Focusing attention on baseball's ADHD anti-deficit

The Los Angeles Times focused on the ADHD (Attention-deficit Hyperactivity Disorder) epidemic in baseball.  It appears that with the initiation of serious drug testing in MLB, the number of therapeutic use exemptions for ADHD, has mushroomed. (photo is the Pirate's Adam LaRoche, diagnosed with ADHD)

In 2006, the major leagues granted exemptions for attention deficit disorder medication to 28 players. In 2007, that number jumped to 103...

...attention deficit disorder, a condition that for one day last winter overshadowed steroids on Capitol Hill. In the wake of the Mitchell Report, in a hearing that otherwise resembled a Washington victory lap for baseball's oft-beleaguered leadership, Rep. John Tierney (D-Mass.) broke off a wicked curve.

George Mitchell had wanted to know how many medical exemptions had been granted so players could use banned substances -- "a significant loophole in some drug-testing programs," the former U.S. senator had written in his report. Baseball had refused to hand that data to Mitchell, citing the confidentiality in its testing program.

Tierney wanted to know too, and this time baseball provided the figures rather than risk a subpoena from Congress. And Tierney read the numbers aloud, live on television: In 2006, baseball granted exemptions for ADD drugs to 28 players. In 2007, that number jumped to 103.

From 28 to 103, about a 3.5 times increase in TUEs.  However, we would think that the '28' figure might be an artificially low number -- new procedure produces an artificial base.  There are about 1400 players in MLB.  If the prevalence of ADHD is about 7% (low estimate), then about 105 players should exhibit ADHD.  Except the figures lie.  The usual prevalence numbers consider males and females.  MLB obviously plays males only.  So expect slightly under doubling the prevalence (as some of the number would be females).  Fourteen percent would be 196 players with ADHD.  The number quoted above makes more sense now.

Side effects of the drug:

The drugs are not without risk, said Julie Dopheide, associate professor of clinical pharmacy at USC. As stimulants, she said, they could improve concentration even in people without ADD, but side effects could include irritability and anxiety. The drugs also could increase pulse rate and blood pressure, she said, particularly dangerous to anyone with an underlying heart condition.

Those side-effects named above are significant but usually mild. In the hands of a good doctor side effects are minimized.

As the Times article continues it isn't easy to obtain the TUE for a stimulant, thus we doubt that MLB players abuse the diagnosis of ADHD to obtain amphetamines,