While a hotly debated topic, the use of mind-altering and stimulant drugs to treat children for behavioral problems remains unresolved. Ritalin is at the forefront as the drug of choice for treating children with Attention Deficit Hyperactivity Disorder (ADHD), and its use is increasing at an alarming rate. It is especially disturbing considering the fact that, to date, there have been no studies conducted regarding the long-term effects of Ritalin. In fact, concerns regarding over-medication have prompted lawsuits alleging collusion between drug companies and the psychiatric community. While the debates and lawsuits rage on, more prescriptions are written, and more children are at risk for potential misdiagnosis.

Approximately six million children are on Ritalin (or one out of every eight). In the last decade, the number of children on Ritalin increased over 700 percent; and Americans are consuming 85 percent of it. These are frightening statistics. In an October 2 article in U.S. News & World Report, lawyer Dickie Scruggs claimed that “At least 90 percent of those who are taking Ritalin in the United States are inappropriately medicated,” and said that as the definition stands now, “the diagnosis of ADHD would fit every child in America.” If this is indeed the case, how can a parent be certain that their child should be medicated?

Symptoms of ADHD frequently include hyperactivity, difficulty organizing tasks, excessive talking, forgetfulness, and impulsive behavior. These broad and ambiguous symptoms used to diagnose ADHD are cause for major concern because all children are, at times, hyper, unfocused, talkative, forgetful and impulsive. While there may indeed be legitimate cases of ADHD, there is no definitive test and the diagnosis remains subjective. In fact, there are some doctors who believe ADHD is a complete fraud and cannot medically be proven to exist. Additionally, parents must consider the side effects of Ritalin, which can often be as troublesome as the problem. Some of the known side effects include the following: dizziness, palpitations, headaches, insomnia, nervousness, depression (especially upon withdrawal), loss of appetite, nausea, vomiting, abdominal pain, dry mouth and skin rashes. Clearly, this is not a decision that should be made lightly.

In May, the American Academy of Pediatrics published “Diagnosis and Evaluation of the Child With Attention-Deficit/Hyperactivity Disorder.” While the guidelines in it are helpful to physicians and parents alike, it also reveals the problems with the diagnosis standards. At one point, the guidelines state: “Currently, decisions about the inappropriateness of the behaviors in children depend on subjective judgments of observers/reporters. There are no data to offer precise estimates of when diagnostic behaviors become inappropriate. This is particularly problematic to primary care clinicians, who care for a number of patients who fit into borderline or gray areas. The inadequacy of research on this aspect is central to the issue of which children should be diagnosed with ADHD and treated with stimulant medication.” Perhaps the research should be done before these “borderline” children receive any drug treatment. The statistics cited certainly make a compelling case for more caution when diagnosing ADHD.

Peter Breggin, director of the Center for the Study of Psychiatry and Psychology, testified before a U.S. House subcommittee: “By diagnosing and drugging our children, we shift blame for the problem from our social institutions and ourselves as adults to the relatively powerless children in our care. We harm our children by failing to identify and to meet their real educational needs for better prepared teachers, more teacher-and child-friendly classrooms, more inspiring curriculum and more engaging classroom technologies.” Many doctors, such as Dr. Breggin, believe that ADHD is simply a personality type, not a disease.

The Los Angeles Times reported that Jeffrey Schaler, a psychologist at American University’s School of Public Affairs believes that Ritalin is not solving any deficiency. “What it’s doing” he said, “is changing a behavior so the child complies with expectations and behaviors expected of him. You drug the child and get him to comply by drugging.” Many parents are finding themselves pressured by schools to medicate their child and do not feel as though they have an alternative. However, there has been some success with careful nutrition and counseling. If a parent would like to try behavior modification without medication as a first step, nutrition and behavior modification options and information ought to be readily available.

The federal Food and Drug Administration has recently approved a new and improved drug to treat ADHD called Concerta. This new Ritalin rival can be taken in a daily dose, compared to the two or three daily doses required for Ritalin users. Concerta is a relief to school nurses who spend their days dispensing Ritalin, but perhaps it’s time to take a step back and consider the long-term effects of this widespread drug use on our children. With each new drug we produce, the closer we come toward creating an uncertain future for the next generation.

© 2001 Ether Zone.

Written by Dariel A. Colella for Ether Zone, and published on DrKelley.info, March 14, 2001. Embedded links may no longer be active (Ed. 12.30.10)

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