Posted on 04/18/2003 12:38:09 PM PDT by FreeRadical
Pacific Rim Bureau (CNSNews.com) - The debate over attention deficit hyperactivity disorder (ADHD) and the drugging of children diagnosed with it has been rekindled in Australia, one of several countries to have followed the U.S. trend over recent decades.
A youth conference in the eastern city of Brisbane this week was told that no proof has been found that ADHD exists at all.
U.S. psychologist Dr. Bob Jacobs told the Youth Affairs Network Queensland conference that doctors and pharmaceutical companies had turned behavioral problems in children into a disorder.
He voiced concern that misdiagnoses resulted in youngsters being prescribed powerful drugs like Ritalin, which may affect their long-term mental and physical development.
In a radio interview afterwards, Jacobs - who is on the advisory board of the International Center for the Study of Psychiatry and Psychology - said his conclusions had been made as a result of his own observations during many years in practice, working with children and families.
He cited cases where parents reported that their ADHD-diagnosed children could not pay attention - but then those same children could play video games for hours without being distracted.
Sometimes where parents made changes in the way they were doing things, the symptoms would go away.
"A real disease doesn't go away when somebody else does something," he argued.
Jacobs said experts had put labels on different behaviors and called them a disease.
"There's no proof. Nobody has ever presented any evidence of a condition called ADHD, except to say all these children are hyperactive; all these children are inattentive, and therefore they all have the disease. It's the 'and therefore' that I'm concerned about."
Jacobs acknowledged that many parents would disagree with him. Parents tend to believe what has become the mainstream view, in part because the drugs prescribed for ADHD do work in that they make the child more docile and more compliant.
"The child's not getting into trouble at school any more. The child's easier to manage at home, so we say, well this is great, it works."
Also, parents struggling with a behavior problem were made to feel better. Instead of feeling inadequate as parents, they felt they were now struggling with a sick child and doing the best they could.
Money trail
In the United States in 2001, pharmaceutical companies made more than $600 million in profits just on stimulant drugs used for attention deficit disorders.
"If ADHD doesn't exist, those hundreds of millions of dollars in profits go away."
"You have to follow the money," agreed Peyton Knight, legislative director at the American Policy Center, a Virginia-based think tank.
"It's big money," he said by phone late Thursday. "The more diagnoses there are every year the more Ritalin and other mind-altering drugs they are going to be able to market and sell."
Many would vehemently disagree with the arguments against the existence of ADHD, he said.
"But it's never been validated as a disease," Knight said. "It's arbitrary."
"The number of diagnoses has risen exponentially over the past decade. It's not like some epidemic is sweeping the nation like a flu virus. It's just a matter of diagnoses going up because of the popularity of diagnosing children with ADHD," he said.
"In today's society, parents look for the easy way out. If their kids are unruly, we give them a pill and it sedates them. That becomes a very easy thing to do and if a doctor tells them to do this, they feel good about it."
Knight said there was a fairly sizeable grassroots citizens' movement in the United States questioning these issues, and more parents and teachers were becoming aware of the problems.
Unfortunately a similar movement had yet to take hold in the scientific community, although there were some bold specialists who disagreed with the wider-held views.
One of them is neurologist Dr. Fred Baughman Jr., who in a 1998 letter to the then Attorney General Janet Reno, called the representation of ADHD as a disease and the drugging of millions of normal children "the single, biggest heath care fraud in U.S. history."
Massive increase in drug use
According to Baughman, 500,000 children were diagnosed ADHD in 1985 and between 5 and 7 million were today.
Substantial growth has also been reported in Australia, a country of just 19 million people, where it's estimated that at least 50,000 children are now on drugs prescribed for ADHD.
A report in the Medical Journal of Australia last November said Australia and New Zealand have the third-highest rate in the world of the drug use, after the United States and Canada.
Unlike the United States, where Ritalin (methylphenidate) is most often prescribed, in Australia dexamphetamine is more widely used.
University of Queensland figures show that legal use of dexamphetamine in Australia has risen from 8.3 million tablets prescribed in 1984 to 38.4 million tablets in 2001. Over the same period Ritalin prescriptions rose from 1.5 million tablets to 19.3 million.
The federal government early this year approved use in Australia of long-acting Ritalin-LA, which is said to be effective for longer than the usual four-hour period for standard Ritalin.
Rosemary Boon, a child psychologist in Sydney for more than 20 years, acknowledged in a recent article that the drugs were effective in settling the child and this benefited teachers, parents and classmates. But there was little benefit to the afflicted child, she added.
Boon does not argue that ADHD doesn't exist, but says it can be managed with the help of diet, exercise, behavior modification, stress management, identification of "triggers" of the symptoms, and a supportive family environment.
Critics list among the problems with drugs like Ritalin the fact children on them tend not to grow as tall as they might otherwise. There are also concerns that a child's intelligence, creativity and spontaneity may be dampened.
The Royal Australian and New Zealand College of Psychiatrists says medication should not be the first line of intervention for the vast majority of children. Alternatives should be looked into first.
On its website, Novartis, the pharmaceutical company that manufactures Ritalin, describes ADHD as "a physical disorder caused by differences in how the child's brain works."
Novartis has an article in the April-May edition of its journal, Pathways, arguing for the existence of ADHD.
It quotes Prof. Russell Barkley of the Medical University of South Carolina as saying that ADHD is not overdiagnosed in the United States.
"We have more diagnosis now than before due to better public awareness and greater referrals," he said.
Here's why it gets over-diagnosed: schools get more money for "special-ed" kids. It creates a financial incentive. Teachers find that rowdy boys can be made less rowdy if they're drugged. It makes life for the teacher easier
Schools have a list of docs/shrinks that they recommend. The docs get paid for each evaluation. The docs understand that if they do not give the evaluation that the schools want to hear, then they will be dropped from the list and get less business. This gives the financial incentive to the doc to provide the diagnosis that his real customer (the school) wants him to provide.
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I think a large part of the problem is that there are certainly people that can benefit from Ritalin, it is also waaay over prescribed. Many boys who are put on it are simply bright and bored, or for that matter, simply have more tactily-oriented personalities.
I have seen children who are all over the place mentally have wonderous immediate results with going on ritalin (major shifts in self-control within a week). I've seen far more that don't really recall much of their child-hood and teen years. Not like blank periods, but rather really fuzzzy memories. Many of these with fuzzy memories from those times actually have good memories for events since then (and from before ritalin)...though seem to have not learned many of the basic behaviours for interacting with other humans.
Many of those recommended for ritalin are simply smarter and more "boy" than schools are designed for. That said, I have a brother who responded well to it, and a friend who uses it for petit-mal seizure control.
Laz, good to see you back. Missed you.
Absolutely...and they tend to become very educated. I used to get in trouble for reading my chemistry book in math class, and my history book during English. Always learning, but seldom on the expected thing. In the job market it works horribly when you have repetitive tasks (first one to get it right, and six months later, can't remember how to do it anymore - because brain won't go there), and wonderfully if you have ever-changing tasks and whole new job-areas every few months.
I didn't need Ritalin, just accelerated classes.
In some cases it's neither...it's brain structure.
Through about age seven the brain is still undergoing major wiring changes (some of which begin again at onset of puberty). Seeing is not simply optics. There is an interpretaional level where the brain learns how to compute things like vertical and horizontal lines, depth, and patterns. Much of this basic learning is structural guided by environmental input.
It's like "late-talkers", sometimes there's a problem, sometimes the brain just isn't wired for it yet. Many loquatious and brilliant people have been "late-talkers".
By age seven, yes...it's a minority. Most kids hit it in the mid 4 to late 5 year old range, but it still exists as late as late-7s. By beginning of 7, things like dyslexia are far more common problems.
No kidding! A few years ago I copped 40mg of Ritalin from my ADD-diagnosed brother. I finally went to sleep two days later.
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