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.
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.
Al B. does.
however overdiagnosis is rampant.
Unquestionably.
His symptoms? Inattention, disobedience, unruliness, and other things I did 30 years earlier whenever I was confronted with ill-perpared or incompetent teachers.
Your child was probably one of those erroneously diagnosed. I was diagnosed pre-ritalin days, and they hit me with tranq's. I knew something bad was in those little pills so I would hide them, refuse to swallow them, etc.
Decades later, someone who was important to me at the time suggested I had it. I went to a doctor, and soon enough he had identified that I was a genuine sufferer of the malady. I was perscribed ritalin, and EVERYone around me IMMEDIATELY noticed a major increase in my ability to concentrate. Most of them were unaware of my diagnosis, but noticed a drastic change for the better. On ritalin, my life is MUUUUUCH more manageable -- although my current doc is convinced one of the other drugs might be better for me. Fewer long-term health risks, side effects, etc.
Not quite. Any person, pre- or post-adolescent, will get a stimulant effect from ritalin if they do not need it. If they are an ADD sufferer, they will not get a stimulant effect. Age seems to be unimportant in this observed effect.
You failed to provide a link I could check. Furthermore, you failed to define 'brain malfunction', since it could be that they are making the point that -- like clinical depression, which also exists -- no physical 'damage' appears to the brain in an obvious way, but that an observed psychiatric effect is still extant.
I have to go shortly, so I imagine you will have (many) last words.
In her own words, ADHD medication is a blessing and a curse. It helps her focus in math, but dampens her creativity in English and art. Her school has bent over backwards to accomodate her schedule. She takes a short acting adderal in the AM, does math, and by the time it wears off, it's time for Art and then English.
She has discussed with her doctor possibly discontinuing her meds next year in school--a decision I support, not because I want her off meds but because I want her in control.
I agree that I have heard of instances where it appears that meds are overused, but in her case, ADHD is real and the medication allows her to acheive closer to her potential.
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