When you apply the Daytrana patch, you can help your child get ready for school, homework, and his entire day. - An advertisement for Daytrana, an ADHD medication, manufactured by Shire Pharmaceuticals, in Redbook, January 2007.
The recent article on ADHD in The New York Times has opened a can of worms for the medical profession. The article is titled” Risky Rise of the Good-Grade Pill” and it refers to the widespread embrace of stimulant medication by parents and children to improve grades as “abuse.” In the author’s words: “At high schools across the United States, pressure over grades and competition for college admissions are encouraging students to abuse prescription stimulants, according to interviews with students, parents and doctors.”
But to call this “abuse” is problematic, because the practice of prescribing stimulants to improve academic performance is the very same reason used by the medical community to prescribe these medications. And It is not some hidden agenda, but is boldy announced in advertisments and the medical literature.
According to Dr. Joseph Biederman, a leader in the child psychiatry profession, “If a child is brilliant but is doing just OK in school, that child may need treatment, which would result in their performing brilliantly at school” (Gale, 2006). Sharing Biederman’s view, are the pharmaceutical companies who advertise improved academic performance as one of the features of stimulant medication. Take the recent advertisement for Daytrana, a Ritalin patch, manufactured by Shire, and applied to the hip in the morning: “When you apply the Daytrana patch, you can help your child get ready for school, homework, and his entire day.” Lacasse and I pointed out in a letter to the FDA that there was no evidence in support of this claim. The FDA did issue warning letters to the companies about these claims.
Even the patient support groups condone the use of Ritalin for academic enhancement. Take the example of Jonny-Holiday, a celebrity who is a spokesman for Children and Adults with ADHD (CHADD). In Selling Sickness, by Moynihan and Cassels, they report on the following interview with Holiday at a CHADD golf benefit. In a discussion about his daughter with ADD, Holliday reported that she had only taken her medication intermittently during school time, mainly to help with tests and that: “It really did the job,” and that she had just graduated from college with honors (Moynihan & Cassels, 2005, p. 63).
In 1999, the editors of the journal Pediatrics elicited commentaries from several prominent physicians about the case of a teenage boy who had been taking Ritalin for several years. According to the editors: “He purposefully did not take the medication for a few weeks and he said he could not tell the difference…. However, his parents observed that his test results, when off the medication, were below his standard scores…. They also noted that he was more distractible and less attentive when doing his homework during that time.”
The editors saw the boy’s unwillingness to take his medications as an interesting case and sought out commentaries from several prominent child psychiatrists. The most important variable in determining whether this boy should keep taking his medication was the parental satisfaction with the medication, and the subsequent commentaries all focused on how to convince the boy to continue taking his medication, primarily for academic reasons. None of the commentators questioned the ethics of giving a medication to improve grades.
If the medications are advertised by the pharmaceutical companies, and prescribed for academic performance by the medical profession, then isn’t it a double standard to say that when parents and children do the exact same thing that it is an abuse?