Posted on 05/17/2004 5:13:11 AM PDT by Cincinatus' Wife
TRENTON, N.J. - As more children pop pills for attention deficit and other behavior disorders, new figures show spending on those drugs has for the first time edged out the cost of antibiotics and asthma medications for kids.
A 49 percent rise in the use of attention deficit/hyperactivity disorder drugs by children younger than 5 in the past three years contributed to a 23 percent increase in usage for all children, according to an annual analysis of drug use trends by Medco Health Solutions Inc.
"Behavioral medicines have eclipsed the other categories this year," said Dr. Robert Epstein, Medco's chief medical officer. "It certainly reflects the concern of parents that their children do as well as they can."
Antibiotics top the list of the most commonly used children's drugs, but parents are paying more for behavioral drugs, such as stimulants or antidepressants, according to the analysis of drug use among 300,000 children younger than 19.
Medco, the nation's largest prescription benefit manager, was to release the data culled from its customers' usage today.
The most startling change was a 369 percent increase in spending on attention deficit drugs for children younger than 5. That's in part because of the popularity of newer, long-acting medicines under patent, compared with twice-a-day Ritalin and generic versions available for years.
But the use of other behavioral drugs also jumped in the past three years. Antidepressant use rose 21 percent, and drugs for autism and other conduct disorders jumped 71 percent, compared with a 4.3 percent rise in antibiotics.
Epstein said 17 percent of drug spending last year for the group of children younger than 19 was for behavioral medicines, compared with 16 percent each for antibiotics and asthma drugs, 11 percent for skin conditions and 6 percent for allergy medicines.
Use of such behavior medicines has been controversial, with some experts questioning whether parents and school officials are too eager to medicate disruptive children.
Some experts say no.
"It's not necessarily a bad thing that these medicines are being used more," said Dr. James McGough, associate professor of clinical psychiatry at the UCLA Neuropsychiatric Institute.
McGough said kids on attention deficit drugs tend to avoid substance abuse and other problems and do better in school.
However, McGough said increasing adolescent use of antidepressants is a concern, because there's little proof they work in young people and evidence shows they might increase suicidal tendencies.
Overall, 5.3 percent of children took some type of behavioral medicine in 2003, including 3.4 percent on attention deficit medicines and 2.3 percent on antidepressants. Some children are on both. That compares with 44 percent who used antibiotics at some point, 13 percent on asthma medicines and 11 percent who used allergy drugs.
Use of asthma medicines increased 15 percent from 2000 to 2003, and use of medicines for gastrointestinal problems jumped 28 percent, mainly because of new drugs for the stomach gas that gives babies colic.
Dr. Richard Gorman, director of the American Academy of Pediatrics' drugs committee, said while there might be "initial overprescribing" of attention deficit disorders, children are typically taken off the drugs if they don't work.
"Either it's better and everyone's relieved, or nothing happens, the kid's still wild and then the parents say to the school, "We tried this stuff, and it didn't work,' " he said.
New attention deficit drugs such as Strattera, Adderall and Concerta require one morning dose, which helps keep children on an even keel all day and eliminates having to line up to get an afternoon dose from busy school nurses or day-care officials.
The side effects are mainly reduced appetite and growth.
Estimates of how many American children have attention deficit problems vary, from 3 percent to 10 percent. According to the National Center for Health Statistics, the number of children 3 to 17 with the disorder rose from 3.3-million in 1997 to 4.4-million in 2002.
Medco said average monthly spending per member was lowest for those 19 and younger, $12.31 a month, compared with $125.58 for those 65 and older.
However, the average cost of a daily dose for one medicine was much higher for children than for senior citizens - $2.12 per day versus $1.29 per day - because many more generic drugs are available for conditions of the elderly.
I'd also be interested in seeing the increase in antibiotic use among children over the last several decades as more and more children are placed in daycare.
School is an unnatural setting, period.
Well thank goodness for that, another Einstein nipped in the bud, shoe-horned into the conformity of secondary education. Read John Taylor Gatto's books about education. These drugs are part of the agenda to get everbody, especially males, to conform to societal norms. You're youngst may have ended up flipping burgers he could also have ended up as a really creative Professor at Princeton.
However, it is a sad fact too many doctors prescribe medicine much too quickly and much too often.
A real behavior modifier too, I would think.
Excellent point.
Economics is sometimes used as an excuse. Kids don't have to go to college. That's part of the "big lie" of "expensive children," that "every child has to go to college to be successful."
Or, they don't have to go to a four-year college and live away from home. They can take college-credit courses while they're still in high school (for free in some states or reduced-rate in others.) They can go to a community college for two years, and work at the same time. They can finish off at a four-year university and still live at home.
Too many kids are too pressured to live up to some social-prestige ideal. They're even told not to get jobs in high school because it might "take time away from school."
He couldn't FOCUS on ANY activity. An intervening thought, sound, or sight sent him off in a different direction.
It is one of those "you had to be there" kind of things.
My neighbor, on the other hand, has a kid on Adderall who is basically just a handful. They have always sat back and let the little monster do whatever he wanted. When he was five he took his dad's hammer to his swing set and beat the hell out of it. There was no punishment, no scolding. He is now a pre-teen terror and they have "calmed" him down with drugs. They didn't see a neurologist, they just went to their regular pediatrician and said "We want..."
You've just described my son. He would go to the bathroom, then just stand there, confused, totally forgot what he went in there for. He couldn't finish a meal. He'd just wander off. The schools said he had ADD. One doctor said he had ADD. IQ was 138, but couldn't stay interested in a paragraph long enough to get through it. I started homeschooling and figured I would just wait it out and give him a chance to mature. He got worse instead of better. I finally took him to a neurologist who said he wouldn't touch him until he'd run every test he could think of.
A month later the test results were in and BINGO! There was a marker for gluten intolerance. (abnormal IGA) We went to a pediatric GI, got a biopsy and found out that he was a Celiac.
OK. We cut out the gluten and I made one change in his curriculum. I let him read whatever the heck he wanted. Now he reads for hours a day with no problems.
So I have a friend in Georgia who visited with her son (diagnosed with ADHD/ODD). In casual conversation I mention the food intolerance possibility to her and she says, "Oh, it's not that. I've tried eliminating everything. Besides, the doctors gave him all the tests and he's normal." I pulled out my son's test results (a packet of paper 3/4 of an inch thick) and ask her if she'd ever seen results like this. No, she said. It was just two sheets of paper. I then asked her if she tried the food elimination for at least 6 months. No. It was just for a few weeks. Well, most folks don't know that it takes 6 months for the brain to begin to recover from food intolerance. No improvement should be expected until then.
Now, as a mom, I'm going to try EVERYTHING I can to get to the root of my kid's problem. If he there really were no other problems, then I'd be fine with the ADD diagnosis, but I'm not going there until I'm really SURE. If there was the possibility that all this crap could be caused by food intolerance, I'd look into it. If I saw a packet of papers like the one I showed her, I'd want to know why EVERY test hadn't been done to eliminate all other issues before doping a developing brain. Her reaction? She's moved him to a special class and hasn't even spoken to the doctor about checking for other factors that may be making her kid crazy.
This is why the whole ADD thing makes me crazy. The symptoms of ADD can be caused by MANY things, including hearing issues, bad eyesight, food issues, allergies, lack of exercise, chronic headaches, dietary deficiencies, boredom, an inflexible environment, and on and on. Kids USUALLY react to a body issue by acting out. Chronic pain makes it impossible to concentrate, think or remember. And if you ask them if it hurts, they'll say no if it's the same feeling they've always known. Most parents are either unable or unwilling to look harder. It's so easy just to give the kid a pill and let all the problems go away without even considering the fact that this could be a SYMPTOM of a larger problem and not a disorder in itself. I've seen it over and over and I've come to the conclusion that women have simply forgotten how to fight for their kids. It took me 8 years, a homeschooling adventure and about two dozen doctors before we found our answer.
If a parent is ignorant of the possibilities, that's understandable, but if you had tried food elimination and gave up because you didn't see an improvement over even a two month period, then you found out that it took 6 months to get a result, wouldn't that make you think? Wouldn't you question? Wouldn't you wonder what else you didn't know? My friend is only one example out of about half a dozen cases that I've personally witnessed. I'm not saying that ADD is total BS, but I do believe that it's become a catch-all diagnosis for any kid who's not totally with the program.
It seems people have forgotten that our society was built on teaching our children how to act.. how to have morals.. why belief in Christ is a good thing.
It seems now that people want their kids to know what society is all about without actually having to teach it to them.. here... just take a pill and be done with it.
In our quest for the big houses and the fancy cars.. parents(both working) seem to think having their kids raised at school is a good thing.
I used to believe like this until I witnessed firsthand the before and after of my hubby's neices daughter. Believe me, this child in no way behaved within the normal parameters of behavior for a normal child. I see you and some others mention normal children a lot--well there has to be some behavioral and developmental parameters that classifies that child as NORMAL. Being that is the case, there will be children, granted not as many as are diagnosed now, whose behavior is out of those parameters and needs attention if the child is to have a normal existence including making friends, learning without distraction, etc. I'd be curious as to what those parameters are since it doesn't seem like a child needs to meet more than one or that their homelife is considered. I know with my autsie son I believe he had to meet all of some general big developmental criteria and then several of a number of smaller issue type of things to be considered autistic. Our homelife was examined to to be sure his problems were not related to abuse or neglect of some kind. ADD/ADHD should be evaluated as stenuously and probably is in some places.
BTW, those meds are a financial hardship for this family. Believe me if they could, the would stop them and her mom tried for 6 years to deal with her behavior issues until she relented and decided to give meds a try. Not every story is of one where the parents just don't want to deal with it or haven't tried other things.
I agree with you Crusher. I wonder how many of the great parents here actually have to deal with children with issues like these. I'm sure there are abuses, but give some of us credit that we know when something is not quite right with our children and that we also have had a lot of guilt over what we may have done wrong to boot while exploring the issues. Hell, I even have a normal child to compare my other one too and believe me it does not take a degree in neurology to know that not talking at age 4, having rages that can not be calmed, and being self-destructive is not normal behavior. My son is autistic though.
BTW, just to address this comment:
not only wasn't he autistic, but his IQ tested out in the 150's"
Autistics, many of them, test out in IQ as well. Many do not have a problem with learning, particularly visual and their intensity lends itself to them excelling in specific areas. The biggest problem with autistics like my son is communication, language, and interacting. They have a hard time making the connections that make us enjoy one another as people--eye contact, body language, verbal skills while at the same time they can be aces in math or take apart a car and put it back together with more skill than a licensed mechanic.
I'll agree with you there. I think there is way too much emphasis on the lauded "4 yr degree", particularly on leaving home to get it. Also agree on kids not being given enough responsibility by getting a job so it doesn't "interfere with homework or extracurriculars".
But what is so wrong with that? If a kid is happy even if they spend most of their time alone and have no need for a social life why worry? I have a son who is very happy taking apart old electronic things, building his "inventions" but shows no interest in anything social. I'd never think to medicate him or try to make him different.
Well --- what is normal? If a child can learn and eventually get a job and exist happily then that seems normal enough. I realize there are kids that have true learning disabilities who may need drugs but kids who test high and show in other ways they are absorbing knowledge and facts are learning even if their grades don't reflect that. Sometimes what looks like hyperactivity is really a great ability to multitask --- it's not so much lack of ability to pay attention but an ability to pay attention to the child behind his desk, the fly on the wall, what's going on outside in the parking lot, what the teacher is saying, plans for after school etc. He's absorbing many things at once but it looks to the teacher that he's not paying attention --- he is -- but paying attention to many things. To me that's just a very active mind -- and there are ways around that besides doping the mind up.
Yeah, it's not substance abuse if a doctor prescribes it.
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