We saw a similar whiplash with Ritalin after over-prescribing in the 90’s/2000’s. ADHD medication absolutely works, but for a lot of people it didn’t for this reason.
My point is if you include more and more people who don’t need it because of over-prescription it’s going to appear as lower overall efficacy while still helping a lot of people in the pool.
Making up numbers: If only 20 out of 100 people actually have ADHD then out the gate you’ve ruled out helping 80% of the people. So if 15 of the remaining 20 see improvement in their daily lives that means 75% suddenly looks like 15%.
Diagnosing and treatment is never that clean, there will always be some people who don’t necessarily need a certain medication yet get it prescribed (or don’t when they need it! Especially women with ADHD) because doctors are fallible like anybody else, systemic issues, etc. But with a commonly prescribed medication like Adderall the problem is definitely more pronounced.
Anyway I’m curious enough to look more closely at the study, this is a very interesting topic. If Xanax is really not helping people that’s pretty serious.