Sometimes it’s hard to imagine that different people have different goals. When we talk with patients in our offices, it’s our goal to help them as best as possible. Sometimes that means prescribing ADHD medications, sometimes it doesn’t, and that may or not align with the patient’s goals. When there is disagreement between what the patient wants and what we are willing to do for them, it becomes necessary to explain why we disagree, and hope that our relationship with the patient is enough to carry the day. Recent allegations regarding shady prescribing practices at Done—a telehealth provider of ADHD services—have made headlines and shaken the ADHD community. Two executives of that company have been arrested and indicted for distributing controlled substances, conspiracy to commit healthcare fraud, and other charges motivated by the allure of profits from prescribing stimulants. The Department of Justice alleges that Done pressured its providers to prescribe stimulants to patients who wanted them without ensuring appropriate diagnostic procedures, training, or clinical supervision, while simultaneously discouraging follow-up visits.
It’s horrible that a pandemic-inspired surge in telehealth practices may have spurred bad actors to overdiagnose ADHD and prescribe stimulant medications to people who don’t need them and might abuse them. However, the recent headlines about this incident also miss a wider point.
Somewhere around 4 percent of the population, including both kids and adults, are trying to regularly fill ADHD medications, and the number of these patients is growing. Some of the recent growth in ADHD diagnosis may be due to practices such as those alleged to have occurred at Done, and it’s easy to generalize from that to blame the telehealth system more generally. However, whatever its faults, the telehealth system has improved access for millions of people who otherwise would have problems getting diagnosis and treatment for mental health concerns—and it’s clear that mental health treatment access is inadequate.
Source: Psychology Today
