On Sunday, the New York Times ran a lengthy article titled “Risky Rise of the Good-Grade Pill,” and it illustrated, in vivid detail, how our society—and the medical community—may view a “drug of abuse” through one prism (as harmful) and a “prescribed drug” through another (as helpful), even though the drug in both cases is the same.
This was a story about high school students abusing stimulants in order to perform better on academic tests, and so, in this case, the article highlighted the harm these drugs can do. Here is the key paragraph: “Abuse of prescription stimulants can lead to depression and mood swings (from sleep deprivation), heart irregularities and acute exhaustion or psychosis during withdrawal, doctors say. Little is known about the long-term effects of abuse of stimulants among the young. Drug counselors say that for some teenagers, the pills eventually become an entry to the abuse of painkillers and sleep aids.”
All of this is quite true. But—and this is the key point—these happen to be the very side effects that show up in trials of stimulants prescribed for ADHD. There, in the scientific literature, you will find reports of the drugs causing mood swings (and thus leading to diagnoses of bipolar), psychotic episodes, hallucinations, depression, heart irregularities, and withdrawal symptoms. While the literature regarding whether stimulants lead to substance abuse in adulthood is mixed, there certainly are a lot of anecdotal stories about youth initially prescribed stimulants for ADHD ending up with a drug addiction problem.
However, in newspaper articles about the prescribing of stimulants for ADHD, those side effects are never featured prominently. Instead, in those instances, the drugs are presented as being effective and safe. Thus, in this story, the New York Times obviously had a dilemma: How could it reconcile those dueling images of stimulants as both helpful and bad?
The reconciliation comes in two paragraphs. First, the New York Times writes: “While these medicines tend to calm people with A.D.H.D., those without the disorders find that just one pill can jolt them with the energy and focus to push through all-night homework binges and stay awake during exams afterward.”
In other words, youth with ADHD respond differently to the drugs. Stimulants calm them but keep non-ADHD youth awake.
Then, it quotes Paul L. Hokemeyer, a family therapist at Caron Treatment Centers in Manhattan, who says: “Children have prefrontal cortexes that are not fully developed, and we’re changing the chemistry of the brain. That’s what these drugs do. It’s one thing if you have a real deficiency—the medicine is really important to those people—but not if your deficiency is not getting into Brown.”
And thus, in this quote, readers are told the reason that youth with ADHD respond differently to stimulants — such youth have a “real deficiency.” They have a “chemical imbalance” (and given that stimulants up dopamine levels, the implication here is that youth with ADHD have low dopamine levels.)
So is this true? Do youth diagnosed with ADHD respond in a fundamentally different way to the drugs than “normal kids” do? Do they suffer from a known “deficiency?”
The literature shows that they experience the same harmful side effects that non-ADHD youth do. Youth diagnosed with ADHD who take stimulants, rather than feeling “calmed,” may suffer from insomnia, just the same way that “normal” kids do. Youth diagnosed with ADHD who take stimulants may tell of being able to “focus” better on school tests, just as “normal” kids do. As for research into the “biology” of ADHD, it certainly has not been shown that such youth suffer from low dopamine levels, or that they have a “real” chemical deficiency of any kind.
This was an article intent on exploring how high school students abuse stimulants in order to get better grades. But, unwittingly, it also perfectly revealed our society’s cognitive dissonance around the prescribing of stimulants to youth diagnosed with ADHD. Indeed, we can see our societal mindset vividly on display; how we turn a blind eye to the many side effects these drugs can cause, and how, when we explain to ourselves why stimulants are good for youth so diagnosed, we tell false stories about how they respond differently to the drugs than “normal” kids do and what is known to be “wrong” with them.
Stimulants may help youth—whether diagnosed with ADHD or not—focus better on tests, and thus do better academically over the short term. But it would be helpful, I think, if the prescribing of these drugs did not rely on this sort of cognitive dissonance, but instead was done with medical eyes wide open regarding the harm they can cause too.
Related MiA Blogs:
Stimulants for Good Grades: A Legitimate or an Abuse?
Better Living Through Chemistry?
Well done! The pharmaceutical industry effectively exploited the same strategy in marketing the painkillers–claiming that a narcotic is not addictive if the patient is in pain…What I don’t get at all: how do educated medical professionals come to the point where they’re blind to the harm caused? No comprende nada.
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“What I don’t get at all: how do educated medical professionals come to the point where they’re blind to the harm caused?”
Because drug pushing is what’s paying their salaries. They are not truly stupid. They all know what is really what, but they also know that if they acknowledge it that they will ruin their careers, so they rationalize.
You probably wont find a psychiatrist who doesn’t have a gloom and doom perspective of “mental illness”, because if they didn’t, they wouldn’t be able to watch the patients suffer the effects of their drugs. Every time a patient get’s tardive dyskenisia and dies in a diabetic coma, a psychiatrist has to say to themselves, “Well, without the drugs, he/she would have been homeless, dead or in prison anyway.”
As you can see, it’s not just the drugs that they are blind too. They are — and have been for decades — ignoring the outcomes literature too, because there is no way to sanely or intelligently disregard how harmful these drugs really are.
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“What I don’t get at all: how do educated medical professionals come to the point where they’re blind to the harm caused?”
That is the multibillion-dollar-question, isn’t it?
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“Well, without the drugs, he/she would have been homeless, dead or in prison anyway.”
That may be the justification post-mortem. In our family’s experience the justification pre-mortem has been the following: A dead artist or genius will be referred to, ie. Beethoven or Mozart, and casually diagnosed, and then they ask, “can you imagine what Beethoven could have accomplished on the meds?” They go to blasphemous extent to justify the damage.
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I read the same interesting article, and was also considering a letter to the editor or a blog. However, I mainly see adults with likely ADD, not adolescents, so my perspective is a bit limited. Nevertheless, despite the brain changing in a different direction in adults, there are some similar issues.
In adults, such stimulants can also be abused and diverted. That is why there are usually not on the formularly in prisons. There, we mainly use Wellbutrin, which sometimes helps, but is less effective. We also do know a lot about amphetamines for when they were abused in the late 60s and 70s.
However, there is at least one way to be more sure that someone has a condition we call ADD. That is through sophisticated psychological testing, which can be done in adolescents and adults. This is testing that is generally done over a whole day and can find specific and different problems in information processing. The testing can then be done again if the patient takes a stimulant. I personally never prescribe a stimulant unless that testing is done first and confirms the suspected proble, given how easy it is to fake the symptoms.
With adult and adolescents, it does seem pretty clear to most everybody when the stimulants work, as not only does focus improve (for mundane things), but impulsivity is less, and any hyperactivity can decrease. Side effects are actually usually not a problem for those with substantiated ADD, nor is withdrawal a problem in this situation. Unfortunately, those who seem to really benefit can also sell and divert the medication, so how to reduce that is a real problem.
Some people think the benefits of stimulants should be available to anybody to enhance cognition, sort of like the much weaker caffeine in coffee does. I am not one of those, for reasons Mr. Whitaker conveys.
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“Side effects are actually usually not a problem for those with substantiated ADD, nor is withdrawal a problem in this situation. ”
But in this very article that Whitaker wrote, he is saying that is not the case. That the drugs do the same in both ADD and non-ADD people. That there is no significant difference in how people respond to them based on whatever symptoms or diagnosis they had before.
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In children there is evidence that the drug stops working after a while. I wonder if this is true for adults?
ADD means not paying attention – I however do not see this as a disorder. It is a valid way of reacting to something. I knew someone who thought he had ADHD but could paint and do art for hours at a time. So he only found it difficult to concentrate on things he was not interested in but thought he should be. This is not a disorder, it maybe inconvenient for him, but it is not any kind of medical problem, it is a psychosocial one.
There are Drs and therapists and others who treat children who either are diagnosed with ADHD or who have symptoms that others might diagnose as ADHD or ADD but who do not diagnose, without drugs. If they do this then why can’t people offer help to those who find it hard to concentrate without recourse to drugs?
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I know someone exactly like the person you describe. He is not ill in any way, just eccentric for a young person. He is wonderful and witty and wise in so many ways and is an extremely talented artist who can work for hours on one of his projects. He isn’t interested in a lot of the “fluff” that makes up so much of modern life and because of this he got the dredded ADD label. He does not have a disorder, he just knows what he’s interested in and will not waste precious time on things that don’t matter to him.
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Oh, yes, Wellbutrin, methamphetamine’s weaker cousin.
What a hypocrisy, prosecuting purchasers of speed, a drug of sin, while dispensing chemical variants that are supposed to be virtuous by way of a prescription pad!
That speed and its analogs focus a wandering mind and make boring situations a lot more interesting is no secret. Its the way many of us got our college finals done in the ’60s.
I’m always amazed that methamphetamine analogs are touted breathlessly as therapeutic breakthroughs. Hello, decades of illegal users have already demonstrated all the advantages and disadvantages.
When children are prescribed meth analogs, how can they be faulted when they get a little older and trade the pills among their friends?
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Great point! Thanks
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It’s a drag that we antipharma activists have to struggle to make the point with each individual psychiatric chemical that there is no physical disease or deficiency that is healed by drugs that work by damaging the brain. All of the behavior control chemicals are toxic to the brain.
My opinion is that all drugs should be legal and freely available. The responsibility for informing people who choose to take these chemicals to alter themselves rests with the makers and distributors of these substances.
The following paragraph is reprinted from my blog, where I am discussing the hypocrisy of psychiatric peers in paid positions having to remain “medication neutral” with respect to someone’s choice to control their pain with corporate chemicals, and yet demonize a peer who controls his symptoms with marijuna:
“The truth is that all drugs are morally neutral and that our drugs laws are about the corporate ownership of healthcare and profit for these gangsters and not about protecting us from evil drug-crazed villains. There are no “good” drugs that heal and “bad” drugs that kill. The problem is never the object or chemical or behavior that is addictive, it is the pain of the addict that is out of control. And I have no easy answers for that problem.”
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This good drug/bad drug (same drug) paradigm is also explored masterfully by Richard DeGrandpre in chapter one of his book The Cult of Pharmacology, where he discusses another ADHD drug — Ritalin.
Ritalin (methylphenidate) is nearly chemically identical to cocaine; pharmacologically, it IS identical. Take the same amounts of Ritalin and cocaine by the same method, and you will have the same results. At the same time that the US was destroying hundreds of thousands of hectares of South American agricultural land (dusting) as part of a “drug war” against cocaine, American kids were being handed Ritalin scripts like candy. Politicians were literally decrying Ritalin as a “demon drug” while parents thanked their lucky stars for the “angel drug” Ritalin. Everything depends, not on the pharmacological effect, but the social context and cultural perception of the chemical.
Good drug/bad drug (same drug). Can we find this paradigm anywhere else? I bet we can if we look hard enough!
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Also, a similar critique of the NYT article was published in Forbes, but with an intriguing pro-Pharma twist at the end…
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No, Ritalin is not the same as cocaine, regardless of where one gets the information. Ask any drug addict who has tried both. Saying it is, is getting as simplistic as the chemical imbalance theory.
As to when someone has what is called ADD and has a different response to Adderall than those that do not, if the patient is honest (and that is a big if) and if psychological testing is done, you can tell the difference as the clinician prescribing as well as from the changes in psychological testing (which can not be faked). This psychological testing is very sophisticated and can indicate the precise areas of learning difficulty. I wish such good testing was available to help other sorts of mental distress or emotional distress.We do know that when someone really likes what they are doing, they can focus better, even with ADD. However, the mundane things of life we all have to do some or most of the time. We also know that previously untreated ADD has a much higher rate of substance abuse of all kinds of stuff.
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Point being, of course a meth analog helps an ADD patient concentrate. No doubt you will see a difference in testing. You’re likely to see the difference in anyone but those with exceptionally steely focus.
It’s speed!
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Um, just because you can test for a learning difference doesn’t mean that there is a chemical to fix that difference. And of course the intense focus effect of the stimulant wears off with habituation. Don’t have handy links…I think they are on this site, about the fall off of effectiveness of these chemicals. All stimulants have the same effect on the endocrine system and brain whether it’s coffee, crank, ecstasy, or ritalin. And then there’s the cumulative damage to the brain and heart. Change the teaching and the parenting, not children’s brains and bodies. Don’t maim the foot to fit a broken shoe.
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“Don’t maim the foot to fit a broken shoe”
I like that! I’d like to use that with your permission Jeanne.
This applys globally to our broken mental health system. How many people have we “maimed” over the years? How many more will be “maimed” for the sake of refusal to ackowledge the shoe is good and well broke!
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Yes, we agree, Jeanne.
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It’s ispiration from the Inner Curmudgeon, go ahead and use the slogan!
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I must take issue with the statements about the validity of psychological testing. Over many years of practice, I have seen qualified, experienced psychologists test children without first checking to see if they have had their hearing and eyesight checked; testing a child without his hearing aids in or having working batteries; aids stuffed with cerumen; without eyeglasses and on and on. Most troubling though, is the failure to determine whether or not the so-called ADD child has a history of early and severe ear infections that more often than not lead to auditory processing problems that look like inattention, cognitive impairment, even oppositional behavior along with what appears to be explosive outbursts including harm to self and others entirely due to the excruciating pain.
Environmental,social and cultural issues are every bit as important. There is no substitute for the time-consuming, careful interview and observation of the patient, listening with respect to what he/she has to say – or quite often, doesn’t want to say and listening carefully to parents. Alas, it’s much easier to “treat” with the prescription pad, isn’t it.
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Psychological testing for ADHD, are you kidding! I have an adopted son who suffered head injuries in an auto accident when he was but a baby. His teachers throughout his school years thought he needed stimulants like Adderall or Ritalin and we fought them for years. Teachers with MA are the worst. I have a younger biological son who was his highschool class Valedictorian and has now graduated from MIT, who had a major psychotic break, because he put himself on stimulants and push his mind to the brink, because the pdoc’s convinced him he had ADHD. We have doctors and teachers and parents, that are all well meaning, that want to put us into the same nice little box so that we all might look, and smell, and behave the same way. Wouldn’t that make their life easier, but thats not how God created us. I refer you to the song by The Beatles, Let It Be.
Look out the window and you will find we all see something different. To find a test to define that difference in what we all see and to narrow that down to one type of individual is not only crazy but is like trying to define crazy.
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Judith Rappoport et al thoroughly discredited the “paradoxical effect” theory way back in 1978. She gave stimulants to “normal” kids and saw the same effects as we see in “ADHD” kids: narrowing of focus, increased willingness to continue with activities normally found dull, reduced motor activity, etc. She called the idea that they worked differently an “artifact of observation” – in essence, we are LOOKING for these effects in those diagnosed “ADHD” and so we notice them when they happen.
Of course, the idea that “ADHD” kids don’t experience side effects is ludicrous on the face of it. There is no question that they suffer in great numbers from loss of appetite, sleep disruption, and reduction in growth. Less common side effects include increased anxiety or depression, agitation, aggression, “manic” episodes, psychotic symptoms (as high as 6+% in one study in the Canadian Journal of Psychiatry), increased heart rate and blood pressure, and many more. In that last case, actual harm to the heart muscle has been noted, and in rare cases, death has occurred that has been medically determined to be caused by long-term stimulant use.
Combine that with the clear data that there is no long-term positive impact on any important outcomes, despite 50 years of research, and it really is time to question why we promote this questionable practice. Oh, I forgot – we do know why. It keeps kids quiet and makes money for doctors and pharmaceutical companies. There is no other reason.
—- Steve
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It was great to read the article “with” you Bob. We also read last Sunday’s front page article on big pharma and workplace injury through the lens of Anatomy of an Epidemic . Oxycontin treatment has turned what used to be a few months of therapy and back to work recovered into a life of chronic pain and disability. The insurance companies and politicians may finally catch on.
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Yes! Diana, would you say more about this? Are hospitals “obligated” to ensure patients are not in any pain? Is this why they are so liberal with handing out the oxys? I’ve heard that their internal quality scores go down if people report they are in pain and the hospital isn’t addressing it adequately.
Hisorically, it seems to me, hospitals tolerated the fact that patients would be at a higher level of pain after certain procedures and so did the patient. This led to a shorter “disability” course. As you suggest, by minimizing pain in the short term we’ve increased pain over the long term. Surely this is yet another result of American’s penchant towards Pragmatism.
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David, what an interesting question you’ve raised about short term “obligation” to alleviate pain at the cost of long term healing. Or is it a growing cultural impatience for people expressing suffering? “He doesn’t need to suffer” was the line we were fed that lead us down the path of med treatment, with disastrous results, with a family member. (This same obligation or impatience may also help explain how cesarean sections have become a new normal despite the higher rate of mortality and longer recovery involved.)
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Here’s a link to a a story that began when a 19 year old Harvard U. sophomore received a prescription for Adderall from the NP at the University Health Services . No prior diagnosis of ADD, or any psychiatric disorder, this young man sought advice for improving, enhancing his study habits. Prozac and Wellbutrin were added to treat adverse effects of Adderall. when the student emailed the NP complaining of feeling more anxious, she responded via email “Make an appointment”. He did not follow up. Two days later he committed suicide.
http://abcnews.go.com/Health/dad-sues-harvard-sons-suicide/story?id=9303555
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This entire discussion, like so much else in psychiatry, would not be happening if we had a reliable way to diagnose “real” ADHD, or to prove that there is such a thing in the first place.
The downfall of psychiatry, in my opinion, will not come at the hands of reckless prescribers or a public outcry at the harms it causes (although those are certainly valid reasons), but when the profession wakes up to the fact that most of its basic premises have been built on thin air, and yet have been adopted as truth by a legion of “experts” whose medical eyes, to borrow Mr Whitaker’s phrase, are decidedly not wide open.
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I agree totally. All of this is based on diagnosis and all of that is based on faulty fantasies cooked up in the DSM.
It is not necessary for me to know a person’s diagnosis for me to “walk” with her/him on their journey of dis-ease. I don’t need to diagnosis the person; such things really have no bearing on dealing with the issues. It is in making the human connection with someone suffering dis-ease that makes the true difference. It is not a diagnosis nor is it toxic drugs. The issues are dealt with only in the listening and the caring for that human individual who is in terrible distress.
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I am quite sure that they are already well aware of that, and that it is the reason why they are so defensive about being educated.
It is why when psychiatrists are asked to read Whitaker’s books, they turn away and forget about it. Or, they read it and come up with lame and illogical arguments, “It’s because the patients who weren’t as sick didn’t need the drugs, not that the drugs made the sicker patients sicker! (Harrow study)”
Psychiatry is perfectly well aware that they have no real science behind what they do. I truly cant believe that anyone, especially not a med school graduate, could honestly believe that psychotropic drugs were balancing people’s brain chemistry. But they also know that to acknowledge the reality of their profession would be the end of it and all the money would disappear.
You said, “but when the profession wakes up to the fact that most of its basic premises have been built on thin air,” and you are right. That day will be the end of psychiatry and they already know it, and that is why we have this battle. But you said it as if you really believe that they are innocently ignorant. I truly believe they are not.
As Whitaker wrote at the end of the chapter titled The Story that was… And wasn’t told.
“There is a story that psychiatry doesn’t dare tel, which shows that our societal delusion about the benefits of psychiatry drugs is not entirely an innocent one. In order to sell our society on the soundness of this form of care, psychiatry has had to grossly exaggerate the value of it’s new drugs, silence critics, and keep the story of poor long-term outcomes hidden. That is a willful, conscious process, that the very fact that psychiatry has had to employ such storytelling methods reveals a great deal about the merits of this paradigm of care, much more than a single study ever could.”
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There’s a great deal of cynicism and passively going with the program among doctors. And I used to believe they were independent, scientifically minded thinkers!
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Perhaps its a cause & effect issue, in a Western culture of “I think therefore I am,” which has led us to this notion of diagnosis judgments & creating stimulants for “real” ADHD?
Is it because we’ve invested so much of our sense of self in a cognitive defense against our deeper “sensitive” nature, our soul? Have we become so “disembodied.” that can’t access the natural stimulants of organismic health within? Consider;
“TUMMY TALK:
The enteric nervous system is our oldest brain, evolving hundreds of millions of years ago. It produces many beneficial hormones, including 95% of the serotonin in the body, and thus is a primary natural medicine factory and warehouse for feel-good hormones. Amazingly, as much as 90% of the vagus nerve that connects our guts and brains is sensory. In other words for every one motor nerve fiber that relays commands from the brain to the gut, nine sensory nerves send information about the state of the viscera to the brain. Many of our likes and dislikes, our attractions and repulsions, as well as our irrational fears, are the result of implicit computations in our internal states.
It can be said that humans have two brains; one in the gut (the enteric brain) and the “upstairs brain,” sitting in the vaulted dome of the cranium. These two brains are in direction communication with each other through the hefty vagus nerve. And if we go with the numbers – nine sensory/afferent nerves to every one motor/efferent nerve – our guts apparently have more to say to our brains (by a ratio of 9:1) than our brains have to say to our guts. (p, 121)
When aroused to fight or flight (sympathetic arousal), our guts tighten, and the motility of the gastrointestinal system is inhibited. After all, there is no sense in spending a lot of metabolic energy on digestion, when it is best used to speed up the hearts rhythm and to strengthen its contraction, as well as to tense our muscles in readiness for impending action. (p, 122)
My approach to healing trauma rests broadly on the premise that people are primarily instinctual in nature – that we are, at our very core, human animals. It is this relationship to our animal nature that both makes us susceptible to trauma and, at the same time, promotes a robust capacity to rebound in the aftermath of threat, safely returning to equilibrium. More generally, I believe that to truly understand our body/mind, therapists must first learn about the animal body/mind because of the manner in which our nervous systems have evolved in an ever changing and challenging environment. (p, 225)
However, there is an almost violent schism lurking in our cultural zeitgeist. Lets face it; the fight against evolution by the proponents of “creationism” and “intelligent design” is not really about professed gaps in the fossil records; its about whether or not we are basically animals. (p, 225)
In fact, the word instinct is rarely found in modern psychological literature. Rather it is purged and replaced with terms such as drives, motivations and needs. While instincts are still routinely drawn upon to explain animal behaviors, we have somehow lost sight of how many human behavior patterns (though modifiable) are primal, automatic, universal and predictable. (p, 231)” Exerts from “In an Unspoken Voice” by Peter Levine, PhD.
After five weeks of psychosis energy peaked on the 7th, and is now dissolving as I re-emerge from the “well.” & the fire within. My 4th full term psychosis in the last 5 years and my “felt” understanding, “this is not a brain disease – its “nature” emerging from within?
Yet of coarse we think, “what could psychosis experience possibly teach, its just delusion & sickness, I think?” Therefore….
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“The literature shows that they experience the same harmful side effects that non-ADHD youth do.”
Are you sure you read the right literature Bob? As a well trained journalist, did go looking for an “angle,” to use as a “hook” in the your story about “us & them?” Do you really understand the term cognitive dissonance?
It is the easiest view in the world, too see the “obvious” in “their” nature, its another issue entirely to dig deep within oneself, and “feel” the nature of our endless emotional projections onto “them.”
“Myth is much more important and true than history. History is just journalism and you know how reliable that is.” _Joseph Campbell.
Please don’t all SCREAM at once, as you “react” to my perceived attack on a hero. This is not about me being disrespectful?
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Why are all of your posts so long?
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Ha!
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Good “reaction,” David? I’m sure you thought about it though.
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To try to bring an alternative view to the literature that psychiatry is “schooled” in?
If we read this “its all about the brain,” research stuff, which is more about the livelihood of the researchers than an attempt to uncover empirical evidence, what should we expect to see?
The stuff I post is science based, a language that psychiatry likes to think its founded on, so point towards science which shows “natural” cause.
I understand the “need” for short, plausible and easily digestible posts, but it is a complex and highly emotive issue we are trying to debate. Or we only here to point the finger of “blame.”
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Always Mr. Bates! Always.
Give us your pithy comments here and we will sign up for your online classes if we want the less digestible and complex bits.
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For our resident young genius with those shiny letters after his name?
In response to my wall promotion of Michael’s “Jung’s first dream post.
“Michael Cornwall, I’m humbled by your words David as i have looked to your voice for the clear understanding of madness that is beyond compare.
April 27 at 10:10pm”
So tell me young Mr Ross, at first glance subjective assumptions can be deceiving, No?
If you look more carefully, you may see that I’m trying to enhance Michael’s position, not detract from it?
Good friends will tell you what you don’t necessarily want hear, not just play sycophantic games with you? Its the nature of “honest debate.”
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By your logic we must be close friends…
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Why are they so cryptic?
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Ha! Two in one day. My my Mr. Bates.
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Because life is paradoxical, not “black & white?”
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These drugs do not discriminate when it comes to brain damage; they cause brain and body damage no matter the “why” one takes them. You have kids dying of heart disease at 14 having the same damage as someone who has been on ecstasy. (http://www.ritalindeath.com/)
School officials forbid “speed” while at the same time pushing it – one has to wonder about how educated they are if they don’t realize how crazy this is. Kids need to be taught to regulate their behavior – the answer is not in a pill.
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David (Bates), I am pretty familiar with the literature on ADHD and see nothing that suggests these agents act any differently on ADHD vs. non-ADHD kids. Why would they?
— Steve
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If your reading the literature of “pathology” what do you expect to see?
Have you read the latest literature on early childhood development? Or Allan Schore’s latest book?
“The Science of the Art of Psychotherapy (Norton Series on Interpersonal Neurobiology)”
The latest work from a pioneer in the study of the development of the self.
Focusing on the hottest topics in psychotherapy—attachment, developmental neuroscience, trauma, the developing brain—this book provides a window into the ideas of one of the best-known writers on these topics.
Following Allan Schore’s very successful books on affect regulation and dysregulation, also published by Norton, this is the third volume of the trilogy. It offers a representative collection of essential expansions and elaborations of regulation theory, all written since 2005.
http://www.amazon.com/Science-Psychotherapy-Norton-Interpersonal-Neurobiology/dp/0393706648/
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I am all about considering ADHD as a developmental phenomenon. A recent study showed that kids who entered Kindergarten early were something like 30% more likely to be diagnosed with ADHD. That’s not even getting into developmental trauma. But there are also many other potential reasons for the described list of behaviors.
Which is why I doubt anybody will ever come up with evidence that the “ADHD” brain is somehow defective. It is going to be different for each child. We all know that both genetics and environment affect brain chemistry and behavior, but we also know there are many reasons why a kid may act in the manner described as “ADHD,” including the simple concept that it’s a genetic variation that is important to species survival.
So it would make no sense that “ADHD” kids would respond differently to stimulants than “normal” kids, because “ADHD” kids aren’t a homogeneous group. Some have been traumatized, some have low iron, some have sleep apnea, some were entered into Kindergarten too young, some are “active learners” in an inactive environment, some are smart and bored to death with their insipid “education,” and some just don’t like sitting still and being told what to do. ADHD is not a disease phenomenon. “ADHD” kids are simply kids seeking more stimulation. If we really want to help them, we need to either figure out why they need this, or arrange an environment that provides it. The latter worked great for my two “ADHD”-type boys. They turned out fine, drug free, but we sure didn’t put them into a regular education classroom in Kindergarten!
It’s all about development – helping kids build on the strengths they have to overcome the challenges they face. No drug has yet been shown to help with that process.
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Wasn’t it a student of Adler’s who stated,”We cannot protect our children from life and that is why we have to prepare them for it.” A paraphase but I think it gets the general idea.
I often think of how in many childrens’ sports programs these days there are only “winners” and everyone gets trophies. I don’t want to make little kids feel badly about themselves because they may not be the greatest athelete at the age of six, but I think that giving everyone trophies denies a valuable learning opportunity for the kids and a great teaching opportunity for parents. As we all know, in real life everyone doesn’t get a trophy and to instill this expectation in kids is a disservice to them in their process of development. It hurts to see your child hurt, but learning to accept adversity and defeat is a vital part of developing. Parenting is the most difficult job in the world but if you don’t work with the development of your children you do them no service, even if you give them all opportunities and all the material goods. Sometimes, I get the feeling that it’s easier to let the child get labeled with a diagnosis than it is to work with their development as you did with your kids. Poking pills down them is a lot easier than dealing with their aggravating and disturbing behavior.
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Robert,
Great post.
When we are going to start calling these psychotropic agents by their real name?
They aren’t “meds”.
They’re “drugs”.
And they’re no different than the street variety.
And they’re no less dangerous.
Period.
Mary Ann Block, D.O. explains in her Congressional testimony –
http://www.youtube.com/watch?v=095sN0xP-UA&lr=1
For any NAMI members who read this blog:
Wake up!
We’re talking about kids!
And we’re talking about amphetamines!
Duane
Duane
Duane
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apologies for the multiple names..
not sure what happened, computer typing gliche
duane
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Robert, I emailed you a couple years ago about our son, an MIT grad who had been using Adderall and pushed himself into psychosis. Which was followed by numerous visits to numerous pdocs who where clueless as to what his problem was. Then I find a friends son had just went through a similar experiences. I can’t help but think and worry about how many parents are sending their child off to college only to get a call at some point that their son or daughter has been hospitalized at best. Wow…The damage cause by Amphetamines has to be or will be at epidemic levels. There is way more to this story…
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