The drugs we give our kids today
Charlie Hueber & Michael Riley
4/3/00
Does your child have a hard time concentrating or paying attention? Does your child's teacher or doctor suggest that your child may be suffering from Attention Deficit Disorder? If so, you as a parent may want to consider having your child put on Ritalin, a drug designed to reduce hyperactivity. Then again, you as a parent may not want to put your child on Ritalin. If you as a parent are asking yourself "why not?", then please continue reading.
To help you better understand the situation to be discussed, you must first understand what the drug Ritalin really is. In medicine, Ritalin, which is manufactured by the Ciba-Geigy Corporation, is used in the treatment of Attention Deficit Disorder (ADD), also known as Attention Deficit Hyperactivity Disorder (ADHD), formerly known as Minimal Brain Dysfunction and it should be noted that this drug is also used in the treatment of narcolepsy. Ritalin, or methylphenidate, is a mild central nervous system stimulant that boosts the brain's ability to control impulsive behavior and helps children to concentrate. This particular drug acts in a similar manner on the nervous system as would the intake of amphetamines. As you can see, we are dealing with a very powerful drug.
Although the use of Ritalin may in fact provide a positive return on one specific child, do not be mislead. Not all children respond to Ritalin in the same manner and if misused, Ritalin can and does cause some very serious health problems. This is why you as a parent must be educated on the effects of this drug. As you will soon learn, Ritalin is not a simple prescription and Ritalin is not what you may think it to be. More harm than good can come from the use of this drug.
The use of Ritalin is a very hot topic in today's society for many, many reasons. One of these being the side-effects, or to be more specific, adverse reactions that can become instated upon a user of Ritalin. For example, Ritalin can cause a person to experience nervousness, insomnia, hypersensitivity (skin rash, urticaria, fever, arthralgia, exfoliative dermatitis, erythema muliforme with histopathological findings of necrotizing vasculitis and thrombocytopenic purpura); anorexia, nausea, dizziness, palpitations, headache, dyskinesia, drowsiness, blood pressure and pulse changes, tachycardia, angina, cardiac arrhythmia, abdominal pain and weight loss. Toxic psychosis and rare reports of Tourette's syndrome have also been reported.
Now that you understand the possible reactions from the use of Ritalin, one of the most important aspects we must consider when dealing with Ritalin and why the understanding of this drug is so important is that Ritalin is derived from the same family as cocaine. Because both cocaine and Ritalin are addictive, this gets children into the habit of taking drugs. This is why Ritalin is such a problem in our society. Children are becoming addicted to Ritalin and unfortunately there is now a booming market in the selling and transaction of Ritalin.
The Drug Enforcement Administration (DEA) has realized that the use of Ritalin has become epidemic in nature and is warning that teenagers and even younger children are abusing Ritalin. Nationwide, the DEA estimates that Ritalin prescriptions have increased 600 percent in the past five years and the Food and Drug Administration (FDA) says that the national production of Ritalin has increased two-to-three fold in the last five years.4 It is estimated that 15 percent of the pediatric population will be on Ritalin by the end of year 2000. The problem is that there are about 2.4 million children who are currently on Ritalin and more times than not, the drug is being used in a manner for which it was not intended.
Since Ritalin is a Schedule II Controlled Substance, the federal government strictly regulates the amount that may be manufactured. Over the past several years, as ADD diagnosis increased, the manufacturing quotas have not increased sufficiently to allow for the increased demand. This has led to shortages of Ritalin which in turn has led to the creation of an illicit street drug trade which again creates a shortage of the already available Ritalin to legitimate medical cases.
When purchased in a pharmacy, Ritalin tablets cost between 25 cents and 50 cents. When purchased on the street, Ritalin tablets will sell for $3 to $15 a tablet. To shed some light on this troubling scenario, take for instance the following examples: In the city of Chicago, it is not uncommon to find Ritalin sold in conjunction with heroin. In the state of Texas, there is a known illegal trading route of Ritalin being brought in from Mexico obtained through the cooperation of Mexican pharmacies and physicians. There are also documented cases in the state of Texas in which parents whose children are on Ritalin are illegally selling their child's prescription on the street. The street market for Ritalin has become so profitable that in the state of Illinois, if a person is caught dealing the drug, depending on the quantity, location and age of recipient, the punishment could be a Class A Felony resulting in a prison term of 45 years and a fine of up to $10,000.
Another major problem with Ritalin is that believe it or not, schools actually make money off of students listed as "disabled." The Wall Street Journal reported that schools receive an extra $420 in federal funds for each student diagnosed as being "disabled" which makes one wonder whether there are certain economic incentives involved in the increase of ADD diagnoses. For example, in the state of Virginia, the prevalence of children getting a dose of Ritalin during the school day was two to three times the national estimate of the disorder. This statistic in itself brings up the most alarming and troubling aspect of Ritalin abuse, the abuse of Ritalin by the children who carry the drug and the schools that administer the drug.
As powerful a drug as Ritalin is, one would think that it would be closely monitored. This is just not the case. Ritalin is now being abused as badly if not worse than cocaine. In the state of Wisconsin, based on a Marshfield Clinic Study, 16 percent of 161 students surveyed say they have been approached to sell, give or trade their prescribed Ritalin and 44 percent of the students aged kindergarten to grade 12 say Ritalin is stored unlocked on school grounds. Nine of the 53 principles who participated in the study say they have no formal policy on the use of the medication on school grounds. What should get your attention is that none of the principles surveyed say that they saw no problem with Ritalin abuse.
There is a problem with Ritalin abuse and the problem is easy access and juvenile mentality. The Community Epidemiology Work Group, a drug use epidemiology forum reported that children (these being students) from all age groups have learned to snort and intravenously inject Ritalin. In order to make the 5- to 20 mg. dose tablets large enough to handle, at least 100 mg. of "inert ingredients" such as lactose, starch, polyethelene glycol, magnesium stearate, sucrose, talc, cellulose, mineral oil and various dyes and conditioning agents are added to the tablet. Although these ingredients are "inert" when taken orally, they can cause serious problems when injected or snorted.
Although Ritalin is readily water soluble, when dissolved in a water and "cook", Ritalin may be injected. When the drug is injected, the syringe allows anything in it such as bacteria, viruses, dust, allergens and other contaminants to pass directly into the blood stream and body tissue along with the liquefied Ritalin. The rapid delivery of drugs via injection makes it difficult for the user to control the intensity of the drug effect, thus making toxic overdoses more likely.
When Ritalin tablets are snorted, they are crushed into a very fine powder and taken in through the nasal passages. Ritalin tablets contain the hydrochloride salt of methylphenidate and yield dilute hydrochloric acid when they come into contact with moisture. In the nasal passage, the acid can "burn" the delicate nasal tissue, resulting in open sores, nose bleeds and deterioration of the nasal cartilage. When Ritalin is crushed into a powder suitable for snorting, the drug can also cause seizures, psychosis or even a stroke. The street names for snortable Ritalin are "Vitamin R," "R-Ball," or "the smart drug."
Because Ritalin has become such a "popular" drug, Ciba-Geigy has contributed over $1 million to Children and Adults with Attention Deficit Disorder (CHADD) between 1991 and 1994, possibly compromising CHADD's ability to help those with ADD. The DEA warned that the contributions are "not well known by the public" and that the relationship between Ciba-Geigy and CHADD was an "unhealthy co-mingling of medical and commercial interests." CHADD has petitioned the DEA to reschedule Ritalin from Schedule II to Schedule III in order to make it less expensive and more available. Although easier access to Ritalin will obviously support an already growing abusive trend, CHADD stated that they had not been aware of the abuse of Ritalin. Again, this brings up the question of economic incentives. The DEA is currently awaiting a response from the Department of Health and Human Services relating to this issue.
As a parent, you must consider whether you want your child's doctor or teacher to prescribe Ritalin because it is not labor intensive, it does not take a great deal of energy, insurance will pay for it and it takes a huge burden off of doctors and teachers. As a parent, you must realize that Ritalin has allowed doctors to disregard the importance of finding out what is clinically wrong with your child. Essentially, what we are beginning to learn is that managed care and psychotropic drugs are a destructive mix and this destructive mix is being fed to your child whether directly or indirectly. In American society, we want things fast and medicine works fast, but do you as a parent really want to put the health of your child in jeopardy if it really does not need to be?
In an article titled Why Ritalin Rules by Mary Eberstadt, we see how the use of Ritalin is "widespread." In her article she goes on to tell us why this drug is so prevalent today. Parents are looking for a "controller," something to keep their children calm as they handle the stresses of the ever-growing double income household. In an interview with Susan Williams, she said that she gives her son, Daniel, the drug because she does not have the "nerves to put-up with a rambunctious nine year old," without the aid of Ritalin. She claims that before Ritalin her house was a "zoo," nothing was ever done; everyone in the family focused their attention on Daniel, and by the end of the day she was too worn-out to function. We see how ADD or AD/HD affects the home now we look at the school.
Former teacher, Chris Mercogliano in his article Rid-A-Him or: Why Are So Many Boys Given Drugs In Schools, tells us that children with ADD or AD/HD fail to control their ability to "pay attention" without the use of drugs such as Ritalin. Parents see a drop in grades because of this and also because of the increased strain on the home life. Mercogliano later says that Parents are concerned about their children's grades, but with today's stress filled lifestyles and with more and more mothers going to work, parents' only solution is Ritalin. Mary Anne Prater states in her article, What teachers and Parents need to know about Ritalin, that parents love the results of Ritalin - "good grades, calm children, and fewer fights."
This choice to place these children on a medication such as Ritalin is often suggested by doctors. Steven R. Pliszka in his book, ADHD with Comorbid Disorders: Clinical Assessment and Management, says that after the diagnoses of ADHD is reached doctors must find a solution such as prescription of drugs, most commonly "Ritalin." In an article titled Wonder Drug or Quick Fix? A Review of Research on Ritalin, by William Frankenberger we read that, because of the unknown causes and mystery of ADD or AD/HD doctors simply do what everyone else is doing and prescribe Ritalin. We see in Mary Eberstadt's article that several major companies with "political and medical clout" support the use of Ritalin. These companies affect how the doctors react to ADD or AD/HD, because of their pull within the medical community.
According to Mary Anne Prater the number one drug, for any attention deficit disorder, is Ritalin. Parents are forcing their children to use this drug because of the stress of their lives, and the simple fact that these kids are not making the grade in school. We see doctors prescribing medicines because they do not understand ADD or AD/HD and because large companies support its use.
Arguments supporting the use of Ritalin
Despite the controversy over the use of Ritalin and other stimulant drugs to relieve the symptoms of Attention Deficit Disorder, there are many groups and people who support the drug and for good reason. Recognizing that Ritalin is often an over-prescribed drug and over-abused, the drug still has positive effects and is useful in calming a hyperactive not overactive child. My research will show three main arguments for the use of Ritalin and other stimulant drugs for the treatment of ADHD and ADD.
While Stimulant drugs don't cure the disorder, they treat the symptoms.
When your child has influenza, you often give him pain reliever for the headache and often an antihistamine for the stuffy nose, but that doesn't cure the flu. It does, however, help relieve the symptoms and the pain tremendously. And no one wants his or her child to suffer. It is the same way with the stimulant drugs used in treating ADD and ADHD. When a child has ADHD, their brains don't filter information, and stimulus we often refer to as noise. They get it all, and therefore it is impossible for them to concentrate on one particular thing. This is something that we are supposed to do naturally, but they can't. Ritalin, and other stimulant drugs are designed to arouse alertness in the central nervous system, so that it can help filter out unwanted stimuli, like an air conditioner running, or the TV in the other room. (Friedman, 1992.) So while the drug doesn't actually cure the disorder, it helps the symptoms so that the child can cope, and so can the family. Nobody wants their child to suffer. Also, while the symptoms are being relieved, the children are concentrating better in school, and they are behaving better in the home making it easier for everyone to deal with them. ADD is a long-term disorder, but you can't just lock a kid up. You have to make it possible for them to go on with every day life and live as normally as possible.
Ritalin does not drug, sedate, or tranquilize an individual.
As we just looked at in treating the symptoms, we learned that Ritalin is a stimulant. It is designed to arouse alertness in the central nervous system in an individual so that they can filter out unwanted and unnecessary information. It is not a tranquilizer. Many people will often say that kids who are on Ritalin are sedated and are "walking zombies". This is not so. They are actually more alert than usual, and they are simply able to focus and concentrate on one particular thing at a time. "The medications correct an underlying neurochemical deficiency and allow the individual to function normally." (Silver, 1999)
While Ritalin is abused, patients or their families rarely abuse it.
Many people will oppose the use and prescription of Ritalin because it is addictive and abused. However the drug is not addictive in children, and while the Drug Enforcement Administration has published reports of thefts of Ritalin, street sales, illegal importation and the like, reports of Ritalin abuse by patients and their families are rare. (Silver, 1999)
There are clear improvements in behavior for people using Ritalin.
This is undeniable. Numerous testimonies have been made by parents about the behavior of their children and how it changed when the drug was used. Russell A. Barkley, in his book Attention Deficit Hyperactivity Disorder say's that many studies have clearly demonstrated medication-induced, short term enhancement of the behavioral, academic and social functioning of the majority of children using Ritalin. We can't possibly deny how helpful it actually is for children with this disorder in treating the symptoms.
Arguments supporting the our side of the issue
Our group is against the widespread use of Ritalin as a behavioral-altering medication for children suffering from Attention Deficit Hyperactivity Disorder (ADHD). We feel doctors immediately jump to prescribing medications such as Ritalin and other stimulants instead of taking more time to 1) properly diagnose patients and ensure the presence of ADHD and 2) explore better, safer, and more healthy forms of treatment for ADHD and other behavioral disorders. No shortcuts should be made regarding the safety and mental health of children. Doctors over-prescribe Ritalin and other medications all too often.
A better understanding of our position can be achieved by examining the research and findings of Dr. Peter R. Breggin, M.D., Director of the International Center for the Study of Psychiatry and Psychology and associate faculty member at Johns Hopkins University. Dr. Breggins’ book, Talking Back to Ritalin, provides details from many scientific studies that have been ignored by Ritalin advocates.
According to Dr. Breggin, America’s children are being exposed to a "prescription epidemic" of dangerous, addictive stimulants such as Ritalin and Adderall. "Ritalin does not correct biochemical imbalances- it causes them," Dr. Breggin says. He adds there is some evidence that it can cause permanent damage to a child’s brain and its function. These are facts not widely known by parents, teachers, and even pediatricians. "These groups are unaware of these hazards because a large body of research demonstrating the ill effects of this drugs has been ignored and suppressed in order to encourage the sale of the drug," Breggin reports.
The damaging effects of Ritalin include:
-Disruption of growth hormone, leading to suppression of growth in the body and brain of the child
-Permanent neurological tics, including Tourette’s Syndrome
-Addiction and abuse, including withdrawal reactions on a daily basis
-Decreased ability to learn
-Worsening of the very symptoms the drug is supposed to improve, including hyperactivity and inattention
According to Dr. Breggin, Ritalin and other stimulants are currently prescribed to several million U.S. children in the hope of improving their supposed hyperactivity, inattention, and impulsivity. However, adverse effects dominate the situation. "Ritalin produces robotic and zombie-like behavior in children," says Breggin. "Contrary to claims by drug advocates, giving this drug to children does not help prevent future problems such as school failure or delinquency. The enforced docility and obedience can produce a few weeks of subdued behavior but no positive long-term effects at all."
This evidence given by Dr. Breggin paints Ritalin in a dark, negative light, which is not our campaign’s purpose. However, its vital to look at the negative aspects of this drug to cast light on why it is important to control the widespread distribution and use of Ritalin. Our argument to control Ritalin’s use is further backed up by an article by Arianna Huffington, commenting on a 1998 Federal Food and Drug Administration (FDA) report regarding new rules requiring drug companies to study more thoroughly the safety and effectiveness of drugs for children.
The FDA reports a frightening fact that many drugs regularly prescribed to children, including Ritalin, are tested only on adults. All the while, the public (and even many physicians) is not made aware of this fact. All studies, whether showing adverse effects or benefits, should be made available to the public.
The National Institute of Health concedes another alarming bit of information: "There is no current, validated diagnostic test for the diagnosing of ADHD." This fact hasn’t stopped prescriptions of Ritalin to children diagnosed with the disorder from jumping to 75 percent in 1996, up 20 percent since 1989. At the same time, the percentage of those receiving psychotherapy dropped from 40 percent to 25 percent. This demonstrates the root of our campaign: health care providers putting more emphasis on giving kids relatively cheap drugs that provide a quick fix to problems rather than allowing them therapy, which costs more. This problem was summed up by Dr. Lawrence Diller, author of Running on Ritalin, "Settling for Ritalin says we prefer to locate our children’s problems in their brains rather than in their lives." Therapy, in essence, might possibly get to the root of problems better and in a more healthy fashion than Ritalin or other drugs.
The preceding evidence has demonstrated our position to control the widespread use of Ritalin for children.
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