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