"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.
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