ADHD: A Quebec reflection is essential

ADHD: A Quebec reflection is essential

An article published in the push more This Morning reports on the preliminary results (which also corroborate publications in other circles) of a study by UQAM showing that younger children born in July-August-September were more likely to receive an ADHD diagnosis, or 20.8% of the cohort. But among the others, older and supposedly more mature, 15.4% had still been diagnosed, which is huge.

In early 2019, a few dozen pediatricians published a letter in the media denouncing the worrying increase in prescription drugs for hyperactivity.

Data for children and adolescents insured with RAMQ showed a significant increase in ADHD drug use between 2006 and 2015, reaching as much as 14% among 10-12 year olds. Among all patients, whether privately or legally insured, usage reached 13.9% among 10 to 12 year olds and 14.5% among 13 to 17 year olds. These numbers are three times higher than the rest of Canada.

recommendations

Following this media position, a parliamentary committee was commissioned to deal with this issue and hold hearings in autumn 2019. In its report, the committee essentially took up the recommendations of our paediatricians’ group, namely:

  • providing better access to mental health resources for children with ADHD-like symptoms;
  • Better validation of the diagnostic tools used by doctors and psychologists;
  • Updated guidelines with the College of Physicians and the Order of Psychologists, with specific attention to non-hyperactive ADHD;
  • Provide more aerobic physical activity in schools and verify its impact through pilot studies;
  • Restrict cellphone use in schools and retest impact through pilot projects.

We can only conclude that these recommendations have remained dead letter and that little has been done to better manage ADHD medication use.

In 2022, a new INSPQ study on users of statutory drug insurance was published. It showed that ADHD medication prescribing was stable, but still at fairly high levels (11.3% among 6-11 year olds and 13.4% among 12-17 year olds). year olds).

It must be said that while psychostimulants are very effective in the short term in reducing restlessness, impulsivity and difficulty concentrating, their long-term effectiveness has never been proven. In addition, they have side effects that shouldn’t be overlooked, including on growth.

More psychostimulants among Quebecers

Thus, among our 5-18 year olds, Quebec is by far the Canadian champion, and probably the world champion, in prescribing psychostimulants and other medications for ADHD. Are we a separate society of pill addicts?

And yet our kids and teens probably play the same video games and are just as addicted to cell phones and social media as they are in the rest of Canada or any other developed country.

In our first letter from January 2019, we called for educators, psychologists, parents and doctors to be put through their paces.

What have we done to our children that their restlessness, impulsiveness, or difficulty concentrating have become such that we need to treat them? When I first started my practice, it took a lot of persuasion to get parents to put their child on ADHD medication. Now it takes a lot of persuasion to get parents to stop medicating their child and find other ways to deal with their inattention and turbulence.

I beseech parents in Quebec to be more critical of being diagnosed with ADHD and treating it with medication. I beg doctors and psychologists to improve their diagnostic tools. I beg doctors not to jump on their prescription pads too quickly and go for the simple fix of medication.

A sociological soul-searching is essential at this institution in order to have a little pill to treat everything that bothers us.

a child whose depression is sitting on the floor

Photo provided by Pierre Poulin.

Pierre C Poulin, Retired Paediatrician, St-Georges