Micaela Slotin

ADHD Overdiagnosis and the College Admissions Process

“So, do you think you’re ready?” I texted my friend Brian* at 7:30 on a Saturday

morning, bleary-eyed and anxiously waiting for our SAT test to begin.

“Yeah, David* sold me two of his Ritalin so I should be good to go”, he replied.

This blatant admission of an episode of what some may call drug abuse, and others may

call cheating, did not faze me in the slightest. I was used to my peers freely discussing their use

of “study drugs” to try to improve their performance on projects and tests. Research indicates

that as a student at competitive high school who now attends a competitive college, my

experience with my peers is sadly not even slightly out of the ordinary.

According to a recent study by the CDC, 6.4 million children ages 4-17 have received an

ADHD diagnosis, a 16% increase since 2007 and a 41% increase in the last decade. (1) About

2/3 of these children take prescription medications such as Adderall or Ritalin. While many

believe that this increase is due to more widely available and accurate diagnostic procedures,

there is strong evidence to assert that the rapid increase in ADHD diagnosis is directly linked to

academic pressures in today’s society. In a society that increasingly requires a college education

in order to be successful in the workforce, and that values “prestigious” institutions with low

acceptance rates more highly, the pressure for students to attain high grades and perform well on

standardized testing is crushing.

In a 2013 New York Times article, factors cited as contributing to overdiagnosis of

ADHD included pharmaceutical advertising, which often plays off parents fears of their children

failing in school, and which asserts how medication can drastically improve children’s lives,

small complaints of inattention being overblown and diagnosed as ADHD, and pressure from

parents whose children have slipping grades or behavioral problems to medicate them so they

will perform better. (2) Stories of students “gaming the system”- pretending to exhibit symptoms

of ADHD to be given a prescription for medication- are also not uncommon.

Overdiagnosis and ADHD medication abuse are often found to be linked; a study

published in Pediatrics showed a strong correlation between rising ADHD diagnosis and

medicine abuse. Querying the American Association of Poison Control Center's National Poison

Data System for the years of 1998–2005 for all cases involving people aged 13 to 19 years, the

study found that “calls related to teenaged victims of prescription ADHD medication abuse rose

76%, which is faster than calls for victims of substance abuse generally and teen substance

abuse, and that substance-related abuse calls per million adolescent prescriptions rose 140%.” (3)

Some may assert that the current problem of medication abuse is comparatively

unconcerning, as a 2012 article in TIME Health attempts to explain. The articles dictates that “

the National Institute on Drug Abuse’s Monitoring the Future (MTF) study… shows clearly that

we are not even close to the all-time peak of misuse of prescription stimulants by high-school

students, which occurred in the early 1980s. In 1981, 32% of all high-school seniors reported

having taken such a drug, with 26% having used it within the past year and 15% in the past

month. By 2011, the rates had plummeted: just 12% of high-schools seniors reported ever having

misused a prescription stimulant, with only 8% using in the last year and a mere 4% in the last

month. Overall, the trend of prescription-stimulant misuse is down dramatically.” (4) However,

just because rates of medication abuse are lower than they were in the past does not mean that we

should ignore the current patterns of abuse and attempt to find a solution.

Doctors say that abuse of prescription stimulants can lead to depression and mood swings

(from sleep deprivation), heart irregularities and acute exhaustion or psychosis during

withdrawal. However, there is more at stake here than side-effects of medication abuse. The

current culture of competitive college admissions makes students feel like without a 4.0 GPA,

multiple extracurriculars, SAT scores in the 2000’s and hundreds of volunteer hours, they’ll

never make it into any of their top choices. In 2017, Tufts University, a competitive university in

the Northeast, had an acceptance rate of 19%. Numbers are even lower with more “prestigious”,

Ivy League schools like Harvard, Columbia, or Yale- 5.8%, 6.8%, and 6.9% respectively. When

students see numbers like that, can they really be expected to remain calm and unworried about

the admissions process? Statistically, the possibility of rejection is overwhelming, but in the

mindset of many students, rejection means failure, and failure is not an option. They then turn to

methods to enhance their academic performance and thereby “increase their chances”, frequently

the abuse of ADHD and other like medications.

Truly what we need is a cultural overhaul, a serious re-evaluation of the college

admissions process and how we as a society put value on a college education. This involves

increased awareness of and dialogue about the seriousness and abundance of study-drug abuse

and how it links to the current academic and social environment. More time spent on teaching

good study habits and effective time management in middle and high school may also help

alleviate stress for some students. Additionally, students should be informed and aware that are a

variety of different post-graduation plans that are not just immediate enrollment in 4-year

institutions: gap years, technical schools, community colleges, and even entrance into the

workforce are all options after high school graduation, and students should not feel pigeonholed

into choosing one type of post-graduate experience. The current college admissions panic that

pervades the United States will not be an easy one to subdue, but if students are given more

options, if they are taught ways to handle stress more effectively, and if society stops pressing

college admittance on high school students as a life-or-death issue, maybe students like Brian

won’t feel the need to abuse medication to perform better in school.

References

1. http://www.nytimes.com/2013/04/01/health/more-diagnoses-of-hyperactivity-causing- concern.html?pagewanted=all&_r=1&

2. http://www.nytimes.com/2012/06/10/education/seeking-academic-edge-teenagers-abuse- stimulants.html?adxnnl=1&ref=general&src=me&pagewanted=all&adxnnlx=1394726588-hFI+xbf60GHPgMDD538rMg

3. http://pediatrics.aappublications.org/content/124/3/875.short4. http://healthland.time.com/2012/06/11/kids-taking-adhd-drugs-to-get-good-grades-how-

big-a-problem-is-it/