Twenty Years Later We Wonder if Harm Was Done? Huh?

Bill Gardner writing on The Incidental Economist examines an article in the NY Times “A.D.H.D. Experts Re-evaluate Study’s Zeal for Drugs”. The study completed twenty years ago was named Multimodal Treatment of Attention Deficit Hyperactivity Disorder. It was free of pharmaceutical money, fully funded by NIMH and well controlled. It compared community care, high quality behavioral treatment, medication following evidence-based guideline, or behavioral treatment and medication. It ran for 14 months. But it became the single most important paper to support the pharmaceutical management of ADHD.

The conclusion of the researchers was:

Combined behavioral intervention and stimulant medication—multimodal treatment, the current criterion standard for ADHD interventions—yielded no significantly greater benefits than medication management for core ADHD symptoms; this parallels findings reported by others.

Today the authors of the MTA study question if their validation of medication-only may have harmed children in the long run. 

This study was not done in the 50’s and these researchers are well regarded leaders in the medical community. Could they have considered what they are seeing now. Or more likely, they are seeing the reality of their work played out over time as demonstrated in an investigative piece by the NY Times “The Selling of Attention Deficit Disorder“. What will be our collective 20/20 hindsight in 2033? Or perhaps with the Internet and more and more open access to data we are seeing a change. We are all getting collectively smarter and more attuned to our healthcare footprint. 

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