TIME Parenting

The 5 Trends Driving the Surge in ADHD

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Researcher says it's less to do with brain chemistry and more to do with money

Until recently, 90% of all Ritalin takers lived in the U.S. Now, America is home to only 75% of Ritalin users. But that’s not because Americans are using less of the drug, says a Brandeis professor. That’s because ADHD diagnoses, and treatment via pharmaceuticals are growing in other parts of the world.

In a recent paper in the journal Social Science and Medicine, sociologists Peter Conrad and Meredith Bergey looked at the growth of ADHD in the United Kingdom, Germany, France, Italy and Brazil and found that prescriptions for Ritalin-like drugs have risen sharply, particularly in the U.K. and Germany.

Attention Deficit Hyperactivity Disorder, or ADHD, is a controversial subject among many parents, educators and medical professionals. Some doctors insist it’s a genuine neurological condition, if occasionally over-diagnosed and not treated properly. Others believe parents are giving their children drugs unnecessarily. (For a look at what it’s like to be, or parent, an ADHD child, read TIME’s special report, Growing Up with ADHD).

Conrad and Bergey, while not doctors, fall into the second camp. They list five possible reasons for the jump in ADHD diagnoses that have little do with medicine.

1) Pharmaceutical companies are well-resourced and determined lobbyists, and have coaxed some countries to allow stimulants, such as Ritalin and Adderall to be marketed more directly.

2) Treating patients with counseling and non medical therapies is becoming less popular than treating them with medicine. (Many insurers, including Medicaid, will pay for drugs but not for psychotherapy, for example.)

3) The Diagnostic and Statistical Manual (DSM), the bible of mental disorders, is gaining more traction in Europe and South America. The DSM has slightly broader standards for diagnosing ADHD than the system used by many other countries, the International Statistical Classification of Diseases and Related Health Problems (ICD), hence more folks are falling within the standard.

4) ADHD advocacy groups are raising awareness of the condition.

5) Because everybody is occasionally fidgety and distracted and nearly everybody despairs of not getting enough done, people turn to the internet for answers and find checklists put up by drug companies, with overly general questions like: “Are you disorganized at work and home?” and “Do you start projects and then abandon them?” and encourage people to ask their doctors about medication.


According to the study, fewer than 1% of kids in the U.K. had been diagnosed with ADHD in the 1990s, but about 5% are today. In Germany, prescriptions for ADHD drugs rose 500% over 10 years, from 10 million daily doses in 1998 to 53 million in 2008. Conrad, author of The Medicalization of Society, worries that we may be addressing a sociological problem with a chemical solution.

“There is no pharmacological magic bullet,” says Conrad, who suggests that the one-size-fits-all compulsory education system might be more to blame for kids who can’t sit still rather than a flaw in brain chemistry.

“I think we may look back on this time in 50 years,” writes Conrad, “and ask, what did we do to these kids?”

TIME States

Colorado Still Can’t Figure Out Final Rules for Edible Marijuana

Pot-infused cookies, called the Rookie Cookie sit on the packaging table at The Growing Kitchen, in Boulder Colo. on Sept. 26, 2014.
Pot-infused cookies, called the Rookie Cookie sit on the packaging table at The Growing Kitchen, in Boulder Colo. on Sept. 26, 2014. Brennan Linsley—AP

A state group adjourned without agreeing on solutions for keeping THC-laced food away from kids

A working group convened to help Colorado regulate edible marijuana products failed to come up with consensus recommendations at its final meeting Monday, punting the issue to the state legislature.

Officials have long been worried that edible products, which can take the form of sweets like lollipops and treats like brownies, will lead children to experiment with marijuana or accidentally ingest it. In May, the largest children’s hospital in Colorado reported that nine children had been brought in after accidentally eating such products, double the amount the institution had seen in the previous year. Despite fears that Halloween would see a spike of such incidents, the hospital didn’t report any cases of accidental ingestion.

The working group was formed to develop ideas for keeping edibles safe and out of children’s hands. The ideas ranged from making all marijuana edibles a certain color to banning most forms of edibles, limiting production to only lozenges and tinctures. A variety of suggestions will be presented to the state legislature when it reconvenes in January.

Makers of edible products don’t want to see their section of the market shrunk and point out that every “preparation of the plant” was given the green light when state voters approved Amendment 64 in 2012.

Washington, which opened its recreational market after Colorado, instituted emergency rules about edibles in June that require state approval of every edible product, including its packaging and labeling. Colorado’s working group rejected a proposal from the state health department to create a similar review commission.

TIME flu

The New Bird Flu Outbreak: Should You Worry?

birds
Getty Images

So far, bird flu cases in Europe have been identified as the H5N8 strain

Bird flu strain H5N8 has been identified on a duck farm in England and in chickens at a farm in the Netherlands. Should people be scared about a new pandemic? Experts say, no.

Where are the latest cases?

On November 17, bird flu was confirmed on a duck farm in East Yorkshire. About 6,000 ducks will be killed and a 6-mile surveillance zone is going up around the farm. The emergence comes just a day after bird flu was detected in the Netherlands at an egg farm. According to the BBC, the Dutch government has imposed a three-day ban on poultry and eggs transport. Officials are currently figuring out whether the two cases are connected. Earlier this month, bird flu also appeared in Germany.

Should I be afraid?

Not right now. First, it should be noted that there are several strains of bird flu, or avian influenza, and the recent strains have only so far emerged in birds, not humans. The Dutch and German governments determined their strains of the flu are both H5N8, a highly contagious virus that has never been found in humans. The British government has not yet said what strain of bird flu is circulating in the duck farm, but they have confirmed that it’s not H5N1, which can infect humans.

So what’s the big deal?

Farms with H5N8 outbreaks can face serious economic losses.

So it hasn’t affected humans before. Does that mean it won’t—ever?

Experts cannot completely rule out the possibility of human infection. “This particular strain has not been known to infect humans but, based on experience with H5N1, we know that H5 viruses have that capacity,” says Dr. Amesh Adalja, a senior associate of the University of Pittsburgh Medical Center Center for Health Security. “Thus far, avian influenza viruses have very limited human-to-human transmission capacity, so the general public need not panic, however poultry handlers may be at risk for infection. It will be important to understand the dynamics of this outbreak and understand the potential of H5N8 to infect humans.”

What about H5N1 makes it so much more worrying?

H5N1 is the strain that can spread to humans from birds, and it’s infected more than 600 people from 15 countries since November 2003, the Centers for Disease Control and Prevention (CDC) reports. About 60% of people who have contracted the strain have died. The majority of human cases are among people with direct or close contact with sick or dead infected poultry, and the disease does not efficiently transmit from person to person. However, if that were to change, scientists say we’d have a serious problem on our hands.

Is there a treatments or vaccine for bird flu?

Not exactly. In Nov. 2013, the FDA approved a H5N1 vaccine intended for the National Stockpile and not for commercial use. The CDC has told TIME that the vaccine is not very effective and would likely require more than one dose. Researchers are working on other vaccines for bird flu and its various strains, though none are currently approved. Right now, preventing the spread of infection is the best bet for keeping cases low.

“Avian influenza will always be a major infectious disease threat. Certain avian influenza viruses—such as H5N1 and H7N9—have very high case fatality rates and are leading contenders for wider spread amongst the human population,” says Adalja.

And while the current cases of bird flu shouldn’t freak you out, it is important for the global community to pay attention to the various strains and support vaccine and drug development.

TIME Research

Repeated Pot Use Linked to Lower IQ

File picture shows marijuana plants at a indoor cultivation in Montevideo
Marijuana plants are seen at a indoor cultivation. Andres Stapff—Reuters

The average marijuana user's IQ was five points lower than that of a non-user

Repeated marijuana use is correlated with lower IQ scores and less volume in the region of the brain that helps make decisions, according to a new study.

The study found that the average marijuana user’s IQ was about five points lower than that of a non-user. The earlier the study participants began consuming the drug, the worse the condition of the brain. The study, which compared almost 50 marijuana users to a control group, suggests that at first brains affected by marijuana compensate for the deficit in decision-making brain volume by increasing connectivity, a key brain function. But marijuana-affected brains can’t keep up in the long term.

“The results suggest increases in connectivity, both structural and functional that may be compensating for gray matter losses,” said study co-author Sina Aslan, a faculty member at The University of Texas at Dallas. “Eventually, however, the structural connectivity or ‘wiring’ of the brain starts degrading with prolonged marijuana use.”

While previous studies have showed that marijuana causes harm to the brains of animals, researchers said they couldn’t be sure whether marijuana use was the cause of the negative changes in the brain. Nonetheless, the study joins a growing body of evidence that marijuana harms the brains of young people.

 

TIME cities

Marijuana May Soon Spark Just a Ticket in New York

Pot Marijuana Weed
Getty Images

Amid legalization drive in states across the country

New York City officials are considering issuing tickets for possession of small amounts of marijuana instead of arresting people, officials said.

The new guidelines would allow people with low-level marijuana possession to be issued a court summons rather than requiring them to get handcuffed, arrested, and brought into the precinct for finger-printing, the New York Times reports.

Police arrested some 50,000 people a year on minor marijuana charges during the administration of former Mayor Michael Bloomberg. Numerous states and localities have decriminalized marijuana for medical or recreational use in recent years.

[NYT]

TIME neuroscience

Why We’re Falling Behind On Brain Innovation

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PASIEKA—Getty Images/Brand X

A series of reports explains the decline

Brain science is taking a hit, according to a recent series of papers published in a special issue of the Cell Press journal Neuron.

“While the disease burden and economic impacts are on the rise, progress in the development of new therapeutics and treatment approaches has appeared to have stalled,” reads an editorial introducing the issue. “Approval for new therapeutics (whether drugs, devices, or other treatment approaches) for nervous system disorders have been declining and most of the treatments we currently have are not disease modifying.”

Large pharmaceutical companies like GlaxoSmithKline, AstraZeneca, Merck, Pfizer and Sanofi-Aventis have closed or downsized their brain research divisions, according to one paper, a move the study authors believe reflects a growing view that developing drugs for the brain is too difficult and time-consuming. In another report, researchers argue that there are not enough opportunities for various stakeholders to meet and collaborate on the latest research.

Still, researchers of a third paper focusing on Alzheimer’s disease argue that even though stopping neurodegeneration progression “seems daunting at the moment,” the brain and Alzheimer’s community should be encouraged by other fields that have successfully stopped disease onset with prevention efforts—like lowering cholesterol for cardiovascular disease.

The prognosis isn’t entirely dire, because the same researchers also offer their own solutions. To re-gain Big Pharma’s interest, perhaps the incentive model for brain research should change. “One way to do this that would not require upfront funding is to change the policies that regulate market returns for the most-needed breakthrough drugs,” the authors write. “The broader neuroscience community including clinicians and patients should convene to develop and advocate for such policy changes.” Others say they’ve had success in forming their own meetings of minds by pulling a variety of experts together.

There’s also the U.S. government’s BRAIN Initiative, a massive research project to map out the brain and gain a better understanding of disorders that can plague it. It’s unclear what the ambitious project, which is a little more than a year old, will end up contributing to the field. Some researchers have argued it might allocate funding away from labs not involved in the project.

Reisa Sperling, a Harvard neurologist and the lead study author of the new Alzheimer paper, tells TIME the project is a good thing for the disease, but with some caveats. “It is important to note that the BRAIN Initiative is really focused on studying basic mechanisms of how the brain works, rather than identifying disease-specific alterations that are more directly translatable into [Alzheimer’s disease] clinical research,” she says. “So I hope that there will be additional investment that will help us translate mechanistic research on normal brain function into understanding what goes wrong in the brain in early Alzheimer’s disease…to help us find an effective treatment more more quickly.”

The bottom line is that despite lack of funding for the field, the are still reasons to be optimistic. “The pace of research progress in neuroscience over recent years has been nothing short of amazing,” the journal authors write. As long as drug companies can be attracted again to the brain, the vast time spent on trying to unlock it will be well worth it.

TIME Drugs

Voters Lit Up for Marijuana in the Midterms

Pot Marijuana Weed
Bob Leeds, co-owner of Sea of Green Farms, shows some of the marijuana he produces during a tour of his company's facility in Seattle, on June 30, 2014. Jason Redmond—Reuters

TIME rounds up the 2014 marijuana votes

“You did it! Isn’t this amazing?” Oregon Rep. Earl Blumenauer said to a room full of supporters in Portland on Tuesday night after being reelected. But he wasn’t celebrating his own win, he was celebrating another victory for legal pot.

“You knew we could do better than the failed policy of prohibition,” Blumenauer said.

Voters in Oregon on Tuesday chose to follow Colorado and Washington state in passing a ballot measure that will create the country’s third legal market for recreational marijuana. Measure 91, which passed with 54% of the vote, makes it legal for residents 21 and older to possess and grow marijuana, and tasks the state liquor control commission with regulating the substance.

A similar proposal in Alaska passed early Wednesday morning, making it the fourth state to legalize retail pot. “The results are in, and marijuana prohibition is on its way out,” Rob Kampia, executive director of legalization advocacy group the Marijuana Policy Project, said in a statement. Advocates like Kampia celebrated the results as setting the stage for even bigger legalization battles in 2016, particularly in California.

Legalization advocates also won a victory in Washington, D.C. With nearly 70% of the vote in favor, residents in the nation’s capital adopted what some industry experts call a “soft legalization” measure. While the District won’t have a regulated market like Oregon, it’s now legal for residents 21 and older to possess up to 2 oz. of marijuana and cultivate up to six plants at home, as well as give 1 oz. of marijuana to someone else, without payment. Selling pot is still not allowed.

The D.C. news comes with caveats for residents ready to celebrate: the new rules apply only to those who live in the three-quarters of D.C. that is not on federal land, where the substance remains verboten. Congress also has the power to step in and supersede the actions of D.C. officials.

Guam became the first U.S. territory to legalize medical marijuana, joining the District of Columbia and 23 states. But legalization advocates lost their battle for a similar proposal in Florida. After deep-pocketed advocates on both sides spent millions, the measure to legalize medical pot got 57% of the vote but needed 60% to pass. Big spenders like casino magnate Sheldon Adelson, who shelled out $98 million in the 2012 elections, donated roughly $5 million to defeat the measure. For now, this bellwether remains more purple than green.

South Portland, Maine, legalized marijuana in a somewhat symbolic vote, while voters in Lewiston, Maine, shot down a similar proposal. The measure makes it legal for residents to possess up to 1 oz. of marijuana, though consuming or displaying weed in public remains illegal. More important, the drug remains illegal on a state and federal level, and the measure did not address taxation or regulation of a legalized market. Portland, Maine’s largest city, passed a similar measure in 2013.

TIME Drugs

One Family’s Illegal Journey to Get Medical Marijuana for Their Child

A look inside the quasi-legal, science free world of medical marijuana for children, from TIME's Red Border Films

When you’re driving across the country with a stash of marijuana in your trunk, you follow the speed limit. You signal when changing lanes. You might even pick a route that skips Colorado, because ever since recreational pot was legalized there, police just over state lines have been on the lookout for anyone ferrying the drug from the area.

But the Colorado-free route from California, where you bought your marijuana, to the Northeast, where you live, presents a curveball. Cruising along I-40 in Arizona, you encounter a border patrol checkpoint. “Good evening, officer,” you say. A German shepherd approaches your vehicle and somehow doesn’t detect the marijuana that’s under a pile of ice in a cooler. As you’re sent on your way, adrenaline pulses through your body. Tears pool in your eyes.

You are, after all, committing at least several state and federal crimes, but when you get home a few days later, it’s business as usual.

Read the full TIME article by Kate Pickert here

TIME Innovation

Five Best Ideas of the Day: November 3

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. “Ultimately, gender equality is a vital part of humanity’s progress. ” Read the 2014 Gender Gap Report.

By the World Economic Forum

2. Shopping for Water: Markets just might save the American West from its water crisis.

By Peter Culp, Robert Glennon, and Gary Libecap at the Hamilton Project

3. With Ebola in the spotlight, Liberia’s nurses take to the streets to care for the sick crowded out of the overwhelmed health care system.

By Jina Moore at BuzzFeed News

4. Humanitarians are preparing for a future with autonomous weapons, which are unlikely to understand mercy, proportionality or the difference between combatants and civilians.

By Malcolm Lucard in Red Cross Red Crescent

5. Markets in everything: Can letting the rich buy into clinical trials produce cures for rare diseases faster?

By Alexander Masters in Mosaic Science

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME 2014 Election

Where Marijuana Legalization Votes Are Happening Nov. 4

Medical Marijuana
Colin Brynn—Getty Images

A handful of states and cities will vote to loosen restrictions on the drug, setting the stage for bigger battles in 2016

Residents in Lewiston, Maine may have seen an unusual Halloween decoration this year: a mobile billboard, towed around town on the bed of a truck, featuring a face screaming in horror and, in spooky-squiggly script, the words “Marijuana: Less toxic! Less addictive! Less scary than alcohol!”

The ad is part of the campaign to legalize marijuana in the small New England city, one of a handful of places where measures easing restrictions on the drug are on the Nov. 4 ballot. In Alaska, volunteers are going door to door in below freezing weather. In Oregon, where voting is done by mail, legalization supporters are using a Facebook app to nudge their friends who haven’t put their ballots in the post. Legalization advocates see the mid-term votes as a chance to set the stage ahead of larger fights to legalize marijuana in 2016, where it may be on the ballot in California.

Here’s a rundown of the key votes on marijuana this year, which are all hovering in toss-up territory:

Alaska: Legalization with tax and regulation

Ballot Measure 2 would concretely legalize retail pot, giving the state the power to tax and regulate the substance like Colorado and Washington. Two recent polls show the electorate bending in opposite directions. One found that 57% of respondents support the measure, compared to 39% who oppose; another found that 53% of Alaskans would vote no on the measure, compared to 43% who said they would vote yes.

“It’s very much looking like a coin flip,” says Taylor Bickford, a spokesman for the campaign supporting legalization.

Oregon: Legalization with tax and regulation

Oregon has been down this road before. In 2012, state voters rejected a measure to legalize pot 56% to 44%. This year, more activists have been on the ground asking people to support the pro-legalization Measure 91, an effort funded partly by the deep-pocketed Drug Policy Alliance. The chances of passage here may be better than Alaska, but it’s still no lock: the most recent poll shows 46% of voters opposing the measure and 44% supporting it. The numbers have long hovered around 50%.

All the campaigns are hoping for young people—who are generally more supportive of legalization—to turn out, despite their habit of staying home in non-presidential election years. “The young and young at heart are going to be important for us to pass this measure,” says Brad Reed, a spokesman for the Yes on Measure 91 campaign. “What’s clear from all of the polls is that it’s going to be a very close race.”

Washington, D.C.: Semi-legalization

Initiative 71 falls short of creating a government-regulated, taxable pot market like the ballot measures in Alaska and Oregon. But it would push the nation’s capital into decidedly cannabis-friendly territory, allowing people to possess up to 2 oz. of marijuana and cultivate up to six plants at home without facing criminal or civil penalties. Polls have shown locals supporting the measure by nearly 2-to-1.

The question is not so much whether it will pass as whether it will stand. There remains a disconnect between the reaches of the local and federal governments in the District—the substance would remain illegal in the roughly one-fourth of D.C. on federal land—and Congress could choose to intervene, passing laws that supersede the actions of D.C. officials. Though Congress has held hearings about D.C.’s past pot-related decisions, like decriminalizing marijuana, passage of this measure may spur more than talk. Marijuana is, after all, still illegal under federal law.

Florida: Medical marijuana

Voters could make Florida the 24th state to allow medical marijuana. Despite the lack of history at stake, the campaign for Amendment 2 has drawn millions from big spenders on the left and right, including casino magnate Sheldon Adelson. It’s also an issue splitting the gubernatorial candidates in a very close race, with Democrat Charlie Crist in favor of legalization and Republican Rick Scott against it.

Because it’s a constitutional amendment, the measure requires a 60% supermajority to pass, which is a tall order. Surveys have been all over the place during the campaign, but a Tampa Bay Times poll conducted in mid-October showed 48% of people supporting legalization of medical marijuana, compared to 44% opposing.

Maine: Semi-legalization

In 2013, Maine’s largest city, Portland, legalized recreational marijuana. The vote essentially gave police the power not to prosecute anyone for possessing up to 2.5 oz. of weed, though the sale and purchase of marijuana remain illegal. And some police prosecuted people anyway, drawing on the authority of a state that still views the drug as verboten.

Following Portland’s lead, two other cities have measures loosening marijuana restrictions on Tuesday’s ballot. Residents in Lewiston, Maine’s second largest city, and South Portland, Maine’s fourth largest city, will vote on laws similar to the one Portland passed last year. It’s not exactly polling data, but David Boyer of the Marijuana Policy Project, a legalization advocacy group, says the driver of the Halloween billboard has been lousy with thumbs up. “It’s been creating a real buzz around town, if you will,” he says.

Read next: Republicans See Senate Majority Within Reach Day Before Elections

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