Summary 

Western Australia (WA) has a unique history as the world's only ADHD hot spot to have experienced a significant and sustained downturn in child medication rates.  From 1989-2003 in WA there was a massive increase in the prescription of dexamphetamine and to a lesser extent methylphenidate (Ritalin) for ADHD.  By 2002 WA prescription rates were amongst the highest in the world, exceeding the US national average.[1]  In 1989, in WA 880 people were prescribed stimulant medication.   By the year 2000 this had increased to 20,648 with the majority being children.[2]  WA prescribing rates continued to grow until the introduction of tighter ADHD amphetamine prescribing accountability measures in late 2003. Since then child prescribing rates in WA have fallen significantly with 6188 children on stimulants in 2007.[3]  Simultaneously amphetamine abuse rates by West Australian teenagers fell approximately 38%.[4]  Whilst WA adult ADHD prescription rates remain the highest in the nation, WA is the only state where total prescribing rates are trending downwards.  Sydney has now replaced Perth as Australia's ADHD child drugging capital.

In 2004 a WA Parliamentary inquiry into ADHD added to an intense local debate around the validity of the diagnosis and the safety of the drugs.  The inquiry found that the explosion in ADHD drugging rates was in part due to inadequate time for comprehensive assessments that identify children's real problems.  The prime recommendation of the inquiry was to establish multidisciplinary clinics that ensure drugs are not the first line treatment for children with concentration and behavioural problems.  The first multidisciplinary clinic is due to open in November 2009 with another to follow in April 2010.

[2] Office of Mental Health, Attentional Problems in Children: Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder(ADHD) and Associated Disorders, November 2002, Government of Western Australia: p21  Note: The Office of Mental Health estimate 85-90% were children.  This may have been an overestimate of the proportion of ADHD patients who are children as it was based on the age distribution in New South Wales. Western Australia has in later years had a higher proportion of adults in the ADHD cohort than New South Wales.  

[3] Department of Health, Western Australian Stimulant Regulatory Scheme 2007 Annual Report, Pharmaceutical Services Branch, Health Protection Group, Department of Health, Western Australia (2008): p41