The Drugging of Our Children

December 11, 2007

By Gary Null

Note: The information on this website is not a substitutefor diagnosis and treatment by a qualified professional.

All of a sudden, it seems, millions of American children are said to be afflicted with mental illnesses. And they’re being put on strong medications—over periods of years—as treatment. Isn’t it time we stopped and looked at what the mental health establishment is getting us to do to our children?

Overview

As we navigate our way into the 21st century, there is an ominous trend that, strangely, doesn't seem to concern people as much as it should: Millions of children are now taking psychotropic drugs. And they're not doing it illegally, but by prescription. In fact, the medical and educational establishments are conducting a skyrocketing campaign to get kids, and their parents, to “just say yes” to brain-altering pharmaceuticals, with the drug of choice being Ritalin. In 1970, when approximately 150,000 students were on Ritalin, America was alarmed enough to get the Drug Enforcement Agency to classify Ritalin and other amphetamine-type drugs as Class II substances, a category that includes cocaine and one that indicates significant risk of abuse. Despite this apparent safeguard, the number of children taking psychiatric stimulants today has risen over 40-fold;

current estimates are that between 6 and 7 million children are taking them. The American Academy of Pediatrics estimates that as many as 3.8 million school children, mostly boys, are currently diagnosed with attention deficit hyperactivity disorder, and that at least a million children take Ritalin, a figure that many regard as a gross underestimate. And it is not just schoolchildren who are being dosed with psychotropics:

Even preschoolers—those aged 2 to 4—experienced a tripling of such prescriptions in a recent five-year period.[ii]

Exactly why is all this juvenile pill-popping a problem? Well, for one thing, Ritalin is a drug that has a more potent effect on the brain than cocaine.[iii] And we’re supposed to be a country that eschews the use of such mind-altering substances, certainly for children. For another, Ritalin’s side effects can range from unwelcome personality changes to cardiovascular problems to death. Plus there’s the very real issue of whether the “diseases” for which this powerful medicine is prescribed are in fact real diseases at all.

The problem becomes further complicated when you consider that, in addition to the Ritalin explosion, increasing numbers of children are also being prescribed antidepressants, and that these are drugs originally designed and tested for adults.

(A fact not generally publicized is that it’s legal to prescribe drugs “off label,” that is, for conditions or populations that they weren’t originally designed for.)

So in 1996, over 700,000 children and adolescents were taking Prozac and similar antidepressants in the SSRI group, an 80-percent increase from just two years earlier. It’s not that the SSRI’s have been proven effective in battling childhood and adolescent depression. They haven’t.[iv] Nevertheless, today, the number of these prescriptions has surpassed one million. Psychiatrist Peter Breggin estimates that, each year, 10 percent of the school-age population will take one or more psychiatric drugs.[v] Some children are prescribed several at once. And the phenomenon continues to grow despite disturbing evidence of severe drug-induced personality changes, manic reactions, and psychotic behavior.

Medication advocates would argue that those children who are prescribed psychotropic drugs do in fact need them. Children with affective disturbances or attention deficits can focus better, and thus learn better when medicated, they say. Opponents protest that the efficacy and safety of these drugs have not been proven, and some, further, believe that many psychiatric “conditions” exist only as labels in the minds of psychologists.

Whether or not these conditions are real, one must agree that the exceedingly high numbers of prescriptions written for children in recent years are a cause for grave concern. And they’re of concern not just to the children and parents directly touched by individual diagnoses, but to society at large. Consider the Columbine massacre and the rash of other school shootings that have rocked this country recently. As the Washington Times Insight Magazine reports, “the common link in the high school shootings may be psychotropic drugs like Ritalin and Prozac.” For example, in 1998, 14-year-old Kip Kinkle killed his parents and then went on a shooting spree at his Springfield, Oregon, high school, killing two and injuring 22. He was being treated with Ritalin and Prozac. Then there was the15-year-old taking Ritalin who in 1999 wounded six classmates in Heritage High School in Georgia, and the 18-year-old who raped and murdered a 7-year-old girl in 1997, one week after starting to take Dexedrine. One can’t help but ask whether psychotropic drugs are dangerous not just to those taking them, but also, in some cases, to “innocent bystanders.”

And there are some other basic questions people are beginning to ask as well: Do all these children need to be taking all these drugs? Are they really sick?

Is Attention Deficit Disorder a Real Disease?

By far, the overwhelming majority of psychotropic prescriptions for children are given for attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). In some instances, taking medicine is a prerequisite for attending school, with refusal to comply considered grounds for dismissal, or worse, removal of the child from the home by the state. This outrages Dr. Fred Baughman, a board-certified child neurologist trained at New York University and Mount Sinai, and a fellow of the American Academy of Neurology. Baughman feels that it’s one thing for a court to intervene and take over as legal guardian in a case where a child’s life is truly at risk, but quite another thing when psychotropic drugs are forced on children who don’t fit into the mold. For instance, Baughman says, for religious reasons parents may refuse a needed blood transfusion for a child, or they may refuse to allow treatment of diabetes—a real disease—

with insulin, a real treatment. The courts may have to intervene in such cases. But courts should have no place in mandating that behavioral problems in children be treated with drugs. “There are no physical or chemical abnormalities in these children,” Baughman states. “The idea that there is is a false belief spouted by psychiatry…. For courts to intervene and to mandate such treatment, as though these were legitimate diseases or legitimate medical emergencies, is leading to tyranny over parents of normal children….When we’re talking about…so-called psychiatric disorders, none of them are actual diseases due to physical abnormalities within the child,” states Baughman.[vi]

A Diagnostic Deficit. One reason to question the status of ADHD and ADD as real diseases has to do with the method of diagnosis—or lack thereof. Usually, before labeling a patient with a condition, doctors do extensive testing to discover abnormalities. They may perform blood tests, x-rays, sonograms, MRI’s, and so on. But no medical tests exist that can determine the presence of ADHD or ADD; therefore, these “maladies” do not fit the criteria for a disease.

In the absence of objective medical tests to determine who has attention deficit disorder, doctors use task- and memory-oriented psychological assessments, and behavior rating scales, on which teachers and parents rate children on questions such as how much they fidget, how well they follow instructions, or whether they are restless or easily distracted.

An easy-to-see problem here is that the answers are subjective. What one person views as distractibility, for instance, another may view as natural inquisitiveness. Another problem is that some of the questions are based on questionable values or assumptions;

for example, the Conners’ Parent Rating Scale[vii] asks whether the child “actively defies or refuses to comply with adults’ requests.” In some life situations, though, disobedience is a virtue. This questionnaire also asks whether the child “is always ‘on the go’ or acts as if driven by a motor.” But what about the highly motivated achievers of our society, people who are always on the go because they’re bursting with entrepreneurial or creative energy? One thinks of Benjamin Franklin as an early example of this. Interestingly, some doctors, such as Massachusetts psychiatrist Edward Hallowell, are now saying that Benjamin Franklin may have had ADD. As a Philadelphia newspaper reporter put it, “Why else would a man go out into a rainstorm with a key on a kite hoping for lightning to strike it?”[viii] So now we come to the obvious questions. What if Franklin had been drugged for his behavior? Would his creativity have been dampened, and would our society have been the poorer for it?

Or consider these musings of newspaper columnist Rod Allee:

“There was a boy who in his early teens was a bad student, failing in many classes. Thought to be bright and encouraged by his parents and uncles, the boy could not bring himself to pay attention. He dropped out of school and took long walks.

“Meetings were held. No psychiatric medicine was available. The boy’s personality changed not a whit. Nevertheless the boy became a legend.

“Yes, that boy was Albert Einstein. It is possible—in my mind, probable—that had psychiatric medicine been prescribed for the young Albert, the world would never have learned about relativity.”[ix]

Another drawback of ratings questionnaires is that parents and teachers often have a vested interest in the results. Even with the best of intentions, they may, without realizing it, want a child put on Ritalin, believing that it will help, or that it will make their own lives easier.

Also, it is interesting to note that studies show significant disagreement in how different evaluators assess the same child. As psychologist Thomas Armstrong explains in his book The Myth of the A.D.D. Child, “In one study, parent, teacher, and physician groups were asked to identify hyperactive children in a sample of five thousand elementary school children. Approximately 5 percent were considered hyperactive by at least one of the groups, while only 1 percent were considered hyperactive by all three groups. In another study using a well-known behavior rating scale, mothers and fathers agreed only about 32 percent of the time on whether a child of theirs was hyperactive, and parent-versus-teacher ratings were even worse: they agreed only about 13 percent of the time.”[x]

One way of looking at the phenomenon we call ADD is to say that there is a natural bell curve of children’s behavior patterns, and that those who are particularly active simply fall at one end of it. In other words, ADD and ADHD are part of the spectrum of healthy human behavior. Or in the words of Dr. William Carey, University of Pennsylvania professor of pediatrics, “What is now most often described as ADHD in the United States appears to be a set of normal behavioral variations.” He said this at a 1998 Consensus Development Panel of the National Institutes of Health, a group that did admit, “There is no valid independent test for ADHD. There are no data to indicate that ADHD is due to brain malfunction. And finally, after years of clinical research and experience with ADHD, our knowledge about its causes remains speculative.” [xi] Indeed, although psychiatrists have been studying the multitude of behaviors that have been lumped together as ADHD for decades, no more is known today than was known in the early ‘70s, when ADHD was called hyperactivity or mental brain damage.

What is today called ADD has gone by a variety of names over the course of the past century. Psychologist Dr. Thomas Armstrong lists some of them; the list includes “organic drivenness,” “restlessness syndrome,” “minimal brain dysfunction,” and “hyperkinetic reaction of childhood,” to name just a few.[xii] Armstrong is one of the growing number of experts who believe we’ve gone too far in pathologizing part of the spectrum of normal behavior. The psychiatric establishment, of course, tends to disagree, and many would point to the work of Dr. Judith Rapaport as proof that these conditions are real. According to Dr. Rapaport’s MRI research, brains of ADHD/ADD children appear to be different from the brains of other children in that parts of the anterior frontal lobe and basal ganglia appear significantly smaller in ADHD/ADD children, particularly on the right side.

These changes would account for some of the behaviors of afflicted children because the frontal lobe controls such functions as response inhibition and the ability to plan complex sequences of actions.

A closer look, however, finds that Dr. Rapaport tested children who were taking medication prior to and during her studies. Their brain changes, then, could have been caused by long-term use of amphetamines. Even Dr. Rapaport admitted this in an interview in which she stated, “We are also replicating our anatomical MRI work with boys who have never been treated with stimulants to make sure that the differences in brain structure are not a result of stimulant medication.”[xiii] The latest research from the University of Buffalo acknowledges this concern, concluding that long-term Ritalin use may cause changes in the brain similar to those seen with long-term use of other stimulants, such as amphetamines and cocaine.

Those supporting a biological explanation for ADHD sometimes refer to PET scan studies. In the early ‘90s the National Institutes of Mental Health conducted studies using PET scans to measure glucose activity in the brains of normal children and those considered to have ADHD. It was reported that the scans showed lower glucose activity in the brains of ADHD individuals. But it was later admitted that the initial study results could not be duplicated. Also, the individuals in the ADHD group had taken stimulants as part of their treatment. This is germane because stimulants lower glucose activity in the brain, a fact that has been known since the 50s. Thus the PET scan results do nothing in terms of defining a genuine brain disorder. They do, however, bring up the important question of whether or not stimulant drugs are adversely affecting the brains of children. This is not the first time that study data have raised questions as to Ritalin’s role in brain structure changes. In 1986, a research team found brain shrinkage in 50 percent of 24 young adults with hyperactivity since childhood, and concluded that cortical atrophy may be a long-term adverse effect of stimulant treatment. Actually, while doctors have long known that stimulants can cause brain damage when used chronically at high doses, no one has looked at the possibility that chronic low-dose usage, such as with drugs that are commonly used for ADHD, can cause brain damage as well.

An American Phenomenon. An important argument against the thesis that ADHD and ADD are actual conditions is that the epidemic appears to be confined to North America. The use of Ritalin and similar prescriptions is overwhelmingly concentrated in the United States and Canada. In fact, these two countries account for 96 percent of their use throughout the world, and children in the U.S. have been estimated to be from 10 to 50 times more likely to be labeled as having ADD than their counterparts in Britain or France.[xiv] In American public schools, about 10 percent of all children in grades K-12 carry an ADHD diagnosis. Europe, by contrast, has a fraction of one percent so labeled. Could the United States and Canada really be so unique in the recent drastic upsurge of this malady?

Many in the health field are calling for more research in this area. For instance, Thomas Moore, senior fellow in health policy at George Washington University Medical Center, who feels that brain damage from Ritalin is more common than has been admitted, often questions the rationale of giving Ritalin to children, stating that the chemical imbalance theory has not been established by any scientific evidence. And while the public is given information by the National Institutes of Mental Health that ADHD is neurobiological in nature, NIMH psychiatrist Peter Jensen stated in 1996, “The National Institutes of Mental Health does not have an official position on whether ADHD is a neurobiological disorder.” In other words, this agency is talking out of both sides of its mouth—not that this is an uncommon phenomenon in Washington.

Psychologist Diane McGuiness summed up the situation in 1991 by saying, “We have invented a disease, given it medical sanction, and now must disown it. The major question is, how do we go about destroying the monster we’ve created? It is not easy to do this and still save face.”

Psychiatry’s Campaign of Labeling—and Lobbying

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