Skip to comments.Ritalin Debate: Some Experts Doubt Existence of ADHD
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.
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.
One additional thing, if these kids are diagnosed as ADHD ..they are classified as special needs.. the schools received additional funding for special needs kids and it is in the best interest of the schools to have special needs kids identified.
DUH! Parents today are just weenies - trying to "befriend" their darlings and afraid to be parents!
My son was hyper growing up. He was dealt with consistantly and evenly. When he got "wound up" I made sure he did a few laps up and down our street to burn off his excess energy and it always worked.
He also learned the value of discipline. He's a fine adult today and a great parent.
That many diagnoses in one day? Good grief!
However, to a person such as myself, I get NO recreational drug effect from ritalin. All that happens is I can concentrate better.
Everybody's got a cool screen name but me. :o(
The problem is that for some folks (such as will soon be crowding this thread), ADD is primarily an ideological issue. As such, its reality must be denied or minimized. We see above, and will see below, all sorts of calls for punishment and discipline instead of medication. For whatever reason, these same folks tend to end up on the public education-bashing threads -- there's a link of some sort.
The fact is, I know several kids who are on medication because they need it. It helps them to function.
It is anecdotal evidence of an effect observed by independant researchers performing double-blind experiments.
Kinda as if they were ideologically opposed to recognizing the existance of breast cancer, or clinical depression, or whatever else.
I can tell you this, I am hugely and positively effected by ritalin, although I may be going over to another compound shortly. People who have been around me immediately notice a great improvement in my concentration and ability to comprehend verbal instructions when I have been properly medicated. An ADD diagnosis has improved my life beyond measure.
If the naysayers cannot ideologically handle it, joke 'em if they cannot take a f___.
Ask my doctor, he showed me some literature on the topic prior to prescribing. I was, naturally, very leery of taking any medication at the time.
A doctor described this to me as follows: 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.
For dull stuff (such as schoolwork), the impulse is always to focus on something more interesting. The impulsive behavior is moderated by the uptake of dopamine into the brain. Stimulants allow this to happen, which is why they are used to treat ADHD.
As it happens, a little bit of ADHD isn't necessarily bad -- it spurs creativity, and is apparently very common among very bright people. But it can get to the point where it's impossible to focus on anything at all -- in which case mediction helps.
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.
"Hyper" as you describe your son and ADHD are not necessarily the same. Some is behavioral. Some is not.
Too many kids are medicated who should not be. But the fact is, some kids need it.
ADD/ADHD is a psychiatric disorder. This means that its existence is confirmed purely by subjective citeria.
Normal people taking ritalin had disruptions, but ADD people taking ritalin had modifications that got their 'brainprints' looking quite similar to normal people's.
Ritalin stimulates one particular area in the brain that is underutilized in ADD people. If there is no need for the ritalin, it does not concentrate there but instead causes a general stimulant effect to the entire brain. This is why normal people get an amphetamine result from taking ritalin, and ADD people do not.
Look here for a few papers on dopamine uptake and ADHD.
You're wrong. You appear to be one of those who opposes the existence of ADD/ADHD on ideological grounds. Why?
Perhaps, perhaps not. I do know what the doctor showed me. And I do know it helps me, personally.
This is an "ideological" malady, inasmuch as certain people will insist -- loudly, and often with flecks of spittle on the sides of their mouth -- that this which affects me, does not.
Luckily, the medical community will ignore the ideologically extremist on this issue, and continue treating me for a malady that -- at least in my life -- is 100% real.
You are right about the rabid ideological opposition to treatment of this (very real) malady. I guess I feel a little sympathy towards the Prozac crowd, now, since they get the same treatment.
Ah well. The naysayers are in the vast minority, and it is a very good thing, too.
From personal experience, I can tell you that the various forms of Dyslexia can mimick ADD/ADHD as well.
When a child with Dyslexia suffers "disorientation" they often exhibit lack of attentiveness...day dreaming.. pencil tapping, etc.
For more links you can check out my profile page for information on Dyslexia, as well as info on the possible link between Sleep Apnea and ADD behavior as well.
Good point. And I am sure ADD is overdiagnosed among children. Certainly ritalin is overperscribed among children as well.
However, those who deny the existance of ADD sound like they would also deny the existance of clinical depression.
Baloney. Although the behaviors associated with ADHD certainly exist, I oppose it on scientific grounds. NIMH has admitted that there is no evidence that ADHD is due to a brain malfunction. Why won't you?
Interesting! But I am very sure I do ton evah aixelsyd.
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.
I also have a big concern about the difference between boys and girls when it comes to this...you'd think there'd be more similarities.
Citation, please. And while we are at it, define 'brain malfunction' within that context.
I don't disagree. I think it is overdiagnosed, and I am especially leery about putting lots of children on these drugs.
But to deny it's existance is analogous to someone denying the existence of clinical depression.
Here's a nice Google Search. Some of those links point to real science on the matter.
I'm sure you'll be able to find lots of "Level 1" evidence in the peer-reviewed papers that are included among the links. The double-blind question is whether you'll change your tune after reading a few.
I think you failed to end your post in time. Properly edited, it would read:
Most boys can only focus on 1 thing. Girls
There we go. Much better.
Hmmmmm. Sounds like you suffer from a bit of Baghdad Bobism, too. But there's hope -- just read some of the peer-reviewed papers to which I provided the links.