A new study out of Finland, as reported on May 14, 2025, reveals that children diagnosed with ADHD are staying on medication far longer than we’ve ever had reliable data for—and yet the safety net of clinical evidence hasn’t kept pace. On average, kids in the Finnish cohort remain medicated for more than three years, and those in the top decile endure treatment for over seven years.
Imagine handing someone a pair of wings without teaching them to fly—and now envision those wings strapped on for years without knowing how they affect the body. The study lead, Päivi Ruokoniemi, says, “a significant proportion of young children, especially boys, are on ADHD medication for years, throughout their comprehensive school years.” That’s not just care—that’s a long flight into the unknown. Yet, the regulatory safety net only extends to a one‑year randomized study window. After that, we’re essentially gliding blind.
Boys start younger and stick around longer. The largest group—boys diagnosed at age 6 to 8—clock in at a median of 6.3 years on meds, and for a quarter of them it’s over 9.4 years. The metaphor that springs to mind is a young tree planted before its roots can settle—incoming winds may bend it, but we don’t really know if it blooms stronger or snaps in the storm.
The researchers highlight a disquieting gap: “The long‑term effects of ADHD medicines have been studied extensively in various observational and uncontrolled research settings, but these are always prone to confounding and therefore do not provide reliable information on cause‑and‑effect relationships.” In plain English: we’re missing the proof we need for what happens when this medicine becomes a steady companion for most of childhood.
On top of that, there’s the subtle pressure of norms setting in. As the article notes, regulatory authorities only demand safety data for one year, meaning once that year is up, many children keep going—and no one really knows how the journey affects them long term.
Beyond the numbers, there’s an ethical imperative. Ruokoniemi urges that ADHD meds be kicked off only when non‑pharmacological treatments fall short—and that annual reviews by a physician be standard practice. Parents and kids, she stresses, must be given enough “information on the expected benefits and harms of the medicine and the uncertainties associated with them.” That’s akin to checking altitude on a flight simulator—information gives you the ability to course‑correct.
Now, I know what you’re thinking—because I said it myself: aren’t ADHD meds basically just meth in a prescription bottle? And listen, I’ve tried meth a couple times (not exactly a résumé builder, I know), so I get why that comparison might raise some eyebrows. After a couple runs with the real thing, popping an Adderall can feel suspiciously familiar. But here’s the thing: while meds like Ritalin and amphetamines are chemically related to methamphetamine, they’re more like the responsible, sober cousin who went to med school. They’re formulated, dosed, and monitored in clinical settings, and they play by a totally different rulebook—FDA-approved, prescribed by doctors, and (ideally) taken under careful supervision. So yeah, I can joke about it, but I also know there’s a big difference between what I was doing and what a kid with ADHD is prescribed. Even if my brain sometimes blurs the lines, the science doesn’t.
Still, the metaphor is powerful: both substances act on the brain’s dopamine system, and when someone with no tolerance takes an illicit dose, the effect can be a jarring fireworks display. In contrast, when psychiatrists prescribe, it’s more like controlled fireworks in a stadium—with buffers, boundaries, and dismissal of the reckless.
This Finnish study shines a vivid light on something that’s felt but under‐observed—the silent elongation of ADHD treatment through formative childhood years. Without robust long‑term safety trials, it’s a flight without instruments. It’s essential that every year the child takes meds, doctors, parents, and young patients revisit the decision with fresh eyes and informed minds.
To quote Ruokoniemi: when uncertainties linger, “it must be ensured that both the caregiver and the child… have access to sufficient information on the expected benefits and harms… and the uncertainties associated with them.” That’s where wisdom takes root—and where data has to catch up before routine becomes risk.
Link to the article: https://www.sciencedaily.com/releases/2025/05/250514180742.htm
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