Pain-relief scientists have never worked to develop a regimen that relieves pain for 8 or 12 hours a day, then stops. Why do ADHD treatment scientists think it’s okay to do that?
Drug companies say that their ADHD pills last all-day, and they hire research scientists to back up the claim. They should probably hire actual families to judge them first.
When pharmaceutical manufacturers advertise a 12-hour stimulant, check out what that means. (OK, I’ll do it. This is my day job, after all.) Their technical answer is that they started with a stimulant compound which–in its native form–works for a few hours. Chances are it was either Ritalin (methylphenidate) or Adderall (amphetamine). They then modified it to stay in the bloodstream longer.
Typically, they enclose little bits of fast-acting stimulant inside slow-release wrappers that either pulse or dribble out small bits of stimulant through the day. Then, they add a bit of fast-acting stimulant, just to get you up and out the door first thing in the morning. This assumes, that you wake up early and take the pill at least an hour before you do anything day-critical such as prioritize your task list or say something to your spouse.
When the research scientists are satisfied with their concoction, they send a big batch of their pills off to the clinical scientists
who test the pills’ effects in real people to measure how well the pills do what they are designed to do. 12-hour pills need to work for 12 hours or the 12-hour claim goes out the window.
Adderall XR and Concerta are common 12-hour stimulants. Their manufacturers AND the FDA have certified that claim, meaning that behavioral scientists observed statistically significant behavioral differences 12 hours after the pills were taken. That’s not saying the test subjects were behaving well, just that they were statistically less awful than the placebo group which was disassembling the research lab. Don’t judge the placebo group, though. You, too, might behave badly after 12 hours trapped in a lab full of behavioral scientists.
The FDA has final say over the claims a drug company can make about their medications. This introduces scientific oversight and a measure of consistency to the drug industry which is important. But let me take this opportunity to lodge a major complaint about the FDA:
The FDA doesn’t hire actual families to certify these claims.
Every day I ask people how long their 12-hour stimulant (or their child’s) is lasting, and I swear that “12 hours” is the answer I’m LEAST likely to hear. “Eight to nine hours” is the most common answer. “Ten or eleven” is a good solid response. “It lasts all day. I’m not certain when it wears off,” is the grand slam home run for a stimulant user. It happens, but not very often.
Eight or nine hours doesn’t even cover most people’s entire workday. For high-schoolers, it might cover all their classes and part of football practice, too, but not the homework hours. It definitely doesn’t cover all the social hours where there are temptations to resist or all the hours that kids drive cars. Is there is any phase of your life post-infancy during which 8-9 hours would be considered anywhere close to “all-day”?
Let’s post a hypothetical question. Pretend you have a daughter, and she’s going to her first high-school prom. Pretend the young man escorting her has ADHD and will be driving her along with another couple to the dinner, then the dance, then the after-party, then the beach, then the breakfast. Take into account what sleep deprivation and alcohol consumption do to driving safety. Consider that 90% of all accidents are caused by drivers 16-25 years old. Factor in the studies that found ADHD drivers have several times more auto accidents than other teenage drivers.
Now tell me what sort of ADHD treatment you would wish for your daughter’s companion. An 8- to 12-hour one?
Didn’t think so.