ‘dexie generation’ to realise that dexamphetamine is not a benign substance. It might help if we point out that methamphetamine (brand name Desoxyn) is a legally prescribed ADHD treatment in the US. Then again it might simply normalise the use of methamphetamine.

But as it stands many of Perth’s young adults love their dexamphetamine. Despite the fact that the ‘near amphetamine’[2], methylphenidate (Ritalin, Concerta) is the most commonly prescribed ADHD stimulant in Australia, (about three quarters of all scripts)[3] the vast majority of both new (66.9%) and continuing (81.4%) WA adult patients prescribed ADHD stimulants take dexamphetamine exclusively.[4] Many get dexamphetamine rather than Ritalin, because they ask for it and they ask for it because dexies are the recreational prescription stimulant drug of choice amongst Perth’s hard partying young adults.

Perth’s rise in adult ADHD prescribing rates defies the trend for kids. WA’s child ADHD per capita rate has plummeted (approximately 50%) since tighter prescribing accountability measures were introduced in late 2003.[5] However, the number of adults prescribed stimulants (primarily dexamphetamine) has risen 60% since 2004, so that in 2012 there were 10,117 WA adults on prescription stimulants.[6]

I am not suggesting that all of these adult patients are intentional ADHD drug abusers. Some of these are carryover ‘patients’ from Perth’s dexie generation; who still believe the ‘ADHD chemical imbalance’ lie they, and their parents, were told when they were children. Many of these former child patients have become physically and psychologically dependent as predicted on the manufacturer’s guidelines[7] that many of their parents never even had the opportunity to read.[8]

Some new adult patients genuinely believe they have a ‘biochemical brain imbalance’ and mistakenly believe the almost universal focus narrowing effect of low dose oral dexamphetamine is peculiar to those ‘suffering’ from ADHD. However, there is a new group of young adult dexie users, who have learned how to tick the right ADHD boxes and say the right things to the handful of enthusiastic Perth prescribers. (In 2012 five WA doctors prescribed to over 500 patients each with the heaviest prescriber prescribing to a staggering 1,533 patients.)[9] As a result they and their friends have got a convenient taxpayer subsidised supply of ‘uppers’ and can party all weekend and wake up bright as a button for work on Monday morning.

Faking ADHD is not a uniquely West Australian experience. US research revealed nearly a quarter of all adults seeking treatment for ADHD feigned symptoms to get a cheap supply of amphetamines.[10] And you would be mistaken if you thought that this didn’t happen in nice homes and good neighbourhoods. Whilst its child prescribing rates are now relatively low, the Oceanic Health District, which covers Perth’s affluent western suburbs, easily has the highest adult ADHD per capita prescribing rates in Australia’s highest (adult) prescribing state (WA).[11] This may in part be a legacy of the fact that Perth’s western suburbs and the less prosperous south east corridor around Armadale were the two child ADHD hotspots in the 1990’s.[12]

Unfortunately there is little direct data as to how prevalent the abuse of ADHD amphetamines is by WA adults. But we know from surveys that when they were high school students the vast majority (84%) of those who abused amphetamines, abused diverted prescription ADHD amphetamines.[13] Now it’s time to ask how much of Perth’s spate of alcohol related violence is also fuelled by amphetamines, and how much diverted dexamphetamine contributes to this problem.

Whilst at last we are slowly awakening to the ADHD fraud, we are still reluctant to blame the doctors who prescribe these poisons,[14] for a disorder that was voted into existence by a panel of self-appointed mostly drug company funded ‘experts’.[15] But ADHD ‘specialists’ are practising quackery not medicine, and that makes them quacks not doctors, and it is time we said so.

So before we middle aged West Australians bemoan the decadence and decay of youth, remember, it was our generation who put them on this pathway. Too many of our generation unquestioningly accepted the ADHD industry nonsense that, just like diabetes or cancer, ADHD is a disease requiring ‘medication’. Even now it is our generation’s leaders that finds the truth – i.e. ADHD is a dumbed down, unscientific, catch all diagnosis and amphetamines are bad for kids – too confronting to say out loud.

We can’t leave our head in the sand any longer. All the available evidence suggests too many of Perth’s twenty to early thirty-somethings have a large and growing dexamphetamine habit. They get it, they abuse it, they drink too much, they fight too much and tragically a few die too early.[16] And it is not their generation’s fault, it is my generations, because when they were kids, we were their dealers.

[1] Martin Whitely, Speed Up & Sit Still: The Controversies of ADHD Diagnosis and Treatment, UWA Publishing (2010): p.126.]

[2] Martin Whitely, Speed Up & Sit Still: The Controversies of ADHD Diagnosis and Treatment, UWA Publishing (2010): p.34] methylphenidate (Ritalin, Concerta) is the most commonly prescribed ADHD stimulant in Australia, (about three quarters of all scripts)[3. Statistics relate to 2010 calendar year and were obtained from the Medicare Australia website, Available at https://www.medicareaustralia.gov.au/statistics/pbs_item.shtml

[3] Statistics relate to 2010 calendar year and were obtained from the Medicare Australia website, Available at https://www.medicareaustralia.gov.au/statistics/pbs_item.shtml

[4] Department of Health, (2013), Western Australian Stimulant Regulatory Scheme 2012 Annual Report, Pharmaceutical Services Branch, Health Protection Group, Department of Health, Western Australia p 52+41. http://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&ved=0CDkQFjAC&url=http%3A%2F%2Fwww.public.health.wa.gov.au%2Fcproot%2F5605%2F3%2Fstimulant-annual-report-2012-text-without-maps-and-appendices.doc&ei=jxLfUuuYK4TBiQf40YG4Dg&usg=AFQjCNGA8mnUr6xRxknQjkgrdKuAR6r_iQ&bvm=bv.59568121,d.dGI]

[5] See ‘Rise and fall of child ADHD in WA’, http://speedupsitstill.com/rise-and-fall-of-child-adhd-in-wa

[6] Department of Health, Western Australian Stimulant Regulatory Scheme 2012 Annual Report, Pharmaceutical Services Branch, Health Protection Group, Department of Health, Western Australia (2012):p57 http://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&ved=0CDkQFjAC&url=http%3A%2F%2Fwww.public.health.wa.gov.au%2Fcproot%2F5605%2F3%2Fstimulant-annual-report-2012-text-without-maps-and-appendices.doc&ei=jxLfUuuYK4TBiQf40YG4Dg&usg=AFQjCNGA8mnUr6xRxknQjkgrdKuAR6r_iQ&bvm=bv.59568121,d.dGI

[7] The warning issued by the manufacturer concerning amphetamines, such as Dexedrine, and their high potential for abuse can be found on the US Food & Drug Administration website http://www.accessdata.fda.gov/drugsatfda_docs/label/2006/017078s040lbl.pdf

[8] It is a legal requirement that Consumer Medicine Information (CMI) sheets are available for all prescription (S4 and S8) and pharmacist-only (S3) medicines, however there is no requirement that they must be provided with each prescription

 Department of Health, Western Australian Stimulant regulatory Scheme: 2012 Annual Report, Pharmaceutical Services Branch, Environmental Health Directorate, Department of Health, Western Australia (210):p35 http://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&ved=0CDkQFjAC&url=http%3A%2F%2Fwww.public.health.wa.gov.au%2Fcproot%2F5605%2F3%2Fstimulant-annual-report-2012-text-without-maps-and-appendices.doc&ei=jxLfUuuYK4TBiQf40YG4Dg&usg=AFQjCNGA8mnUr6xRxknQjkgrdKuAR6r_iQ&bvm=bv.59568121,d.dGI

[10] Meredith Melnick, ‘Faking It: Why nearly 1 in 4 adults who seek treatment don’t have ADHD’, Time Healthland, 28 April. Available http://healthland.time.com/2011/04/28/faking-it-why-nearly-1-in-4-adults-who-seek-treatment-dont-have-adhd/ (accessed 24 May 2011)

[11] Department of Health, Western Australia Stimulant Regulatory Scheme 2012 Annual Report, Pharmaceutical Services Branch, Health Protection Group, Department of Health, Western Australia (2013): p25+40http://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&ved=0CDkQFjAC&url=http%3A%2F%2Fwww.public.health.wa.gov.au%2Fcproot%2F5605%2F3%2Fstimulant-annual-report-2012-text-without-maps-and-appendices.doc&ei=jxLfUuuYK4TBiQf40YG4Dg&usg=AFQjCNGA8mnUr6xRxknQjkgrdKuAR6r_iQ&bvm=bv.59568121,d.dGI

[12] The Report of the Technical Working Party on Attention Deficit Disorder to the Cabinet Sub-Committee, Parliament House Western Australia, 1997, p. 6

[13] A 2005 survey of Western Australian secondary school students (the Australian School Students Alcohol and Drug Survey or ASSAD) found that 84 per cent of those who had abused amphetamines in the last year had abused prescription amphetamines. Drug and Alcohol Office WA, ASSAD Drug Report 2005, Mt Lawley, March 2007, pp. 30-32.

[14] A Stimulant Regulatory Scheme was established in August 2003, with the legislative framework for the Scheme contained in the Poisons Regulations 1965.  Under the Scheme, the Stimulant Prescribing Code sets out the criteria for the prescribing of stimulant medicines in WA.

[15] Martin Whitely, Speed Up & Sit Still: The Controversies of ADHD Diagnosis and Treatment, UWA Publishing (2010): p.7.]

[16] For further information see ‘Claire Murray (14 March 1985 – 1 April 2010) – A casualty of Perth’s Generation deX’, available at http://speedupsitstill.com/claire-murray-casualty-perths-generation-dex

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by Dr Martin Whitely

Encouraged by its Managing Director Mark Scott, the ABC has promoted Professors Patrick McGorry and Ian Hickie as independent mental health experts and unquestioningly backed their plans for reforming mental health. However both have significant ties to the pharmaceutical industry[1] and there has been prominent international criticism of their methods – and in Hickie’s case his integrity – which has been substantially ignored by the ABC.

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I don’t intend to enter the contentious ‘smacking debate’… I am however struck by the contrast between the RACP’s anti-smacking stance and its promotion of the use of amphetamines to alter the behaviour of children, even pre-schoolers.

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Sign the online petition to Boycott the DSM5 at http://dsm5response.com/

By Martin Whitely

DSM-5, the newest edition of the American Psychiatric Association’s ‘Bible of Psychiatry’ will be officially released in May 2013 and is already available for presale.  However, this edition of the DSM may not prove as profitable for the American Psychiatric Association (APA) as there is a growing international chorus of voices, many from within mainstream psychiatry, calling for a boycott of the DSM5.

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by Professor Allen J. Frances, M.D. Chairperson of the American Psychiatric Association DSM-4 Task Force

This blog was originally Published on December 2, 2012 in DSM5 in Distress at http://www.psychologytoday.com/blog/dsm5-in-distress/201212/dsm-5-is-guide-not-bible-ignore-its-ten-worst-changes

This is the saddest moment in my 45 year career of studying, practicing, and teaching psychiatry. The Board of Trustees of the American Psychiatric Association (APA) has given its final approval to a deeply flawed DSM 5 containing many changes that seem clearly unsafe and scientifically unsound.  My best advice to clinicians, to the press, and to the general public – be skeptical and don’t follow DSM 5 blindly down a road likely to lead to massive over-diagnosis and harmful over-medication.  Just ignore the ten changes that make no sense.

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WA Stimulants Regulatory Scheme 2011 Annual Report contains both good and bad news. The good news is that the 2011 report confirms there has been a massive decline in per-capita prescribing rates for children since the Stimulant Regulatory Scheme was introduced in mid-2003. However, the bad news is that there was a spike in the number of new cases diagnosed in 2011.

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Stephen Colbert’s ‘Meducation’ plan for America’s third rate public schools – Don’t laugh too hard it is already happening!

A video and transcript of Colbert’s ‘Meducation’ rant is available at http://www.dailykos.com/story/2012/10/11/1143009/-Stephen-Colbert-on-medicating-children-to-improve-their-grades

On October 10 2012 American comedian Stephen Colbert coined the term “meducation” to describe the growing practice of drugging with ADHD amphetamines, American children with mediocre school grades, who do not have a diagnosis of ADHD.The catalyst for the mock right wing political commentator’s endorsement of ADHD drugs as smart pills was a front page article in the New York Times in which peadiatrician Dr Michael Anderson advocated their widespread use to compensate for America’s third rate public education system. Doctor Anderson said “we’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.” Unlike Colbert, Dr Anderson is not a comedian but unfortunately for some of the children of Ganton Georgia he is their doctor.

In his comedic monologue Colbert argues the child drugging program should be extended beyond amphetamines. “Folks, I believe this is a great fiscally responsible answer, but we can do more.  I mean, we might be cutting arts programs, but one tab of acid, and your kid will be seeing colours you can’t find in a Crayola box.” Colbert’s mock rant concludes with a serious warning; “Now, of course, eventually it may turn out that drugging poor students creates more problems than it solves.  In which case, we’ll have to stop trying to change our children, and think about changing ourselves.”

Despite Dr Anderson’s claims and Colbert’s mock endorsement, ADHD amphetamines are anything but ‘smart drugs’. Unique long term (8 year) Australian research shows that children diagnosed ADHD and ‘ever medicated’ with amphetamines were a staggering 950% more likely to be rated by their teacher as “performing below age-level” than children diagnosed with ADHD and ‘never medicated’. (see http://speedupsitstill.com/2010/02/17/excerpts-from-the-raine-study/ ) And as pointed out by Colbert the USA, the home of ADHD child drugging, lags most comparable developed nations (and a few second world nations) in terms of academic achievement.

The message is pretty clear – if you want to dumb down – speed up!

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By Martin Whitely MLA

The off colour Australian colloquialism ‘you can’t polish a turd but you can cover it in glitter’ is a fitting analogy for the danger of legitimising ADHD as a diagnosable mental illness by developing treatment guidelines. However, treatment guidelines are being developed and the more conservative the treatment guidelines, the fewer children risk damage with the long-term administration of amphetamines.

That is why I welcome the release by the National Health and Medical Research Council (NHMRC) of the Australian ADHD Clinical Practice Points (CPPs) as a small but significant step in the right direction. (The CPPs available at http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/mh26_adhd_cpp_2012_120903.pdf )

Eventually ADHD will be regarded as an embarrassing footnote of history and society will collectively wonder how anyone ever thought it would be a good idea to give amphetamines to children. But in the meantime improvements like those in the ADHD CPPs, although modest, will hopefully see fewer children diagnosed and drugged.

That said, the CPPs are far from perfect. The statement that, “…stimulants might be considered for this age group (under 7 years)” leaves the door open for drugging very young children.[1] The manufacturers prescribing information for all stimulants state they should not be used in children under 6 years, since safety and efficacy in this age group have not been established.[2] Any clinician ignoring the manufacturers warning is inviting a future law suit for negligence.

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Part One – Is Nick Sick?   (11 minutes)

Part Two – Is Nick Sick?   (9 minutes)

Response to the ‘Is Nick Sick?’ video blog

by Professor Jon Jureidini

“Patrick McGorry’s Orygen Youth Health, CAARMS training video[1] on how to diagnose ‘Attenuated Psychosis’ demonstrates how not to carry out a psychiatric interview and interact with young people.”

As identified by Martin Whitely in his commentary about the CAARMS training DVD, describing Nick as being at ultra-high risk of psychosis (UHR) fails the common-sense test. Even more concerning is that Nick is labelled as having Attenuated Psychosis – in ordinary language, he is already mildly mad.

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