When is it appropriate to go down the medication path? It seems most reasonable to do so if someone was born with a condition rather than it to be caused by external environmental factors. If it was caused by environmental factors, the logical thing to do is to rectify those factors.
With ADHD, there are two well researched etiologies involved. It could be either genetic or environmental. In terms of genetic, a specific polymorphism of the dopamine receptor, DRD4, as well as a polymorphism of the dopamine transporter, DAT, is highly correlated with ADHD behavior as well as novelty seeking behavior.
Environmental wise, today's high stimulation entertainment is a breeding ground for ADHD. Children are playing highly stimulating video games for hours on end. The internet feeds us an incredible amount of information and entertainment that requires very little attention span. These are also very addictive.
Studies show that repeated engagement of addictive behavior makes our prefrontal cortex less active, so we're less capable of directing our willpower to accomplish less exciting tasks that takes sustained attention. It also makes it more difficult to fruitfully carry out our plans and goals. These symptoms are the hallmark of ADHD.
So is the answer to use less internet/gaming? Perhaps, but it seems that we can work out our willpower as well. Meditation is often touted as a method of working out our brain's prefrontal cortex. Or you can just engage in just about any other task that requires willpower.