Wednesday, April 03, 2013

"Mental Steroids"

This shocking sentence leads off a recent New York Times story:

Nearly one in five high school age boys in the United States and 11 percent of school-age children over all have received a medical diagnosis of attention deficit hyperactivity disorder, according to new data from the federal Centers for Disease Control and Prevention.

Holy cow!

The doctors interviewed for the article tend to place the blame on over-diagnosis and worry that medications prescribed to increase concentration are being misused:

"Those are astronomical numbers. I'm floored," said Dr. William Graf, a pediatric neurologist in New Haven and a professor at the Yale School of Medicine. He added, "Mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of amibiguity to pure enhancement of children who are otherwise healthy."

That's right "pure enhancement." Otherwise healthy kids are being given powerful drugs, drugs that can be useful for those with severe ADHD, but that can also lead to addiction, abuse, anxiety, and even psychosis, in the name of higher grades and test scores.

I don't think it's an accident that this spike in ADHD diagnosis has paralleled the increased emphasis on high stakes standardized testing, standardized curricula, and other educational methods that reward rote learning and memorization over critical thinking skills. And I also don't think it's a coincidence that the rates of ADHD diagnosis are highest in southern states like Arkansas, Kentucky, South Carolina, and Tennessee where the drill-and-kill model of public education is more firmly entrenched than in the rest of the country. The drugs prescribed to treat ADHD, such as Ritalin and Adderall, help these children with concentration and drive, but they also "work," apparently, not just for these children, but for anyone who takes them. The article cites studies that show that up to 30 percent of these prescribed drugs are being used by non-diagnosed peers and points out that the drug-maker's advertising seems to be marketing their products to worried parents as a short-cut to better grades, causing them to put pressure on their doctors for an ADHD diagnosis.

And lest you think this is simply an attack on ADHD as a diagnosable condition, even such leading proponents of the diagnosis and treatment of ADHD are concerned over this phenomenon, including author Dr. Ned Hallowell who says, "We have kids out there getting these drugs to use them as mental steroids -- that's dangerous, and I hate to think I have a hand in creating that problem."

Making matters worse is that the American Psychiatric Association is set to re-define the ADHD diagnosis in a way that will allow even more people to receive the diagnosis and treatment. Pharmaceutical companies have seen their profits from these ADHD medications more than double over the past five years. I wonder how much influence pharmaceutical companies had in re-writing that definition? 

Listen, I'm not an ADHD denier. I know it's a real thing, and that these medications have been a godsend for many of them. But I also know that if we have to drug 10 percent of our student population, 20 percent of our teenaged boys, and are currently laying the groundwork to drug even more of them in order to get them to function properly in our schools, this should tell us there is something horribly wrong, not with the kids, but with the direction our schools are heading.

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Christi said...

Amen! Yes, there IS a problem - but no one seems to want to address what the real problem is (like you do here). And I can't believe that so many are willing to drug their children, the ones who have no need. Yet another reason we happily homeschool. :-/

Anonymous said...

My son has a sensory processing disorder which I have often wondered if lots of kids diagnosed with ADHD have misdiagnosed SPD. Many of the symptoms seem the same, but SPD is not as widely known about. The management strategies we use for SPD are all therapeutic. By controlling some of the sensory stimulation around my son and by giving him bigger sensory experiences where he needs them, the changes in his behaviour are huge.

It really is time we started to look at the changing the environment, rather than medicating the child. I don't doubt that ADHD exists either, but I do think it is extremely over diagnosed and over medicated. I was a behaviour management teacher for ages and saw the side effects of ADHD medications - especially long term use. There really has to be a better way.

Anonymous said...

I know ADHD can be a crippling disorder for some, and drugs really can be an enormous help. My husband has pretty severe ADHD and I see the difference they can make, I would even say they saved my marriage. But I really believe there is a wide spectrum that people fall on and drugs aren't the quick fix that everyone needs. For instance, exercise and sleep have a huge impact on my husband's symptoms as well. I'm suspicious that the rise of ADHD symptoms might partly have something to do with the decrease in physical activity in kids, both recess and just playing outside in general. I'm also concerned that for even those kids who really do need meds, there is no other component to their treatment. John Ratey's book Spark is just one text that makes a compelling case for increasing exercise for all of us, explaining how it impacts a myriad of brain functions.