ADHD and Ritalin - The True Story

Maybe Attention Deficit Isn't the Real Problem

By Nicholas Regush ABCNEWS.com Between 1990 and 1996, prescriptions for methylpenidate, know as Ritalin, increased more than 60 percent, according to the Drug Enforcement Agency. Back in my newspaper days, I often would catch reporters describing their editors as having the attention span of a gnat. When I began work in TV, several producers quietly pointed out correspondents and senior producers who were known to have the attention span of a sand fly. But to my knowledge, none of those allegedly afflicted were required to take a drug to reverse their attention deficit. This came to mind when I was in the thick of dissecting the scientific literature on Ritalin, a drug reputed to calm hyperactivity and help people pay attention to things. Its use is extremely popular these days for schoolchildren who, for example, have trouble sitting still, or difficulty keeping track of what they are being taught. Overprescribed or Underprescribed? In reviewing the data, I came across a study from Virginia showing that up to 10 percent of children in second through fifth grades are on medication to fight such problems, after being diagnosed with attention-deficit hyperactivity disorder (ADHD). Being the compassionate type, I naturally wondered whether tests would show that at least 10 percentor even more of reporters and producers in newsrooms where I have worked also should have been on Ritalin or other brain drugs. And should the scientific diagnostic drive extend into the professions, perhaps tests would show that many more psychiatrists, pediatricians and teachers have the attention span of a gnat or sand fly and need to be advised of the fact. Maybe many doctors have ADHD without the benefit of Ritalin and therefore lack the attention span or patience to consider other factors that may contribute to the behavior and demeanor of their young patients ? such as how and where the children live, what they eat, whether they are loved, and the consequences of being taught in schools with curricula too underdeveloped to meet modern childhood needs. The Real Epidemic Am I being unkind to the Ritalin pushers? Yes, and I want to be. This Ritalin sham must stop! It is far out of control. While there are some children ? and some editors and producers ? who obviously need major help in adjusting to our zany world, there is far too much drugging going on. The drugging is the real epidemic, not ADHD. (A note to psychiatrists: Please read this paragraph carefully, with close attention, so you won't waste time writing me nasty e-mails about tragic cases of truly uncontrollable children. I readily admit there are such cases.) I am most concerned that the science on ADHD and related so-called illnesses is not very compelling. Sure, studies are popping up all the time now, but most are preliminary. Looking for Evidence Consider the latest, most publicized entry ? imaging the brain to detect biochemical differences, a tool some claim could lead to a test for ADHD. Watch out, because psychiatrists who may have the attention span of a gnat are already proclaiming this foray into brain imaging as a triumph in biological psychiatry. It is nothing of the kind. We know too little of the brain and its amazing interconnected elements to be so foolishly brash. We also know too little of what much brain imaging really means, and we are lacking gold standards for such testing. What we essentially have here is an epidemic of dumb doctoring and child abuse bordering on the criminal, sitting on a limited view of human behavioral variability. Granted, there are children at the extreme end of the continuum who need a variety of assistance ? not necessarily drug-focused help. Meanwhile, there are probably millions of kids unnecessarily on drugs, obtained not from pushers in schoolyards but from pushers with medical degrees. The Easy Way Out Rather than stare social problems straight in the face and try to determine why certain children are anxious, depressed, irritable or noisy troublemakers, the tendency in this culture is to try to drug the problems away. What if the problem is simply that some of these kids have minds, and spirits, of their own?