Ritalin Debate: Some Experts Doubt Existence of ADHD

Cybercast News Service (CNSNews.com) ^ | April 18, 2003 | Patrick Goodenough

[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.

[luvtheconstitution]

You're addressing hyperactivity, not attention deficit - there's a big difference.

[luckystarmom]

I said in an earlier post that if your child is not reading at the end of second grade because some kids do need extra time to learn how to read.

My son could barely read at the end of kindegarten, and he is gifted. It all fell together him in first grade.

My daughter with brain damage is in kindegarten now. So far, she is keeping up with learning how to read. If she was not catching on to reading, I would be concerned and start getting her extra help. However, I know she has a problem, and our goal is to keep her at an average level. We don't want her falling behind.

[FourPeas]

Oddly enough, my husband was given some sort of medication almost forty years ago because he was "hyper". His parents stopped giving it to him because it made him "zombie-like". Recently, we've experienced the same thing with our nephew. It's obvious when he's taking his medication. I'm not sure it's an improvement.

Frankly, the only reason I'm even considering it at this point is because sometimes he seems like he's having difficulty socially. He has such trouble controlling himself that it's obvious that one grandmother favors his little brother. The other grandmother clearly doesn't like to be around him when he's having troubles. I really can't blame her, she's almost 80 and being around an incredibly hyperactive five year-old isn't easy even for us "younger" folks" (*whew* found a way to consider myself "young"! :) )

I have found, too, that sugar is causes big problems. Unfortunately everyone from his Sunday School teachers to grandmothers think giving a piece of candy is OK. They don't think, either, that everything from the soda pop or Kool-aid or jell-o they want to give him is laced with sugar. Sugar literally turns him into a completely unmanagable child. I've tried removing all sorts of other foodstuffs from his diet from meats with nitrates to artificial colors to even limiting dairy products. It's amazing the various combinations I've tried to find a solution.

I'm still leaning against medications but there ARE times when it's tempting to have a child for whom I don't have to be constantly on edge whenever we leave the house.

[FourPeas]

Medication would be the last resort.

That's always been my belief, too. There are times when I think we may be at the last resort.

Thankfully, academically he's doing well. He's progressing well in his reading, which I think may take off if my suspicions are confirmed that he needs glasses. (Not that the concept of trying to keep eyeglasses on a hyperactive five year-old is my idea of fun.) At his yearly check-up several weeks ago, both of his eyes tested at 20-40. The doctor recommended we wait until next year to see if it changes, but needing glasses early runs in my family; my dad needed glasses at age four. I plan to have him tested again within the month. Being able to see better, in and of itself, may solve some problems.

Thanks for your input.

[matthew_the_brain]

ADHD should be relabeled DADD.......Dad Attention Deficit Disorder. Most of these poor kids suffer from lack of a Dad's presence in the home, either the old man is working too much, or simply an incompetent boob. I have read many studies that show that 'ADHD' mysteriously disappears when someone, like a Dad, spends quality time with the poor kid.


ADHD is a fraud, sold mostly to single moms, and other dysfunctional family types.

[FourPeas]

ADHD should be relabeled DADD.......Dad Attention Deficit Disorder. Most of these poor kids suffer from lack of a Dad's presence in the home, either the old man is working too much, or simply an incompetent boob. I have read many studies that show that 'ADHD' mysteriously disappears when someone, like a Dad, spends quality time with the poor kid.

ADHD is a fraud, sold mostly to single moms, and other dysfunctional family types.

Interesting view. Incredibly ignorant, but interesting. For my ADHD son, here are the facts:

1) His dad comes home each day around 6pm and spend the entire evening with his sons. He gives them their baths and reads them bedtime stories EVERY night. He very rarely works weekends.

2) Each Saturday morning he takes them somewhere: to The Guy Store, to get their haircut, to grandmother's house, wherever, so I can have some time alone. In the afternoons, we work on house projects together. Currently my husband and the boys are finishing our deck.

3) From the time they were infants, if either one of them needs something in the middle of the night, he helps them. When they were very young, he would change their diapers and then I would feed them. He spends time, quality and quantity, with our sons.

4) Our family is far from dysfunctional. My husband works; I stay home and educate our children. We live in an "average" neighborhood in a small town in the midwest.

5> My husband works in IT security. Last Monday he was given an award by the RSA for The Best Security Practice of the Year (yes, and he still came home by 6pm weekdays). Recently he was featured in an article in Network Fusion. He's far from an incompetent boob.

Keep in mind that prior to having and living with my son, I was very skeptical about the whole ADD/ADHD thing. Until you've been "here", I can understand how it can be hard to believe. However, simply because you don't understand something is no reason to make blantantly ignorant statements.

[matthew_the_brain]

I am sure your son is an energetic, creative and independent young man struggling within the constraints of an inattentive, conflicted or stressed adult environment, created entirely by the adults in his reality.

The main problem is, we end up drugging our best and our brightest, and stigmatizing them with the label of a disability of ADHD.

The fact is, there is no medical, neurological or psychiatric justification for the ADHD diagnosis.

The key "symptoms" include such behavior as "often fidgets with hands or feet or squirms in seat," "often leaves seat in classroom or in other situations in which remaining seated is expected" and "often has difficulty awaiting turn."

This is quackery at its finest. I truly feel sorry for people like you who fall for such quackery. The damage you do to your son by labeling him with this quack disease, and God forbid, you give him ritalin, will have lasting effects.

[FourPeas]

I am sure your son is an energetic, creative and independent young man struggling within the constraints of an inattentive, conflicted or stressed adult environment, created entirely by the adults in his reality.

You are correct that my son is energetic, creative and independent, however everything following that is incorrect. We are homeschoolers, relaxed homeschoolers. Inattentive? No, I spend each day with my chidlren. Conflicted? I have absolutely no idea what you're aiming at here. Stressed? Not any more than usual. Most people, when speaking about my son, remark at how happy he is.

The main problem is, we end up drugging our best and our brightest, and stigmatizing them with the label of a disability of ADHD.

First, I do not "label" my son. Other than my husband, our ped and I, no one else who knows my son IRL have been told we believe my son has ADHD. I see no purpose in it. It's not an excuse, it's an explanation. My son IS quite bright and I plan to foster it in any way I can.

The fact is, there is no medical, neurological or psychiatric justification for the ADHD diagnosis.

The key "symptoms" include such behavior as "often fidgets with hands or feet or squirms in seat," "often leaves seat in classroom or in other situations in which remaining seated is expected" and "often has difficulty awaiting turn."

I used to argue those very same points. I'll simply tell you that there's something different about my son. He does have some of the traits you mentioned and a few more. As we've tried to work on these behaviors, it's become obvious that there was something more at work, but all of this changes the subject.

In your first response you wrote about a deficiency of dads in the children's lives. Would you care to respond to me on that or do you simply want to keep changing the subject because your arguements are just that fragile?

One last thing, before you accuse me of doing harm to my child, make sure you have some facts. Thus far you have failed to realize that we homeschool, that my husband is a good father, that we currently do not use any medications, and that we have not "labeled" our child. So, until such time as you actually have some facts to back up your allegations, kindly keep them to yourself.

[SoftballMominVA]

I realize from your post that you are not treating your son's condition with any type of medication. However, my daughter who sees a pychiatrist, does take medication.(And I'm not implying that one way is superior to the other) Her doctor has told me before that she prescribes medication to many homeschooled children. The theory "that all these children need is one-on-one attention" is invalid.

It's frustrating and heartbreaking to watch your child struggle. I hope your son does well. It sounds like he has a great mom.

[cherry_bomb88]

That's an ignorant statement. I'm a parent of a son with ADHD, and I can assure you we are not afraid to parent.

You go!!!! I TOTALLY agree...and that IGNORANT AND SELF RIGHTEOUS statement about the majority of the kids being from single parent families is just another prejudice. Probably propegated by those who are NOT parents...it's so easy for those who are not parents to give advice on parenting, although I regard advice from non-parents kinda like the war advice from "arm chair generals" both do not have all the information, but at least in the case of the arm-chair generals they do have SOME battle experience!!!!

I will agree that there are TOO MANY mis-diagnosis, but I would wager most of the overdiagnosed cases are from upper class weenie parents that want the "perfect" child. Not from those of us who work our butts off to discipline, not befriend, and take care of a child. I have child that has gone WAY beyond ADHD, she is bipolar, OCD & anti-social contact disorder. I will ASSURE you that from the time we started working with her (age 7) we (her father and I) went every route we could BUT medication. Yes, I am a single parent, but that had NO bearing on if she is ADHD,bipolar or other. That started long before I became a single parent...perhaps look at the parents that "run away" from the "difficult" children as the weenies. The divorce rate is FAR higher in families with children with these kind of problems because everyone wants to point the finger of blame or worse, ignore the problem, rather than deal with it!!!

I did not start medicating her until age 12 when she became abusive, violent & self mutalating, winding herself up in the hospital. Until you've walked a mile in our (the parents who do deal with this) shoes....perhaps you best save your opinions for yourself. I am so damn tired of this being made a liberal"socialist" vs. conservative issue...it is NOT...it's a medical issue, got it???? Good!!!

There are just as many conservative parents that deal with it as liberals, and I can assure you that 80% of us who did go with medication tried EVERYTHING we could before we medicated.

A boot up the ass approach often NEVER works with these kids as they "just don't care" and they will become equally violent with you.

[Pagey]

Exactly!
I was : 1.)Aggressive---being the youngest of many
2.)Inattentive---Because learning came rather easily for me
3.)Unruly---Only in controlling my friends,while away from my siblings and parents
4.)Non-Compliant---learned my 'ways' from the many mistakes of my siblings
5.)Is it my fault I loved to read and learned how to read faster,(completely understanding what I was reading) because my mind was rolling at a different pace than my friends?
It would never have occurred to anyone to feed me pills to change my behavior in any way. I have a relative who claims their 2 kids have ADD and they give their kids those pills.It is entirely untrue IMHO.They simply didn't discipline their kids when they were younger,didn't read to their kids at a young age to develop those skills and frankly who can't stand each other. Blame it on the kids is such an easy out!Some self-centered people don't think about their own behavior regarding their own kids,much to the detriment of the U.S.A. as a strong nation.Admittedly, some children do have ADD, that's apparent,but not as many as people are led to believe.

[Marie]

Well, I was a 'hyperactive' kid, inattentive, unruly, non-compliant, etc... and I never had to take any pharmaceuticals to change my behavior - and yet, now I am a responsible, well-adjusted adult... ;0)

As an exasperated mother of a 10 year old, inattentive, unruly, non-compliant, etc... this is good to hear! ;-)

[Politicalmom]

Have you discussed Strattera with your doctor?

It isn't a controlled substance, but works directly on brain chemistry.

My son has been on it since June, and it has been a Godsend.

[Xenalyte]

Your son can concentrate and focus on one thing exclusively, and he's been diagnosed with - wait for it - Attention DEFICIT disorder?

[Politicalmom]

You sound EXACTLY like me. I finally broke down after over five years of resisting medication. It was the best thing we ever did for our son.

It was hell before. My life is finally coming to resemble something "normal".

[Politicalmom]

I started raving about Strattera before I saw your post. :)

You might want to pass along my thanks to your company. This drug has helped my family immeasurably.

[cupcakes]

And on the other side of the coin there are parents like myself who currently have a son with autistic tendencies in a preschool program and I have implored the teachers to offere suggestions or referrals to info where I can learn more about dealing with the rages and extreme behavior that comes with not only being a boy, but being an autistic boy. I get no response. I can tell you out of frustration, as someone in a hypertensive pregnancy, I have thought more than once of just taking him to the hospital psychologist who originally evaluated him and oking the meds. It gets hard to deal with the extremes that do come along with some neurological illnesses. I never wanted to medicate my son, but when you reach out and get nothing back to help you deal with a child who follows you screaming and if you isolate him hurts himself or destroys the house(he's only 4), then you just get to the point where medication sounds awfully nice just to get a break from crying in the bathroom when you can't take anymore.

K.
ps yes, it has been rough with the rages lately!

[Politicalmom]

My parents refused to accept my assertion that there was something wrong with my son. I cried buckets of tears over my father's "He just needs to be spanked more often". I would have been beating my son constantly. I broke down in tears when my mother finally admitted that she could tell my son could NOT control his behavior and that there was a problem.

I hope your children appreciate you and your support. : )

[Marie]

One of my friends works at a school and she says that in some of the classes, 3/4 of the kids are on some kind of medication.

[petercooper]

Follow the money. Schools get more money for kids with "disorders". Drug companies sell more product when more kids are "diagnosed" with the "disorder".

ADD/ADHD is a scam.