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Doping the Young: the ADHD Dilemma

Heavily-marketed drugs may not be the answer to behavioral problems

By Tom Glaister
ConsumerAffairs.com

Editor's Note: In this two-part series, vagabond correspondent Tom Glaister suggests ADHD is more cultural than physical, while Dr. Henry Fishman begs to differ.

November 12, 2007     Spanish

ADHD Special Report: Two Sides of ADHD • Doping the Young: the ADHD Dilemma • ADHD: A Real Disorder Needs Real Treatment --- News • FDA Disputes Link Between ADHD Medications and Kids' Heart Problems • ADHD Meds Seen as Safe for Kids • Heart Tests Needed for ADHD Children • Study: Ritalin Can Impact Brain Development • FDA Wants Stronger Warnings on ADHD Drugs • Study Finds Ritalin Safe for Pre-Schoolers • Politicians Likely to Suffer from AD/HD • Many Children With ADHD Not Being Treated • FDA Approves ADHD Patch • FDA Withdraws Approval for ADHD Drug • Childhood ADHD May Lead to Smoking in Adulthood • Canada Pulls Adderall After 20 Deaths • FDA Issues Suicide Warning on ADHD Drug • FTC Files Against Natural Organics, Inc.

The first time I heard of Ritalin was when I was volunteering as a teenager, teaching math at home to a single mother who was trying to get her high school diploma.

As we struggled our way through fractions and percentages, I had to duck as a tea cup came flying through the air and smashed against the wall behind me – her 4 year old son, Jan, had woken up and wanted some attention. Much wailing and screaming and sounds of heavy crashes later, my student came back down the stairs having put her son to bed.

"I don't get a minute of peace," she sobbed, "He just never stops. Sometimes the kindergarten even calls me up to bring him back home when he gets too disruptive."

The solution, the doctors told her, was to give him a daily dose of Ritalin, a drug with a similar structure to amphetamines. She didn't understand how giving 'speed' to her child was going to slow him down but it seemed to help and she felt like she'd run out of options.

We all remember the problem kid in the school classroom. The one who could never sit still, kept pulling the girls' hair and forgot the teacher's instructions within minutes. They used to call kids like that trouble makers or just plain dumb. They got low grades, a bad reputation and often dropped out of school early, much to everyone's relief.

Now, thanks to masses of genetic and behavioral research, most of these kids are classified as ADHD (Attention-Deficient Hyperactivity Disorder) or, if they're unable to concentrate but in a non-disruptive kind of way, plain old ADD.

As every fashionable psychological condition is inevitably accompanied with a heavily-marketed drug to treat it, the last 20 years have seen Ritalin becoming a household name in America. Drug companies, doctors and schools across the country have pushed the drug so much that now around 5 million American children daily pop the pill to help them concentrate.

A godsend

For overworked teachers in schools, Ritalin seemed like a godsend. The problem kids began to listen, behave and let the rest of the class learn. Schools even began to ask parents of disruptive children to get them on Ritalin or one of its close relatives as soon as possible.

If not, they argued, the child would be unable to learn, become more rebellious and anti-social with the years and the statistics, after all, show that young offenders frequently suffer from ADHD. If only they'd been treated in time ...

ADHD not only became all the rage for children but many adults, too, found a new lease in life in explaining why they find it hard to concentrate. It's genetic, you see. Give them some drugs and they'll be able to focus on the task in hand and get their life together.

I met a medical student who was on Ritalin and he declared it was vital to his college education. Without it he just couldn't study for more than about 5 hours at a time. When I suggested that 5 hours of memorizing long lists of symptoms and conditions might already be asking too much of himself, he looked at me like I was nuts.

Hyperactivity and low attention spans are a reality, no doubt about it. Families suffer all over America because of uncontrollable children running wild.

But a social phenomenon doesn't necessarily translate into a genetic brain disorder – at least not one that has to be treated with addictive drugs. When 5 million children are fed pills in order to function in a classroom setting, it seems something is badly wrong.

When I was a child the teachers complained that I was always daydreaming. I lived in a fantasy world of my own and paid little attention to what was written on the board. I didn't complete the assignments and was kept in during breaks until the teacher finally just gave up.

Had I been born 20 years later, I would probably have been diagnosed with ADD and stuffed with Ritalin to help me focus.

But I didn't need drugs. The reason I didn't concentrate was that my parents were splitting up and I found the lessons boring beyond belief. With schools on a tight schedule and an even tighter budget, however, it's far easier to just blame it all on the genes and recommend medication.

As Robert Reid of the University of Nebraska noted: "The allure of ADHD is that it is 'a label of forgiveness.' The kid's problems are not his parents' fault, not the teacher's fault, not the kid's fault. It's better to say this kid has ADHD than to say this kid drives everybody up the wall. But to really work out what's going on would mean psychological profiling and that would take time and money."

Slow hands

I remember in school how the better part of my attention was focused on the clock on the wall, willing the hands to move around faster to the final bell of freedom. It was only years later when I got my first job that I realized that this regimentation was training for the working life that lay ahead for most of us.

Fortunately, in the world of work it's not necessary to be the kind of person who can still for 8 hours a day. If you have ADHD symptoms of excess energy you might make an excellent bartender, salesman or entrepreneur.

After all, the world is better off because humans are of such varied natures and talents – we'd hardly expect the same qualities of an acrobat as an accountant.

Most schools, on the other hand, are structured as though children were all the same. There simply aren't enough resources to customize the education of each child to their needs and strengths. The structure of the curriculum and the school day is designed to meet the needs of the average student at the expense of the kids for whom such a system just won't work. Unless they're drugged.

Something new?

But where does ADHD come from? Have there always been millions of American kids who couldn't concentrate or is it a modern disease?

It seems that most current scientific thinking holds ADHD to be largely a genetic syndrome. Studies indicate that it's passed on from parents to their children and there seem to be noticeable differences in the brains of ADHD and ADD children.

The same can of course be said for Buddhist monks that meditate a lot and professional musicians but I'm not a neurologist and so I won't go there.

In fact, there's rarely much room to argue with the scientists. They're specialists in their fields, the evidence always looks overwhelming and in any case, tens of millions of dollars of drug sales depend on them being right.

What we can do is observe some of the changes in the culture over the last 50 years and ask ourselves if the condition that we observe in hyperactive kids might actually be a syndrome?

In my travels around the world I've been fortunate enough to see how children grow up in less modern countries. In most places, children still play together in the street and their parents aren't afraid they'll be abducted.

They return home to a large extended family and the responsibility for feeding, nurturing and entertaining the child is taken by whichever uncle, sister or grandmother happens to be around at the time.

Didn't it used to be like that in America, too?

In developed countries, however, it's often considered too dangerous for children to play outside on their own, so they immerse themselves in television or computer games and, as people live increasingly alone, it's up to the overworked, stressed parents to shoulder the entire burden of raising them. It brings to mind a quote from the Simpsons when Bart tells Homer:

"It's just hard not to listen to TV: it's spent so much more time raising us than you have."

Parental attention deficit

Maybe some of the children on Ritalin are indeed suffering from a deficiency of attention in that they never received enough -- attention from their families, that is.

As for the adults, ADD may be symptomatic of the world we live in rather than a genetic condition. Why is it, for example, that in spite of all the wonderful time-saving devices that we have invented – the washing machine, the cell phone, the car – that we never actually have any time?

And that's not to mention the age of technology addiction. In a society where you can be reached at any time, distraction has forced its way into our lives.

The intimate conversation interrupted by the ringing of a cell phone. Waking up in the morning and checking your email before washing your face. If attention is something that you have to pay it's little wonder that so many of us are broke.

In the bestseller, Driven to Distraction, Edward Hallowell and John Ratey reason that:

"American society tends to create ADD-like symptoms in us all. The fast pace. The sound bite. The quick cuts. The TV remote-control clicker. It is important to keep this in mind, or you may start thinking that everybody you know has ADD."

Ok, so this is still speculative. But so was the observation known to just about any parent that their children get hyper after consuming too much soda and candy. Until recently science wrote off the alarm about artificial colors and additive as hippie nonsense. However that all changed when a British study group recently published a paper in the Lancet, concluding that:

"The finding lends strong support for the case that food additives exacerbate hyperactive behaviors (inattention, impulsivity and overactivity) at least into middle childhood."

Is giving your child Ritalin the price of a lousy diet?

Here's a little known gem: Novartis, the pharmaceutical company that makes Ritalin, owned until this year Gerber Products Company. Get that? The company that sells drugs for hyperactive children also used to sell baby food, a product containing additives that might in themselves cause hyperactivity. One hell of a way to create a market.

It works

Of course, at the end of the day, Ritalin does work. But if a child appears to 'improve' on medication it doesn't mean that the diagnosis was accurate. Drugs with the effect of amphetamines make everyone focus. That's why armies give them out to their soldiers in the field.

Trouble is, like most drugs they have side effects, causing problems with appetite, amnesia, possibly problems with growth glands and sometimes cardiovascular difficulties. Indeed, the deaths of 25 patients, 19 of them children, prompted the FDA last year to demand a black box warning for Ritalin, Concerta and other legal stimulant drugs.

All of this doesn't say that ADHD doesn't exist – I've only to think of little Jan aiming a teacup at my head to believe it – but the current bandwagon of slapping brain disorder labels on troubled children is out of control. For one thing, it can become a self-fulfilling prophecy where a child learns he needs drugs in order to fit in. Granted, that might make him a customer of psychotropic medication for life but does little to help him understand himself.

Adults are old enough to decide if they want to take medication. If Ritalin helps them get through their day, they at least have the maturity to decide for themselves. But when social workers put pressure on parents to take out prescriptions for their children and school nurses spend more time administering drugs than anything else, we've reached a stage of affairs where the 'war on drugs' was lost long ago.

In fact, Ritalin has taken youth drug culture by storm and is sometimes known as 'poor man's cocaine'. Tablets are swallowed or crushed up and snorted, sometimes for the high or sometimes as an appetite-suppressant by weight-conscious teens.

If drugs are to be handed out casually and liberally by health care professionals, it's not surprising that juveniles should treat recreational use of the same with the same blasé attitude.

Next: ADHD: A Real Disorder Needs Real Treatment

Tom Glaister is the founder and editor of www.roadjunky.com - The Online Travel Guide for the Free and Funky Traveller.

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