There are a number of people who clearly have ADHD or the
equivalent to the extent of not being able to adequately
function in life. This article is not intended to dismiss the
use of Ritalin in all cases.
There is a difference between drugs given in therapy and
chemical restraint. If your child is in that
category (or if you are in that category), I'm sure you won't
be dissuaded in any case. You'll probably also agree that the
drug is being grossly overprescribed to those who do not
require drug therapy!
Ritalin is a tradename for Methylphenidate hydrochloride, an
antidepressant stimulant. There is no generic common name for
the drug. Other antidepressant stimulants are real cocaine,
novocaine, other cocaine substitutes. Ritalin is not a
classic antidepressant in the sense of Prosaic.
Street names for Methylphenidate hydrochloride are
"r-ball" and "vitamin r."
While children are the obvious victims here, the same message
applies to adults. If you are the
student, please excuse the third party ("your
child") language. The message is the same!
Legally Ritalin is a Schedule II drug in the same category as
opium, cocaine and morphine. (In contrast, Valium is not and its
dispensing is only regulated under state laws.)
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The amazing thing about these early tests was the degree to
which the experimenters were willing to use these drugs on a
maintenance course of treatment (administering the drugs on a
daily basis).
Adult use of Ritalin or any other drug is a completely
different issue. If an adult takes a drug, be it a coffee,
alcohol, strong pain relievers or illegal drugs, the adult is
presumed to make an intelligent evaluation as to its use,
benefits, counterindications and efficacy.
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Myths About Ritalin
Confusion of the drug's efficacy with the
effectiveness:
This usually takes the form of, "It has a physical effect;
therefore it's indicated (as a proper
form of treatment for the given condition). Not so.
If it didn't have a physical effect, it would be a placebo.
to the contrary ADD is such that if the child has
it, you know it. The reason is simple - ADD is a
condition where the natural tendency for distractions exceeds
the ability for the child to control it. It is not the
native tendency for distractions. It is not boredom in
an oversized classroom.
A variation is the hocus-pocus theory:
"Ritalin is a stimulant, but in the case of ADD it calms the
patient down. If the patient did not have ADD, it would have
an opposite effect." WHERE did that one come from? Not from reputable
medical literature. What is this - a magic drug? This theory
belongs with beads and rattles. (Ritalin is a stimulant used
to calm the patient down, much as coffee relaxes people. That
has little or nothing to do with the ADD condition.)
Specifically, there are some drugs and medications which have
this effect. Heartworm preventative medication administered
to dogs testing positive for heartworm is dangerous. (The
reason is that the dying parasites of an already-infected dog
can impede circulation.) Certain antimigraine drugs should
only be taken prior to the headache stage of a migraine
attack. But to say that a general purpose
antidepressant/stimulant exhibits such qualities is at best
disingenuous.
It helps school performance
Its efficacy is in reducing a tendency toward
inattentiveness. This is quite distinct from skill
development. It does have the advantage of making life easier
for the teacher, especially in a large classroom environment.
The use of an antidepressant-stimulant is required for
my child to stay in school.
Wrong.
The only thing the school administration can do is
recommend professional consultation. It's up to the parent to
chose a professional. Then the onus is on the school to
either follow the professional's advise or legally explain why
the professional is wrong.
If you chose the professional recommended by the school
administrator, expect the worst.
NOTE: As provided by the IDEA
Reauthorization Act, at 20 U.S.C. §1412(a)(25)
- Prohibition on mandatory medication, it is illegal for a
school district to require a child to obtain a prescription
for a substance covered by the Controlled Substances Act
(e.g., R-ball; Adderal) as a condition for attending school.
This applies to all students of a school receiving funds under
IDEA, which includes all public schools. This Federal
prohibition applies to all students; not just those falling
under IDEA.
The high use of Ritalin is tied to a relationship between the
teacher, "Resource Room" counselors and those
psychiatrists who work with the counselors.
The teacher is encouraged by the "Resource Room"
counselors to send "problem" children to the
counselors for analysis. If the psychiatrist doesn't return
the child with a script for an antidepressant-stimulant drug,
the psychiatrist doesn't get further recommendations.
Oh yes -- the "Resource Room" returns to the teacher
a sedated pupil!
NOTE: " Those tactics have been made illegal by the
IDEA Reauthorization Act, at 20 U.S.C. §1412(a)(25)
- Prohibition on mandatory medication. I was surprised to see that this particular section of the
law appears to track the language in this webpage!
When is it Necessary?
When environmental changes (class size, food chemicals,
etc.) are ineffective, then antidepressant-stimulants may be
warranted. In such cases the problems become quite apparent.
Drugs are never an acceptable form of punishment.
Drugs are not a substitute for lack of educational facilities.
When the prescribing physician needs a larger sailboat.
(Pardon the cynicism here; your visit wouldn't quite pay for
the sailboat's new GPS receiver.)
ADHD can coexist with some conditions, such as autism
(Asperger's Syndrone and other autism spectrum conditions).
Ritalin may adversely affect people on the spectrum, so it
helps to obtain advise of an expert in autism spectrum
conditions first. (Generally autism is not
"treated" with drugs or otherwise; it's a
personality type!)
Tale of Two Cities
When I moved to Seattle it became apparent that there were
substantially less kids given antidepressant-stimulants. I
believe the reason is cultural:
The parents in Seattle are less likely to blindly accept a
prescription recommendation from a school administrator.
There is a bias in Seattle against drugging kids.
If pressured to have the child treated, the parents in
Seattle are more likely to go to a psychiatrist or
psychologist of their own choosing.
Alternative remedies (e.g., naturopathy) are very much
mainstream in Seattle. Naturopaths generally send back
prescriptions which include such items as dietary
recommendations. While special meals may be outside the Individuals with Disabilities Education Act
(USA), removing food colourings from the cafeteria could
be deemed a reasonable request. (At present the Berkley,
Calif. School District is offering an all-organic meal
option!)
Finally, the Kurt
Cobain tragedy is a too close in the minds of Seattle
parents. (The lead singer of Nirvana was a Ritalin child who
eventually succumbed to heroin abuse and suicide.)
If You're a Teacher
Just don't do it. The quieter classroom just isn't worth what
you're doing to the kids.
Facts About Antidepressant-Stimulant
Drugs
Increased Likelihood of Drug Use
Children administered antidepressant-stimulants are
three times more likely to become cocaine users. The
reasons are speculative but:
The threshold of taking antidepressant-stimulants is
already crossed.
The prescription antidepressant-stimulant becomes a
"starter drug" for street antidepressant-stimulants
(e.g., cocaine).
The kid become familiar with taking drugs for their effect
on mood.
The message that "it's not okay to 'get wasted'"
on street drugs but it's okay if the drug is given for the
benefit of the teacher eventually becomes hypocritical.
Explain it away, but the basic contradiction will remain.
It's possible that an ADD child will automatically
(3:1 probability) become a cocaine user but this has
nothing to do with taking antidepressant-stimulants. This
contradicts basic logic but it is a possible
explanation.
Antidepressant-stimulants are addictive.
This is different from heroin and nicotine addiction but there
is now considered to be little question that
antidepressant-stimulants are addictive. This includes
prescription antidepressant-stimulants
(e.g., Ritalin), cocaine, crack cocaine and
similar drugs.
Possible Future Job Consequences
The U.S. Armed Forces will not accept candidates who
have been on Ritalin unless the applicant has never taken more
than a single dosage of medicatoin or has not been prescribed
medication for [ADHD] for more than 24 cumulative months after
the age of 14.; and
documentation from the applicant's prescribing provider that
continued medication is not required for acceptable
occupational or work performance
ADHD by itself is not likely to be a disqualifying condition.
A choice of Ritalin treatment and No
therapy at all is a "false dichotomy"
(sometimes called "horns of the dilemma"). The
"false dichotomy" states that one must either drug
the student or ignore the issues.
In some cases, one of these extremes makes (some) sense. In
many cases, the student has ADHD issues, but is not at the
point of inability to function. This suggests that there are
usually intermediate steps that can be taken to address
issues.