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Ritalin Debate: Some Experts Doubt Existence of ADHD
Cybercast News Service (CNSNews.com) ^ | April 18, 2003 | Patrick Goodenough

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.


TOPICS: Culture/Society
KEYWORDS: adhd; australia; drugs; education; health; ritalin; youth
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To: Lazamataz
"Secades" is "decades" spelled backwards; at least it's pronounceable unlike "ecnalubma" which shows up a lot when I'm driving.
181 posted on 04/19/2003 1:37:51 PM PDT by Doctor Stochastic (Vegetabilisch = chaotisch is der Charakter der Modernen. - Friedrich Schlegel)
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To: nmh
I am always amazed at the great lengths people will go to, to defend their drug addiction

Do you believe that acute clinical depression exists?

And are people medicated for that malady also 'drug addicts'?

Or maybe is that your thumb up your ###? :o)

182 posted on 04/21/2003 8:15:07 AM PDT by Lazamataz (c) Entertaining beautiful women since 1972 ! :^)
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To: r9etb
ADHD is not an inability to concentrate; rather, it's an inability to suppress the impulse to concentrate on more interesting things. For interesting stuff, there's no impulse to focus on something else -- indeed, the impulse is to block out everything else.

The real debate here, just under the surface,is not whether a disorder "exists" or not. It certainly exists, because it is observed.

The real debate is just another iteration of the endlessly repeated nature vs. nurture debate. Is it a defect present at birth or is it acquired? And that, like all iterations of nature vs. nurture, soon becomes a logical circle. The fact that medication works on something does not tell us whether or not the condition is congenital or acquired by behavior.

If this "ability" of attention is normally formed in early childhood in response to external demands to pay attention to one thing and not another (read: parenting), and if a child were to simply not form this ability due to a lack of externally imposed discipline, then that lack of "ability" could easily be hardwired into the child as the developing brain bypasses that developmental stage and leaves a cognitive gap behind as it moves on to other developments.

This cognitive gap would look, by observing behavior at school age, just like a congenital defect. And medication would work.

The debate is fierce because the possible conclusions are so disparate: either there is a lot of bad parenting in the first 3 or 4 years of life, or we have discovered a condition which long was attributed to bad character.

Either a terrible injustice is being done on this generation of children by their parents, or a terrible injustice was done on earlier generations of children by their parents.

183 posted on 04/21/2003 8:37:20 AM PDT by Taliesan
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To: IYAS9YAS
"I think that there is a middle-ground that needs to be reached where the schools and drug companies need to be taken out of the equation. I don't doubt some people need medication, I do doubt that every so many kids has ADHD..."

Actually, there are many MD's trying to classify ADHD and ADD as diseases or syndromes, etc. The reason for this is that once its reclassified, only a doctor can diagnose and prescribe. As it stands now, as a disorder, any lay person such as a teacher or school "therapist" can diagnose a child. This is part of the reason so many children are diagnosed and medicated. Once the school has diagnosed the child... the parents then are more or less forced to medicate.

So there are very serious medical experts working on the problem to quantify symptoms and monitor progress as in the case of other syndromes.

Those of us with children and in my case, grandchildren, appreciate the seriousness of ADHD and ADD. We also appreciate the effects of medication in allowing our children to live worthwhile lives. We also appreciate the dangers of those "experts" who continually ignore the seriousness of ADHD and those of you who feel that somehow a "swift kick in the rear" will magically clear out the raging storm in an afflicted child's brain.
184 posted on 04/21/2003 9:00:12 AM PDT by myrabach
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To: Taliesan
The real debate is just another iteration of the endlessly repeated nature vs. nurture debate. Is it a defect present at birth or is it acquired?

Just like athletic ability, it's probably some of both. The "nature" part is a physical tendency toward the symptoms (for example, a tendency toward inhibited dopamine uptake), and the "nurture" part might either reinforce an actual condition, or introduce a similar sort of behavior in those not physically pre-disposed toward it.

I know kids who fall fully on either side, where nature or nurture are probably completely dominant. I also know kids whose cases are somewhere in the middle. For example, with our daughter (who is very bright) we find that we can manage things by behavioral things (ours and hers), and by diet (we have to keep her away from red dyes). As parents we can guiltily point to things we could have done differently when she was little. But there's undoubtedly a strong "nature" component with her: she's pretty much exhibited the tendencies since birth.

I am quite certain that ADHD is too-often used as a convenient excuse. But that doesn't mean it's fake.

As I said at the outset, there's a powerful ideological component to the ADHD debate, as can be seen in this very thread. I have to say that those folks are probably as damaging to kids as are those who over-subscribe to ADHD diagnoses.

Not only do they loudly shout out piles of misinformation (i.e., "there's no such thing"), but they also make those on the "pro-ADHD" side appear to be calm and reasonable -- thereby strengthening the very thing they seek to get rid of. (Sean Hannity made a complete ass of himself on Friday with just such a claim, when he was discussing this article.)

I have no use for them.

185 posted on 04/21/2003 9:04:52 AM PDT by r9etb
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To: Zipporah
I have a new friend who has been having trouble with her teen son. Finally, she told me he has been diagnosed with ADHD and she was going to medicate him. Well, we were over for dinner last week, and I can tell you that all this kid needed was a smack in the face. He was the most disrespectful, snotty piece of crap I'd ever seen. The parents did nothing as he sat in front of family and friends insulting them. Finally, I couldn't take it. I got up, asked him to show me where the bathroom was. I pushed him in the bathroom and gave him a piece of my mind. The first thing he told me was that he was going to "sue" me. I told him to "bring it on". After telling him EXACTLY what I thought of him, I INSISTED that he apologize to his father and to everyone at the table for his cowardly and mean remarks. His parents were THRILLED I did this. Apparently, they've never tried this strategy before. I guess takinw away one of his TWO cars was the extent of his punishment in the past. She told me the next day that I did what they had been unable to do for years. I felt very sad for them.
186 posted on 04/21/2003 9:10:52 AM PDT by Hildy
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To: r9etb
Hannity takes himself too seriously, and is not a good debater.

I only have one child, a 4 year old boy who is an angel and can clean up his room for 20 minutes without losing focus. So my anecdotal experience biases me. When he won't pay attention, I just make sure his choice produces a miserable universe for him and rely on his innate intelligence and self-interest to take hold.

It is hard for me not to notice that all the children in my church who are diagnosed with ADD also have parents I consider shockingly lazy in their parenting.

I can't make an argument for the whole world based on my amateur and anecdotal experience, but it is hard for me not to notice the pattern.

187 posted on 04/21/2003 9:30:07 AM PDT by Taliesan
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To: Taliesan
Hannity takes himself too seriously, and is not a good debater.

Not everything any one person says is always accurate.

Hannity mentioned that there cannot be ADD because an ADD kid can play video games and not lose concentration.

That argument was absurd. Video games have such a high level of sensory output that it satisfies the ADD's need for a high level of sensory input.

No one called into his show to point out the absurdity of his argument. Well, one woman mentioned it very lightly but didn't hammer the point home and was quickly distracted onto a related topic.

188 posted on 04/21/2003 9:33:24 AM PDT by Lazamataz (c) Entertaining beautiful women since 1972 ! :^)
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To: r9etb
Note my post above....this, I suspect, is from whence you note that Hannity was a bit of an ass Friday.
189 posted on 04/21/2003 9:34:16 AM PDT by Lazamataz (c) Entertaining beautiful women since 1972 ! :^)
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To: Lazamataz
this, I suspect, is from whence you note that Hannity was a bit of an ass Friday.

Correct.

190 posted on 04/21/2003 9:37:43 AM PDT by r9etb
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To: r9etb
Correct about what?

(that was a little ADD humor, there, y'see....)

191 posted on 04/21/2003 9:39:50 AM PDT by Lazamataz (c) Entertaining beautiful women since 1972 ! :^)
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To: Lazamataz

Correct about that being where Hannity made an ass of himself.

A little added stimulus for you ADD types....)

192 posted on 04/21/2003 9:44:27 AM PDT by r9etb
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To: r9etb
Your picture managed to make me stand up and pay attention!

(well, one part of me, anyways...)

193 posted on 04/21/2003 9:46:17 AM PDT by Lazamataz (c) Entertaining beautiful women since 1972 ! :^)
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To: oldcomputerguy; Johnny Gage; SoftballMominVA
http://www.dyslexia-add.org
194 posted on 04/21/2003 9:58:22 AM PDT by Dakotabound
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To: longtermmemmory
doctors also supported lobotomies and electroshock therapy

And electroshock therapy is still used, just not as the cure-all. Heck, there are several allopathic doctors taking another look at leeches.

195 posted on 04/21/2003 10:07:16 AM PDT by technochick99 (Self defense is a basic human right. http://www.2ASisters.org)
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To: FourPeas
We medicated my now 13yo son when he was 6 or so. Improved his attention span, but also made him "zombie-like." Appetite decreased to nearly zero. He lost weight, and was skinny to begin with.

We took him off after several months, and since we homeschool, we were able to emphasis the behavioral aspects of his condition. Actions had consequences. He is long over his symptoms for the most part, but still has hyper-focusing. But he's still a "kid" and still has a lot to learn.

My point is that medication can work, but isn't always the answer. We had some *very* tough years there, but he's a terrific young man. We found that sugar had a remarkably negative effect on his behavior as well.

Oh, and both his dad and I have been diagnosed as well, and used medication for a time. It helped me focus, but made me very snippy when coming off the medication, so I decided to forgo it.

196 posted on 04/21/2003 10:07:25 AM PDT by Dakotabound
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To: technochick99
Therapeutic leeches are still used for a blood condition wherein too many cells are present. They are also used during limb replacement. The following link is a PDF file.

http://www.biopharm-leeches.com/pdf/brochure.pdf
197 posted on 04/21/2003 10:20:55 AM PDT by Doctor Stochastic (Vegetabilisch = chaotisch is der Charakter der Modernen. - Friedrich Schlegel)
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To: luckystarmom
The big telling sign is that your son could not read

Not necessarily so. My son (ADHD, non-medicated and homeschooled) was not ready to read until he was seven and a half...which is quite true of many boys. But our government school system says now if you can't "read" in kindergarten you are defective.

My son reads well above grade level now at 13.

198 posted on 04/21/2003 10:34:14 AM PDT by Dakotabound
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To: FreeRadical
I don't know about ADHD but I'm disabled and without Ritalin I wouldn't be able to get outta bed. As I understand it, it calms down the youngsters and juices up us geriatrics. I spent five years going from bed to the toilet and back. Ritalin's given me "some semblance" of life and I can even think "semi-clearly" for a few hours a day. Some might dispute that, LOL, but Ritalin has been a God-send for me.
199 posted on 04/21/2003 10:35:16 AM PDT by geedee
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To: Lazamataz
For your comments:

Genetic Research on AD/HD Finds Evolutionary Link

By Bob Seay

AD/HD May Not Have Always Been a Disorder; Research indicates that traits may have contributed to the survival of early humans

Thom Hartmann took a lot of flak when he proposed an evolutionary model of AD/HD. Now, researchers at the University of California, Irvine, have concluded that his controversial theory may well be correct. Researchers now believe that a gene variation associated with Attention-Deficit/Hyperactivity Disorder (AD/HD) first appeared 10,000 to 40,000 years ago and was probably a significant advantage to the early humans who had it.

In an article published in the January 8, 2002 edition of the journal Proceedings of the National Academy of Sciences of the United States of America, Dr. Robert K. Moyzis and other researchers speculate that early humans with AD/HD traits such as novelty-seeking, increased aggression and perseverance were more likely to survive. These traits have been associated with the DRD4 7R gene. Up to half of AD/HD individuals have this same variant gene, according to Moyzis, one of the authors of the study. More information about the article is available online.

Today, many of these same traits are deemed inappropriate in the typical classroom setting and hence diagnosed as AD/HD. Like their early ancestors, today's AD/HD children are more active and often more aggressive than their peers. These children are always looking for something new to capture their attention. Once they find something interesting, such as a video game, they "lock on" and focus intently on the task. They are often unable to shift their focus to something new.

Researchers speculate that a "survival of the fittest" scenario may have contributed to an ever-increasing number of people with AD/HD. For example, being more aggressive, inquisitive, and willing to take risks meant a higher probability for mate selection and perhaps multiple sex partners, spreading the gene – and its associated AD/HD behaviors – through the population. Primitive hunters with this gene would have been more successful and would have been better providers for their families and tribes. These and other factors may explain why the gene is so prevalent now.

What does the man who has been saying this for nine years say about the most recent research? "I appreciate the acknowledgment of my early work by Dr. Swanson of UCI, one of the authors of this study, in his public comments after the presentation of this study at last fall's CHADD meeting," Hartmann told additudemag.

"In light of these findings, we must also revisit the way we approach AD/HD treatment in adults, moving from a broken/pathology/therapy model to a skill-set/opportunity/coaching model," he added, noting that Thomas Edison, Ben Franklin and other innovators, inventors, and rebels of history would probably be diagnosed as having AD/HD if they were alive today. "This also demonstrates the need for us to revisit the way our schools and classrooms are organized, so our ADHD children are no longer wounded by the experience of growing up in public school." The Hunter School is a private school that specializes in teaching AD/HD students, using a curriculum based on instructional concepts created by Hartmann and others.

Hunters Living in a Farmer's World

Hartmann's Hunter-Farmer theory, first presented in his 1993 book Attention Deficit Disorder: A Different Perception, was featured in a Time Magazine article and was widely embraced by many in the ADD Community as a more positive view of the diagnosis.

Mainstream researchers, however, were not so quick to accept such an evolutionary – and revolutionary – idea. Hartmann and his ideas were blasted by many, including noted AD/HD researcher Russell Barkley, Ph.D. Speaking in the keynote address at the 1999 CHADD Conference, Barkley expressed sentiments he had previously published an article co-written with Sam Goldstein, Ph.D. ( ADHD, HUNTING, AND EVOLUTION: "JUST SO" STORIES. )

"(It) is not surprising that there is an increasingly popular, and to some extent, seductive trend among the lay public to view symptoms of Attention Deficit Hyperactivity Disorder … as adaptive behaviors," wrote Barkley and Goldstein. "Although this romantic view is embraced by many and may well pass the Readers Digest criteria for publication, is it truly accurate?"

Barkley continued, "In not a single instance of peer reviewed, published literature have symptoms or consequences of AD/HD been found to hold an advantage… Further, readers pursuing a brief introduction to evolutionary theory and evolutionary psychology quickly realize that it is implausible to perceive symptoms or behaviors related to AD/HD as being advantageous regardless of the time or cultural context in which one examines these data."

Barkley's comments came as a slap in the face to many in the ADD community.

Respecting Who We Are… And Who We May Have Been

Popular or not, Russell Barkley is perhaps the most significant source of much of what we currently know about AD/HD. His work has been used by other researchers, doctors, therapists, teachers and parents. His ideas about how AD/HD should be treated and managed have allowed millions of AD/HD children and adults to lead normal, productive lives. The ADD Community owes much, including our respect and gratitude, to Dr. Russell Barkley.

Likewise, people who have AD/HD owe much to Thom Hartmann, who stood up nine years ago and dared to disagree with the conventional wisdom. Hartmann's theories about AD/HD provided the hope and self-respect that had been missing from the medical model of the "disorder." His thoughts about AD/HD, education and other topics are sometimes controversial and always compelling. Books and articles by Hartmann are available on his web site at http://www.thomhartmann.com/home-add.shtml.

Research like the Irvine study can help doctors, teachers and parents to better understand how their AD/HD children think and learn. But for those of us who have AD/HD, the Irvine study provides an important link to our past and hopeful possibilities for the future.

200 posted on 04/21/2003 10:58:20 AM PDT by Dakotabound
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