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Setting the Record Straight About ADHD and Its Treatments

A recent New York Times Magazine article endangers patients’ health by baselessly questioning established science, willfully contorting experts’ words, and ignoring the grave consequences of untreated ADHD.

By Anni Layne Rodgers Updated on May 22, 2025
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April 16, 2025 [Updated April 25, 2025]

Since its publication last Sunday, The New York Times Magazine article “Have We Been Thinking About ADHD All Wrong?” has been called provocative and controversial. We would like to add a few adjectives: misrepresentative, biased, and dangerous.

In his 8,800-word article, writer Paul Tough used cherry-picked bits of decades-old data, very small studies, and interviews with three patients (all men) to exhume long-debunked ideas about ADHD and its treatment with prescription stimulant medication. Tough dismissed the lifelong work of esteemed ADHD researcher Russell Barkley, Ph.D., and suggested that the diagnosis of ADHD was unreliable or subjective because it relies not on a biomarkers or genetic tests, but on a trained clinician’s careful review of patients’ self-reported and observed symptoms in several settings.

To be clear, identifiable biomarkers do not yet exist for many psychiatric, neurodevelopmental, and neurodegenerative disorders. In the case of ADHD, medical experts use rating scales, neuroimaging studies, and/or criteria in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) to assess whether patients meet the threshold for a diagnosis.

“There’s no genetic marker for most psychiatric illness, but there is very clear heritability, as Dr. Russell Barkley has pointed out for years,” says Wes Crenshaw, Ph.D., a licensed psychologist and author. “I wonder if the Times author doubts depression? Or autism? Or anxiety? Or bipolar disorder?”

Though he was also quoted in the Times article, Crenshaw says he was never interviewed by the reporter, who pulled quotes out of context from his ADDitude articles.

ADHD Biases Divorced from Fact

Tough cited findings from the Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) Study to suggest that the benefits of stimulant medication wear off after 36 months. In arguing that Ritalin’s “advantage had completely faded,” Tough failed to report that long-term medication adherence among the MTA subjects was inconsistent — an important fact that undermines the author’s contradictory argument that stimulant medication is somehow both ineffective and “powerfully addictive,” as he claims in the article. (If it were addictive, wouldn’t the MTA subjects have taken it every day without fail? We know that half of teens and adults with ADHD stop taking stimulant medication within one year of starting it, suggesting that it is not addictive and shining a light on how woefully irresponsible it is to claim the ineffectiveness of a medication that is not taken consistently.)

Tough was guilty of biased reporting, or a deep misunderstanding of the subject he was covering, when he suggested that the increase in ADHD diagnosis rates — from 3 percent nearly 40 years ago to up to 11.4 percent of American children today, according to the CDC — represents a medical crisis or evidence of overdiagnosis. In truth, this uptick is is due, in large part, to a revised set of diagnostic criteria for ADHD in the DSM-5, a dramatic improvement in both clinician and patient understanding of ADHD, and critical research on its manifestations, especially in girls, women, and people of color — populations that have been historically overlooked and underserved, with serious consequences.

Perhaps the Times reporter was unaware of the basic fact that, 40 years ago, the scientific community screened almost exclusively only boys for symptoms of ADHD. It did not acknowledge the inattentive subtype of ADHD that many girls and women exhibit. And it insisted that symptoms only caused impairment in school settings. We now know much better.

Sloppy Reporting, Inaccurate Conclusions

Tough did Times readers a disservice by choosing not to interview more esteemed physicians, researchers, and clinical psychologists at the forefront of ADHD care. Instead, he plucked their quotes from the pages of ADDitude, stripped them of context, and did not pursue conversations with authors, like Crenshaw, or patients they suggested. [Crenshaw told ADDitude that, prior to the article’s publication, he offered “the author (through fact checker) a chance to interview an almost infinite number of ADHD people whose lives have been radically changed by integrative treatment.” No interviews were granted.]

For example, Tough quoted a feature from the Fall 2021 issue of ADDitude magazine in which Crenshaw addressed parents’ top concerns regarding ADHD medication. In the article, Crenshaw used established, evidence-based research to suggest that, if your child has ADHD, then stimulant medication paired with behavioral parent training and/or cognitive behavior therapy is shown to produce the greatest results in symptom management. Tough took Crenshaw’s words out of context to make it seem that he was arguing that ADHD exists as a binary, on-off diagnosis without any heterogeneity or symptom fluctuation. This is contrary to Crenshaw’s views and contradicts ADDitude‘s own recent reporting.

In its Spring 2025 issue, ADDitude magazine published a cover story titled “ADHD’s Vanishing (and Reappearing) Act,” in which author Maggie Sibley, Ph.D., explained her recent research into the sometimes unpredictable ebbs and flows of ADHD symptoms over a lifetime. Rather than acknowledge ADDitude‘s work to cover the scientific community’s evolving understanding of ADHD, Tough’s reporting painted ADDitude and its contributors as outdated. This is an unfair depiction.

He manipulated ADDitude content again in quoting an article published in 2020 and written by Roberto Olivardia, Ph.D., a clinical psychologist and Harvard Medical School lecturer. Tough did not interview Olivardia. Instead, he pulled a quote from Olivardia regarding the ways in which stimulant medication may quell a child’s social impulsivity. Tough deliberately omitted this vital precursor to the quoted statement in the ADDitude article: “Clinicians should assure parents that any medication that appears to mute the child’s positive aspects and core personality is indicative of an unsuccessful medical trial. Another medication should be tried.”

Olivardia didn’t mince words in his response to the Times article. “The suggestion that I and other ADHD clinicians would uniformly placate parental concerns with a canned response is insulting,” he says. “This is not the first time this has happened within the ADHD community, and it’s so frustrating. Some things in the article are accurate, but they are mixed in with very inaccurate, overly simplistic information.”

Unraveling a Dangerous Narrative About Medication

Of perhaps greatest concern is Tough’s inaccurate and harmful portrayal of stimulant medication as an ineffective Band-Aid that fails to improve students’ academic test scores and, therefore, must be unnecessary. He cited limited research casting doubt on ADHD medication’s ability to make kids score higher on timed tests, sort specific puzzles more efficiently, or excel in summer school. “If these studies are accurate, stimulant medications don’t do much to improve cognitive ability or academic performance,” Tough wrote. “And yet millions of young Americans (and their parents) feel that the pills are essential to their success in school. Why?”

Inexplicably, Tough did not report that ADHD medication has been shown to reduce impulsivity and, by extension, the risks of car accidents, substance abuse, unplanned pregnancy, comorbid depression and anxiety, incarceration, self-harm, and suicide. In fact, research has found that stimulant medication use among individuals with ADHD reduces the risk of premature death by a staggering 19%.

In a study published in The British Journal of Psychiatry in 2025, the life expectancy for adults with ADHD was found to be 7.5 years shorter than it was for those without the condition. Women with ADHD live 8.6 years fewer years than women without ADHD, while the life expectancy of men with ADHD was 6.8 years shorter than that of their peers. ADHD is a serious condition, and to willfully misrepresent its proven treatments is dangerous at best.

Research has documented the positive impact of ADHD treatment on life expectancy. A Swedish study, published in JAMA Network Open, followed nearly 150,000 adults and adolescents for two years after they received their ADHD diagnoses. The researchers shared the following insights about the use of stimulant medication — amphetamine or methylphenidate — which is effective for roughly 70% of patients with ADHD:

  • ADHD medication use reduced overall risk of death by 19%. Among people with ADHD who did not receive medication, there were 48 deaths for every 10,000 people, contrasted with 39 deaths per 10,000 people within the medicated cohort.
  • ADHD medication use reduced the risk of overdose by 50%. Medication use also reduced the risk of death from other unnatural causes, including accidental injuries, accidental poisoning such as drug overdoses, and suicide.
  • ADHD medication use reduced the risk of death from natural causes, such as medical conditions, for women.

People with childhood ADHD are nearly twice as likely to develop a substance use disorder as are individuals without childhood ADHD. However, research suggests that patients with ADHD treated with stimulant medications experience a 60% reduction in substance use disorders compared to those who are not treated with stimulant medication. Considerable evidence also suggests that children taking ADHD medication experience improvements in academic and social functioning, which translates to improved self-esteem, lower rates of self-medication with drugs or alcohol, and decreased risk of substance abuse.

What’s more, researchers at the University of Michigan and Massachussets General Hospital studied 40,000 high school seniors, more than 4,000 of whom had ADHD. The research team compared the risk for marijuana abuse — the most common drug misused by this age group—among teens with ADHD to the overall population. They found that the students with the lowest incidence of substance abuse started ADHD treatment with stimulants before 9 years of age. When treatment began between ages 10 and 14, it was helpful, but the students still had a significantly higher likelihood of smoking marijuana. The highest risk of marijuana use was found among students with ADHD who started medication after age 15.

The late Joseph Biederman, M.D., the former Chief of the Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD at Massachusetts General Hospital, along with researchers at the hospital and at Massachusetts Institute of Technology, conducted a study in which teens with ADHD were separated into two groups, then tasked with driving through a virtual roadway featuring surprise events, including oncoming traffic. The teens in the first group received stimulant medication (lisdexamfetamine: brand name Vyvanse) while the teens in the second group did not. Compared with the group of non-medicated ADHD teens, the medicated group was 67% less likely to have a collision during these events.

“For families that stop ADHD treatment on weekends and during ‘downtime,’ I emphasize the importance of driving only while medication is active,” Dr. Biederman had said. “A short-acting medication taken about half an hour before hitting the road may just be lifesaving.”

Why Ignore Patients’ Real-World Experiences?

Indeed, ADHD treatment with medication is lifesaving for many children, adolescents, and adults with ADHD for many reasons beyond the decreased risks for car accidents, illegal drug use, unprotected sex, and the other dangers outlined above.

ADDitude readers write to us daily about the social, emotional, professional, and psychological benefits they experience while using prescription stimulant medication to treat their ADHD symptoms. By excluding these patient perspectives, Tough’s reporting could place lives at risk by telling a story that may scare caregivers and adult patients away from the ADHD treatments that are shown to safely, effectively improve and protect lives.

On that note, let us leave you with a few quotes from ADDitude readers explaining, in their own words, the benefits of stimulant medication and the threats they feel in 2025.

“Adderall is literally the difference between crippling depression due to executive function disorder and not. If my access to my much-needed medication goes away, the impact will be exponential.”

“If they mess with my stimulants or access to stimulants, I could lose my job and even my marriage. I rely on it to maintain focus as a design engineer. It also helps communication with my wife when I have my stimulants.”

“ADHD medication has huge benefits. It’s frustrating that the discourse is being steered from the top by someone so willfully ignorant, bringing out everyone who has totally misinformed ‘reckons’ about ADHD.”

Rebuttal from Russell Barkley, Ph.D.

More NYTimes Rebuttals

ADHD Article Corrections: Next Steps

Corrections

This article was updated on April 25, 2025, to reflect the following:

  • Wes Crenshaw, Ph.D., reported to ADDitude that he invited the author to interview several ADHD patients, not himself, and that invitation was not accepted
  • The CDC’s 2022 estimate for the prevalence of ADHD in American children aged 3-17 years, which is 11.4 percent, not 5 to 7 percent
  • Author Paul Tough did not directly describe the ADHD diagnosis process as “arbitrary,” but rather his quoted source, Edmund Sonuga-Barke, did. This quotation was removed.
  • The full quote from Tough’s text was included: “If these studies are accurate, stimulant medications don’t do much to improve cognitive ability or academic performance. And yet millions of young Americans (and their parents) feel that the pills are essential to their success in school. Why?”
  • This phrase was removed, “…and then questioned why American parents and students would accept the ‘risks inherent in taking prescription stimulants.'” The original article stated: “Researchers acknowledge that there are other risks inherent in taking prescription stimulants.”

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