It’s become a familiar scene now in headlines: Some person misuses a prescribed stimulant medication (usually Adderall) which ends up in a severe tragedy. The news channels pick it up and the story is covered usually the following: The person was diagnosed in less than five minutes in one of the recently popular online formats. Usually a nurse practitioner conducted a brief interview lasting only a few minutes, and establishes a diagnosis of ADHD. Stimulants are prescribed, which then leads to drug abuse or other catastrophes in a toxic soup. Next, everyone becomes and outraged about the over diagnosis of ADHD and the problems with telemedicine.

Each one of these steps are problematic vis-à-vis a correct medical standard, which would include the need for in person evaluations, longer periods of assessment, and the use of clinicians with the highest level of training and experience, such as board-certified psychiatrists.  Even so, most of the time the real problem lies elsewhere. ADHD is not a diagnosis in a vacuum. Most of the time it is accompanied by comorbid conditions such as mood, anxiety, and particularly substance abuse disorders. ADHD itself makes a person prone to addictions and addictive behaviors. The tragic stories are usually the outcome of these poorly evaluated conditions that accompany ADHD or mask themselves as symptoms of ADHD. There are no shortcuts or simple answers to prevent all possible bad outcomes. There are also no alternatives to highly skilled qualified physicians in the fields of psychiatry and neurology to diagnose and treat the challenging condition of Attention Deficit Hyperactivity Disorder and Attention Deficit Disorder.