Alan Schwarz

ADHD Nation is an important look at the history and widespread use of stimulant medication to treat ADHD. Schwarz delivers a detailed historical account, punching up what could be a rather dry narrative by focusing on the career of Dr. Keith Conners, an elderly childhood psychiatrist who was a key figure in popularizing the widely used Conners Scale for diagnosing ADHD and who has since turned against the disorder, and Jamison Monroe and Kristin Parber, two young adults who's diagnosis of show more ADHD served as an entry point to substance abuse problems, and who recovered to run a rehab center.

The story bounces across America, and from the 1930s onwards, but always returns to two main themes. First, the medications used to treat ADHD are potent stimulants which are frequently abused by patients seeking stronger highs. Second, ADHD itself is a product of Big Pharma, an artificial market by barely-legal ploys involving hidden payments to influential doctors, consumer advertising that bypass FDA regulations by not mentioning drug names, and scientific malpractice via poorly designed studies.

I literally wrote my dissertation on this topic, and on the one hand, Schwarz isn't wrong on any factual particular. He's right to target "ADHD is both under-diagnosed and over-diagnosed" as a meaningless cliche, and his expose of the very fragmentary system whereby serious stimulants can be prescribed indefinitely on the basis of five minute interview. On the other hand, he's not an academic, and that means that he lacks a strong idea of how medical research should be done, or what counts as trustworthy information about psychiatry for the public. The focus on a handful of very serious cases of drug abuse obscures whether an initial prescription of stimulants lead to ongoing problems (post hoc ergo propter hoc), or the systematic effects on millions of kids who are neither ADHD wrecks, nor stimulated into amphetamine psychosis. A similar focus on ADHD purely as a product of marketing ignores the fact that it fits into a very real hole in our society, an anxiety about merit and competition and fairness that would exist with or without the drugs.

A good book, and one which I wish had come out a few years earlier, so I could have included it in my diss, but not the last word on ADHD. show less

Really elocuent and fast history of ADHD overprescription and abuse in the United States. From the early 20th century to basically today. It intertwine personal stories with estadistics and undeniable facts about it. With a sympathetic last chapter giving a little hope for all this to stop. it all boils down to lazy doctors, frustrated parents and teachers, kids dissapointed in themselves, and of course corporate greed. It is analogous with the opioid epidemic, and in a minor way show more transitioning surgery that is happening right now, let's see how that one sets down in the years to come. The USA indeed has a short memory.

Our culture's handling of the disorder could very well be diagnosed with ADHD itself. From parents to teachers to doctors, we have been to impulsive, jumping at easy labels and even easier medication. We have hyperactively bounced from one definition to the next, scrambling to rationalize the newest ADHD symptom roster that is then swiftly judged insufficient. And the zeal for diagnosis and medicating children, and now adults, had distracted us from the abundantly obvious evidence that ADHD long ago jumped its tracks. show less

Written by an NYT reporter and built from over a thousand interviews with doctors, parents, students, and researchers, Schwarz compellingly illustrates the need for alarm at the nation's current state of affairs with all things ADHD and the subsequent diagnosis crisis. As high as 15% of the population is now being diagnosed with ADHD with no end in sight. Big pharmaceutical companies often subsidize the research studies and diagnostic categories are as subjective as ever. Without a defeatist show more attitude, Schwarz emphatically makes the case that there is a need for action, though it will take time to work through all of the complexities. Increased education in the medical schools, greater diagnostic exclusivity and specificity, along with reasonable and compassionate care for children are a few measures he highlights at the end of the book. show less

The best overview of the development of baseball statistics and statistical analysis (Palmer & Thorn's Hidden Game is a fairly close second; can't think of a third). Really needs an update to cover the Retrosheet, fielding, and Pitch F/X revolutions, which have taken things in unexpected directions. And of course Tango et al's The Book and the Prospectus book Baseball Between the Numbers would deserve mention in that update.

Begins at the beginning, with the New York game's box scores and show more Henry Chadwick's long reign as baseball's preeminent statistician and commentator. Touches at least briefly on most of the 20th century baseball statistical efforts, both official and unofficial. Al Munro Elias gets a chapter, which moves into the modern era and Seymour Siwoff's long Elias Bureau incumbency. Bill James, of course, gets his due, as do Pete Palmer and John Thorn. Many lesser efforts are mentioned; my biggest surprise was learning that Harland Mills is quite famous for his computer industry career. Late in the book is a lot of discussion about how sabermetrics has moved into baseball's front offices, not without controversy and not without problems.

The section on Project Scoresheet is a gem of fairly reporting things the participants all had strong feelings about. This discussion moves into a long portrait of the various agencies working to improve the available statistical universe, of how they've evolved in the recent past, and how their rivalries have affected their outlooks.

There's not a lot of actual statisitics in this book, though nearly everyone's contributions are accurately described. One chapter is devoted to the perpetual clutch hitting controversy.

The book ends with a sketch of Dave Smith (who turns out to be a friend of Siwoff), and of Smith's Retrosheet project. An appropriate ending, methinks, since Retrosheet is driving much of what we've learned over the past few years.

This review has also been published on a dabbler's journal. show less