ADHD meds and diving

[Genesis]

That seems such an incredible and mind-bogglingly high figure, that I honestly - and respectfully (since I do respect Genesis of course) - must be inclined to disbelieve the statement unless statistical or other proof is given (e.g. peer-reviewed references in medical literature).

That's an outside upper bound, but it was precisely those kinds of outrageous numbers that led to laws in several states prohibiting school personnel from recommending (or more) that kids be placed on psychotropic medication.

With the "zero tolerance" environment we have had over the last 10 years, the statistics are simple to collect, at least for those kids who require a dose during school hours - the school nurse ends up being a dispensary.

In many schools there was quite a queue for their daily meds.....

TIME and Newsweek both ran stories on this a few years back; indeed, from as far back as 1996 the "accepted view" was that 7.5% or so of all kids "have" ADHD (not the more benign ADD!) Since nearly ALL of them are boys; that's 15% - for the most serious form of the disorder.

A cite from one such study published in 1999....

By comparison, her research found that 8 percent to 10 percent of children in second through fifth grades routinely took ADHD medication in school during the 1995-96 school year.

That'd be 20% of all BOYS, since again, nearly all diagnosed "cases" are in boys, yet the sampled population is children, which of course includes girls.

And note as well - this is those routinely taking the medication in school.

It excludes those kids who are dosed at home, and indeed, there are specific formulas of the medication available (for Ritalin in particular) that are extended-release, made specifically to avoid having to dose during school hours.

30% of all BOYS is not at all a "wild" number. Indeed, it is representative.

Care to re-think whether ADHD is really as prevalant as you've been told? 30% of all boys have it and need to be medicated? ONE IN THREE? And that is the most severe form of the disorder, and does not include those with the milder "ADD" form?

Is it a bit more clear why this issue pushes my "hot button"?

(BTW, the facts on this are all out there - indeed, it only takes a few minutes to find them. Quality of the research is all over the board on the medical side, but studies on who's being dosed at school are pretty easy to conduct, and pretty hard to get wrong.)

 

[fins wake]

... but I can't resist.

That's an outside upper bound, but it was precisely those kinds of outrageous numbers [snipped] A cite from one such study published in 1999.... [snipped]

But you're still not providing references, merely quoting unattributed sources. Ahem ... :frown2:

As for the percentages you quote, you assume that there's an equal number of girls and boys in all the samples, and equally that almost all diagnosed cases are boys, in order to get the arbitrary 'doubling' of percentages. Some studies point to there being two or three times as many boys as girls afflicted. (This is consistent with my personal experience). This is not the same as "nearly all diagnosed cases are boys".

Care to re-think whether ADHD is really as prevalant as you've been told? 30% of all boys have it and need to be medicated? ONE IN THREE? And that is the most severe form of the disorder, and does not include those with the milder "ADD" form?

I'm not sure what you mean by 'milder ADD form'. The DSM-IV criteria, which incidentally make no mention whatsoever of the much-quoted "diagnosis by effects of ritalin" (or similar) exposure, mention four types of ADHD.

More importantly, I still don't see where you get the 30% figure from. As a matter of fact, I certainly do not believe that ADHD is anywhere near that prevalent anywhere in the world, including the United States. Unless provided with clear and properly attributed references I simply refuse to believe that U.S. physicians have diagnosed almost one in three U.S. boys as having ADHD. DSM-IV estimated prevalence of ADHD among school children in the United States is 3-5% nationally. (National Institutes of Health figures are also 3-5%). I have seen figures ranging between 4 - 12% in other U.S. studies, and figures right up to 16% in one Canadian study, which admittedly could be a local spike in this particular study.

There are some other points I query as well, but we're probably boring everybody else stiff.

Can we agree that people with suspected/diagnosed ADHD and a longing for scuba diving, should consult the medical community first?

 

[Genesis]

... but I can't resist. But you're still not providing references, merely quoting unattributed sources. Ahem ... :frown2:

Proper attributions take time; I've got the cites but need to crossreference them, as some of the source material has moved or suspiciously been "removed" in a couple of cases where online publication was the case.

As for the percentages you quote, you assume that there's an equal number of girls and boys in all the samples, and equally that almost all diagnosed cases are boys, in order to get the arbitrary 'doubling' of percentages.

No assumption necessary. Take any arbitrary school district and you will find that there are between 51-53 girls out of every 100 students. Its just how genetics works. There are spikes in individual schools, but not across larger population groups.
[quote
More importantly, I still don't see where you get the 30% figure from. As a matter of fact, I certainly do not believe that ADHD is anywhere near that prevalent anywhere in the world, including the United States. Unless provided with clear and properly attributed references I simply refuse to believe that U.S. physicians have diagnosed almost one in three U.S. boys as having ADHD. DSM-IV estimated prevalence of ADHD among school children in the United States is 3-5% nationally. (National Institutes of Health figures are also 3-5%). I have seen figures ranging between 4 - 12% in other U.S. studies, and figures right up to 16% in one Canadian study, which admittedly could be a local spike in this particular study.
[/quote]

Yes, and the number of children taking medication consistent with these symptoms (that is, for which the "on label" use is within them) is at least double the expected incidence of the claimed disorder.

This is what I'm referring to.

Now even if you accept the 3-5% of all kids (which I don't), the fact is that in many school districts 10-15% of all pupils were, as recently as 2000 (the last year for which I have statistics), being dosed by the nurses during the school day. I provided one reference; there are many; go do some research. You'll be shocked - I was when I first started looking into this.

Further, as I pointed out, this understates the incidence, since ADHD is grossly overrepresented in boys. So, if the percentage of medication across all pupils is 15%, then the percentage among boys is closer to 30%, since most cases claim to occur among boys.

Finally, as I pointed out, the statistics on dosing of kids in school omits those who are on a time-release form of the medication, and therefore don't get dosed in school! This is not an insignificant percentage of the total.

Both of these factors mean that the numbers reported understate the prevalance of kids being drugged up.

Can we agree that people with suspected/diagnosed ADHD and a longing for scuba diving, should consult the medical community first?

I would say that consulting a doctor before taking up diving is a darn good idea if you are taking any medication whatsoever, whether prescribed or not, simply due to the potential effects of that drug while under hyperbaric conditions being unknown to you.

Indeed, such potential effects are essentially always 'off-label' if they are even known by the general medical community.

 

[Niftynorm]

Just a thought, when I started diving in the early 70's you were required to have a medical physical w/doctors approval to dive as it was considered physically demanding to the point of doing calestenics (sp) in class. Things have changed some and will change some more, even so just because you want to do something doesn't mean you can. I've filled the body bags and seen it isn't worth it! The final say so is with a medical doctor who has hyperbaric training.

 

[unfix8r]

Speaking of which:

I am a chiropractor, and able to perform physicals in this state (WA). Is there any reason why when my fellow Divemaster candidates come knocking for me to okay them, that I can't? Does PADI have a restriction on who can and who can't make that determination?

 

[wvjohn]

My first post here and thanks to all for all the great info on the boards. I am currently trying to see what my Dr. says about me (56 yrs old) and scuba. I'm bumping this b/c my 16 yr old son, who has been on ADD meds for a long time, also wants to learn to dive. Physically I think he is fine, and I wouldn't even be considering diving for him if his ADD symptoms weren't controlled by meds. My main concerns at the moment are any synergies between his meds (ritalin) and the effects of pressure, breathing compressed air, etc.

If anyone has any links or knows of any recent clinical studies in this area, It would be greatly appreciated.

Thanks!