De-constructing the ADHD narrative in the UK

ADHD is a diagnostic category of psychiatry. According to our estimate around 156,000 young people are currently being drugged “for ADHD” in the UK. There is no biological condition ADHD. And no medical test. Thus there is no “treatment” in any medical sense. The drugs simply curtail the disruptive behaviours which constitute the ADHD “diagnosis” (in some users). The main drug used is methylphenidate which the US DEA describes as being “pharmacologically similar to amphetamines and cocaine”. The new drug atomoxetine is linked to suicidal thinking and behaviour.

In this paper we look at how the narratives about ADHD are constructed. We critically review a number of key papers and we review the NICE Guideline on the diagnosis and “management” of “ADHD” in children, young people and adults.

This paper has taken up about two years of my life (in between other commitments) and I”ve at times prioritised it over getting paid jobs. If you are able to contribute the suggested donation please do consider doing that. There is a PayPal form at the bottom of the page. Thanks.

The paper can be downloaded in full. This is the first link in the following table. However; I have broken the paper into its constituent parts which can all be downloaded separately. This may be useful for people who have a particular interest in just one section.

Title	Description	Download
Dividing and Drugging. De-constructing the ADHD narrative in the UK	Full paper.
Part 1 – Critique of the Cardiff Genome Study	Critique of a 2010 genome-wide association study. The study correlated 14% of an ADHD group to a specific type of genetic variation as compared to 7% of a control group. No causality is established and the results also correlate to IQ. The study is best known for the exaggerated claims made by one of the study authors.
Part 2 – Critique of the NIMH Multi-modal study	Critique of the 1999 Multi Modal Study. The Multi Modal Study compared the effects of an intensive regime of methylphenidate versus a behavioural programme on several hundred young people, average age 8. ADHD “symptoms” were recorded. For attentiveness intensive drugging came out on top for both parent and teacher raters; but not blinded classroom raters. The study was constructed in such a way as to produce drugging propaganda.
Part 3 – The Drugs	Brief summary of the main drugs used to “treat” “ADHD”. There is no medical reason to prescribe these drugs. The drugs modify behaviour. The drugs are harmful. For the most used drug, methylphenidate, unpleasant side-effects are the norm. The new drug atomoxetine is linked toÂ suicidal thinking and behaviour. The drugs generate very large revenues for pharmaceutical companies. Usage in the UK has more than doubled over the last 10 years.
Part 4 – NICE Guide on ADHD	A critical review of the NICE ADHD Guideline. NICE is the body in the UK which issues guidelines to the NHS on how to treat certain conditions. NICE commissioned The Royal College of Psychiatrists and The British Psychological Society to produce a Guideline on how to “treat” ADHD. The Guideline was published in 2008 with their recommendations. “Medication” and behavioural interventions are both recommended. The case for drugging is marshalled out of “evidence” which even within its own terms should point to behavioural interventions. A degree of selectivity (in some cases extreme selectivity) can be demonstrated in their handling of their own “evidence-base”.
Part 5 – Discussion	Discussion of various themes. We consider the ADHD drugging programme (very briefly) from a) the point of view of Michel Foucault”s archaeological investigations into psychiatry and b) from the point of view of Ivan Illich”s critique of modern schooling. We also look briefly at the role of The Wellcome Trust in promoting narratives about ADHD which support drugging. And we consider how a BBC management team handled a complaint about a Panorama programme which raised doubts about the value of ADHD drugging.
Conclusion	Conclusion.
Appendices