ADHD…Attention deficit disorder with or without hyperactivity. A neurodevelopmental disorder that can hinder children in their learning… For nearly 30 years, and under different trade names: methylphenidate, classified as a narcotic, is indicated in France to calm the symptoms of ADHD. We looked at health insurance data.
The number of boxes of methylphenidate delivered to minor patients increased by 62% between 2016 and 2021. That year: 150,823 young patients under the age of 19 consumed it. 80% boys.
1 hour from Lyon, we have an appointment with one of these very young patients.
Hugo 10 years old, is in CM1. Last October, the school alerted parents to his inattention in class and invited them to consult.
“It was the last “last resort” treatment. After the adjustments, there was the treatment, explains his mother. And if not, if no treatment, then it was a specialized class.”
A pediatrician at the hospital prescribed him methylphenidate. For 2 months, the little boy will take the medicine every morning on school days, before stopping because of adverse effects, some of which would be very frequent according to the instructions.
“It messed us up Hugo,she confirms. He was full of junk. He was shaking his hands all the time, moving his head, shaking his head. It was non-stop. We really had this feeling that we gave this treatment to facilitate the daily lives of teachers.”
Initially only prescribed in the hospital, the drug is now more easily accessible. In 2021, the High Authority for Health gave the green light to specialist doctors to initiate treatment in the city.“The initial hospital prescription is no longer required. Renewal is possible by any doctor”.
Is this liberalization of prescriptions the cause of the increase in drug consumption among children? Is the use of this molecule always justified?
We make an appointment with an ADHD psychiatrist on the pretext that we have a 7-year-old child who is a little restless. He offers us a teleconsultation at 140 euros.
In a few minutes, he will detect ADHD in our child without having ever seen or spoken to him. About twenty very general questions on behavior are enough for him, for example: “has trouble sustaining attention at work?”, “is easily distracted?“.
The diagnosis falls: ADHD. And for him, methylphenidate would be the only solution:
“The only really effective treatment is a biological treatment, that is to say a drug. […] When someone is hypoglycemic, they are given sugar. […]Parents can also give it on the weekend, if they have a particular activity, for example if you receive family with many children so that things don’t turn into trouble, if you are going to visit a museum… This drug sometimes allows you to have a great happiness in life“, he explains to us.
If it is easier to prescribe methylphenidate today, it is partly thanks to the influence of a reference association on ADHD. We take advantage of its general meeting to ask its president if it is normal to prescribe a psychotropic drug so easily to a child, without even having seen it.
“It’s not what we expect. It’s counterproductive!” annoys Christine Gétin, president and founder of the ADHD-France-Hypersupers association. Because according to her, the drug would be essential in certain cases: “There are parents who get stuck in complex situations because they refuse the treatment that scares them.”
In a report published a month ago, the High Council for the Family, Childhood and Age recalls that whatever the symptoms, it is necessary to privilege: “in first intention non-drug approaches”.
Some psychiatrists also warn about the too systematic use, according to them, of medication, sometimes referred to as the “obedience pill”: “Giving medicine is much less binding than giving long-term treatment, working with schools, families, from an economic point of view, from an educational point of view. If the answer is medication for lack of means, when we know we know how to do otherwise, then yes, it’s dramatic. It’s guilty,” explains Olivier Tarragno, psychiatrist, child psychiatrist and psychoanalyst, in charge of the Health division of Sciences Po.
Contacted, the 4 pharmaceutical laboratories that manufacture the molecule did not, for their part, wish to answer our questions.