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The Dark side of a Wonder Drug-A Selected Collecti

on of Testimony on the Safetyof Ritalin
“We give our children every day, yet we punish adults for taking speed,”
stated a concerned parent(Ritalin Zone). A trip to the principal’s office used
to mean big trouble. These days, more kids are showing up in the school office
just to get their midday dose of Ritalin. Ritalin, the drug used to treat
hyperactivity in children, is being seized on by a generation worried about
controlling inappropriate behavior. But some doctors think Ritalin is being
prescribed to children who are simply having trouble in school. The numbers
suggest they have good reason to worry. The number of prescriptions for Ritalin
increased four-fold from 1990 to 1995, making the stimulant one of the most
prescribed drugs in the country. No one knows exactly what’s behind the surge in
Ritalin use, but experts speculate it’s due to everything from increased
awareness of attention disorders in schools to teachers and parents becoming
less tolerant of unruly behavior.


Some local school offices have become virtual noon-time pharmacies. At one
Ottawa-area board of education, the number of medications dispensed to students
by office administrators has increased 20 per cent over the past 18 months. A
good chunk of those pills are Ritalin. “We always worry that we’re a half-step
away from giving someone the wrong dosage,” says John Beatty, the board’s
superintendent of school operations(Ritalin Boy). “In certain school systems
there’s been a teacher who has seen it work and they’ll start suggesting it as
an option for all children who are acting out,” said Linda Budd, a St. Paul,
Minn., psychologist who has written the book Living With the Active/Alert Child.

“We’ve got some teachers we call “Ritalin bullies’ – he’s not paying attention
to me so he needs Ritalin”(Ritalin Zone). Marcia Ruberg, a school psychologist
in Cherry Hill (N.J.) School District, said the number of children taking
Ritalin varies greatly from class to class, depending on “the teacher’s belief
system”(Ritalin). At some schools, children as young as seven are asked to take
their Ritalin themselves. The little blue pills have become so common in school
yards that some kids are reportedly selling their spare Ritalin to friends, who
take it in the hope of getting a buzz. “Every parent wants their child to be at
the top of the class,” says Dr. Andre Cote, clinical director of the Children’s
Mental Health Treatment Center at the Royal Ottawa Hospital. “What we might be
seeing is that people are trying to improve their kids’ performance by giving
them medication”(Health: Ritalin).


Others worry that Ritalin has become an easy answer for busy families
trying to cope with a hyperactive or aggressive child on their own. Dr. Thomas
Millar, a retired Vancouver child psychiatrist, believes ADHD is not a disorder,
but behavior that discipline and better parenting can fix. “Ritalin may calm
the child,” says Millar, “but it does nothing to increase his or her tolerance
for life’s demands, and when the Ritalin runs out, the symptoms return”(ADHD:
Ritalin). Even proponents of Ritalin fear that normal, rambunctious children
may be being labeled with a disease for which there is still no clear test.

“Basically, you are taking children who are in conflict with adults and drugging
them,” said Dr. Peter R. Breggin, a Bethesda, Md., psychiatrist and leading
opponent of the drug. “You have a child who is depressed, who can’t concentrate,
who is having trouble in school and you’re drugging him instead of saying what
can we do to attend to the child’s needs”(Discover Ritalin). Lawrence H Diller
MD, agrees with Dr. Breggin by saying, “It is easier to medicate a child than
work with a dysfunctional family, decrease the size of a large classroom or
increase funding for special education”(Wonder Drug). Part of the problem is
that while the experts stress that any child who may have an attention disorder
should be thoroughly assessed to rule out other problems, it can take months,
even a year or more, to get a referral to a specialist. “When the mother goes
and sees the family physician and says, “The teacher told me little George can’t
sit still, he wanders all over the class, he has difficulty concentrating,’ the
general practitioner may be tempted to say, “Well I know what your problem is,
take that pill and come and see me in two weeks,’ “says Dr. Peter Byonsen, a
child psychologist(Team Ritalin).


As many as two million children have been diagnosed as having Attention
Deficit Disorder or Attention Deficit Hyperactivity Disorder. The preferred form
of treatment for these alleged disorders is a powerful drug called Ritalin — a
Schedule II controlled substance, as are cocaine and methadone. Attention
deficit-hyperactivity disorder is a baffling brain disorder. Children who have
it are hyperactive, have a short attention span and are easily distracted. Most
experts believe that ADHD stems from biochemical malfunctions in the brain.

Children with ADHD are usually in constant motion, tapping fingers or toes,
wiggling in chairs, jumping up and down during meals, flitting from one activity
to another. They often have problems relating to other children. “It really
makes their life miserable,” Sarah Newtwater, a clinical psychiatrist, says. “It
interferes with all kinds of activities in life – their relationship in the
family, the school, their learning ability, their social contact with other
kids”(Bad Ritalin). Parents of kids with ADHD have a two to three times greater
risk of separating or divorcing than parents of kids with a physical disability
or chronic illness. Though parents may suspect a problem in the pre-school years,
it’s often not diagnosed until a child starts school, when they begin failing or
getting into trouble.


Doctors in every field of study related to ritalin are having trouble
deciding on what the increase of ritalin is from. “Some pediatricians are
guilty of over-diagnosing,” says Mary Anne Garber, Ph.D., who co-authored the
book Beyond Ritalin with husband Stephen (an Atlanta psychologist) and Robyn
Spizman. “We are not pro or con medication, but we certainly don’t think it
should be the first avenue”(Ritalin). Dr. Normand Carrey, a child psychiatrist
the Royal Ottawa Hospital, agreed by saying, “ADHD has become too much of an
easy diagnosis”(Ritalin Boy). On the other hand, leading B.C. experts on ADHD
say the growing number of children taking Ritalin doesn’t mean the drug is being
wrongly prescribed. Rather, more doctors are aware of the disorder and are
diagnosing it. “The numbers may be up, but I would say the numbers are
appropriately up, in the vast majority of cases,” said Dr. Derryck Smith, head
of psychiatry at B.C.’s Children’s Hospital, and the next president of the B.C.

Medical Association(Ritalin). Dr. Craig Fabrikant, chief psychologist at the
Institute for Child Development at Hackensack University Medical Center, agreed
by saying, “In some cases, the drug is perceived as a panacea, but if it is
effectively prescribed and appropriate precautions are taken with accurate
diagnosis, the drug is worth its weight in gold”(H+W:Ritalin).


Doctors say another part of a big increase in ritalin sales may be that a
growing number of adults are being diagnosed with ADHD. Until recently, doctors
believed that children with attention deficit disorders eventually outgrew them
once they reached adolescence and adulthood. Not so. “You have little Jack who
took Ritalin for five years who’s now working at Corel and every five minutes
he’s fidgety, and he remembers that he used to take Ritalin as a kid and it
helped and maybe it can help him now in his career,” Jane Peters, Ph.D.,
says(Team Ritalin). Other adults are being diagnosed for the first time as the
disorder is detected in their own children. “More and more ADD has become a
condition that is well known, for which a medical solution really gives
instantaneous results,” says Ryan Watson, a child psychologist. “Ritalin works
and it works fast”(Wonder Drug).


How far should doctors go with these prescriptions? Increasingly doctors
are prescribing Ritalin to even pre-schoolers. Researchers at the Children’s
Hospital of Eastern Indiana recently studied Ritalin on children aged four to
six to determine just how safe and effective it is in the younger population.

The preliminary results show that the drug can improve cognitive skills in
children with ADHD. Two of 30 children studied were pulled out of the study
because of side effects, but none of the side effects were serious. But not
every child who has trouble concentrating has ADHD. Nor does he need Ritalin or
other stimulants, experts say. “The one question that any good clinician needs
to keep in the back of his or her mind is, “Why?’ ” says Susan Cummings, a
psychologist at the children’s hospital. “If a child walks into the doctor’s
office and the parent says, “He’s restless, he can’t concentrate,’ ask
why”(Discover Ritalin). There could be problems in the family, a crisis such as
a divorce or separation, anxiety of starting a new school or moving to a new
home. “Even something as simple as poor nutrition can reduce attention span, yet
it can easily be overlooked if a doctor does only a cursory examination,” Susan
Carney, M.D., says(Ritalin). Dr. Joel Wallach DVM, MD, author “Rare Earths
Forbidden Cures”, adds that there are many things that can be done instead of
drugs by saying, “What kind of society are we that approves of methamphetamines,
tranquilizers and uppers, but not mineral supplements?”(Ritalin). Sometimes the
child may have a learning disability or another type of disease may be mistaken
as ADHD.


What is in the future for ritalin? Henry Pisterman, clinical psychologist,
says, “Ritalin, like any other drug, can be abused”(Ritalin Zone). And if
doctors are leisurely prescribing the pills, there will be problems. Pisterman
wonders just how well children on the drugs are being monitored. But while
Jerry Kilroy, Ph.D., worries that Ritalin is being overused, “it worries me just
as much that a kid who needs help isn’t getting it”(Ritalin Boy). Hopefully
people will educate themselves about a drug that effects his or her body before
acting on a whim.


Category: Social Issues