Because I’ve served as a dissident child and family therapist for 35 years, I was stirred to write this article about reasons that I think loving parents choose to give their children potentially harmful psychiatric medications after I read, recently, that a new candy-flavored amphetamine drug for children is now on the market. It’s called Adzenys.
My inquiry began immediately, as I imagined parents saying “Here honey, enjoy your yummy Adzenys!” to their child every morning, handing them a new orange-colored and flavored, fructose-sweetened form of the time-released amphetamine Adderall.
The sweet, delicious-tasting, and almost playful-sounding new FDA-approved drug Adzenys, developed to increase compliance for children diagnosed with ADHD is now here. It was specifically designed to help parents to more easily get their children to take a prescribed drug.
It has this product description printed large on every package: “Adzenys – Amphetamine Extended-Release Orally Disintegrating Tablets. 9.4mg.”
In this article, I’d like to explore three of the main very complex reasons why I believe the parents of the 11 percent of all children ages 4 to 17 in the US now diagnosed with ADHD would choose to give their children amphetamine in this new candy-like form of Adderall, or to give their children any powerful prescribed stimulant drug under any circumstances.
Let’s ask ourselves why loving parents are choosing to fill the prescriptions for their child’s amphetamine against the backdrop of the tragic nationwide epidemic of methamphetamine addiction, given that Adderall and meth are both amphetamines, as any cursory Google search will show.
Let’s first consider a very big factor impacting parents’ decision-making process; how the incredibly successful marketing strategies of big Pharma affects parents, and then let’s consider the added enormous impact of a parent receiving a child psychiatrist’s ADHD diagnosis and medication treatment plan for their child, and finally let’s recognize how the crucial absence of trauma informed psycho-social services options for children has also created the void where parents try and get help for their children.
I have seen how all three of these factors powerfully combine to negatively affect parents’ decision making process about choosing the help needed for their struggling children.
First, the parents of kids diagnosed with ADHD are all potential customers of the drug companies who are experts at marketing psychiatric drugs to them directly. In Alan Schwatz’s excellent NY Times article called “The Selling of Attention Deficit Hyperactivity Disorder,” he described a 20-year ADHD drug marketing campaign that has contributed to the rise in children diagnosed with ADHD from 600,000 in 1990 to 3.5 million in 2013.
The huge ADHD drugs advertising campaign that runs commercials on TV, and that puts ads in magazines like People and Good Housekeeping, has very successfully worked to reach concerned parents who are looking for help for their children.
Shire, the company that makes Adderall, even recently subsidized the manufacture and distribution of 50,000 ADHD-themed comic books for kids to read. The comic books have messages like “Medicine may make it easier to pay attention and control your behavior!”
Due to Pharma’s greatly successful marketing campaign, ADHD drugs are some of the most prescribed psych drugs, with over $10 billion spent on them annually now in the US.
In the case of the new Adzenys, a lot of children already happily take tasty chewable vitamins every day, who have had problems swallowing pills with water. The ADHD drug manufacturer got FDA approval for candy-flavored Adderall, solely to increase medication use compliance.
But a huge part of the ADHD drug companies’ successful marketing plan is based on Pharma knowing it can count on psychiatrists to urge parents to purchase new drug products for ADHD and other DSM diagnoses.
This encounter with the disease model of psychiatry is the second big factor that parents face as they try and choose what’s best for a child who is on the verge of being diagnosed and treated for ADHD.
Because psychiatry has the major hand in the development of the ADHD DSM diagnosis in the first place, psychiatrists are naturally invested in having parents medicate their children with amphetamine-based stimulants to help the ADHD-diagnosed child be more able to focus and not be disruptive, especially while at school.
Medicating ADHD-diagnosed children with amphetamines is considered the “best practice,” that is most utilized in the uniform standard of child psychiatric care by physicians who believe in and practice the disease model of psychiatry. It’s very rare for parents to find one of the 25,000 psychiatrists in the US who don’t practice from the disease-model paradigm.
Since I’ve never shared that disease-model belief system while serving as a dissident licensed therapist, I instead look for things happening now, or that did happen in a child or teen’s life that may be causing them to be easily distracted, angry and/or restless – especially in the overly structured demands for regimentation compliance that’s enforced during school hours.
Even though I don’t believe in the validity of the ADHD disorder diagnosis, I have still been able to provide help to many children and teens who were given that diagnosis from other professionals, by engaging them and their families in therapy, without them taking meds.
Therapy is effective because there always are knowable and understandable reasons, in my experience, that children and teens struggle with their emotions and behavior. If we compassionately listen and take time to learn about what has happened and is happening in a child’s life and in their family and community, there is always an opportunity to help alleviate the causes and presence of so-called ADHD. The efficacy of therapy holds true for adults who are suffering from every form of emotional distress too.
So, for decades I’ve been right there in person with parents and kids to notice the second big reason why parents go ahead and decide to give their children prescribed amphetamine and other psych drugs.
The parents I see often have a hard time believing at first that any alternative, non-psychiatric disease model therapy approach could be beneficial for their child diagnosed with ADHD or other DSM diagnoses.
I can understand why, for the following reasons.
In addition to the fact that for decades the public has been indoctrinated into the disease model of psychiatry, to the point where now a majority of Americans believe emotional suffering is caused by a chemical imbalance or a genetic-based disorder, there is now an even more aggressive presentation being given to parents by psychiatrists about the impact of the disease model on their child’s brain.
Parents have recently described to me seeing child psychiatrists, with their child present, and having the doctor take out a plastic model of the brain and emphatically telling the parent that MRI scans now can show that the pre-frontal cortex of children with ADHD is “dark” and “not working right” compared to normal children. This powerful demonstration using a model of the brain is happening routinely now at one of the largest HMOs in the US.
I don’t believe there is reliable scientific research that proves that brain scans can establish a medical diagnosis of ADHD.
Almost all parents will take the doctor’s expert word on that graphic, frightening evidence, though, as they see the model of the impaired child’s brain being held up in full view.
It’s almost like a doctor holding up an X-ray to show a frightened parent the extent of the damage to their son’s or daughter’s obviously broken arm or leg.
It’s not surprising that parents believe the child psychiatrist. All parents have been turning to pediatrician doctors since their child was born for expert advice and medical care to help their beloved child be healthy.
The powerful aura of authority that the highly-trained medical school graduate and licensed MD always projects is of the professional who can be of crucial, even lifesaving, help for us and our loved ones in time of illness and injury. That aura of authority that MDs possess and that we all have deferred to as their patients many times ourselves is very important in setting the stage for a parent’s first fateful encounter with a child psychiatrist.
Many of us writing, reading and commenting here on MIA doubt to varying degrees the veracity of the psychiatric disease model of human emotional suffering.
But how can we better inform parents of our beliefs about alternative mental health care that are so different than what they hear from psychiatrists and other prescribing medical doctors – doctors functioning in the professional role that parents have been so inclined to trust and believe in their whole lives – even since they themselves were children.
It’s a real quandary. I hope this blog can prompt some serious discussion about how to better communicate an alternative model of causation and mental health care to parents who view medical doctors to be the most credible authorities.
But the third factor that contributes to parents choosing amphetamine or other drugs for their children is that there is such a glaring lack of funded trauma-informed alternatives available that can be offered to them, or can even be pointed to as proof that their child would be better served without meds.
At the large urban public mental health system where I served for almost 30 years the alliance of NAMI, big Pharma, and psychiatry was successful in imposing the disease model of care – first for adults, and then for children and teens. I saw the steady erosion of teen and child therapist services happen while the number of med-prescribing child psychiatrists multiplied.
That whole mental health system has devolved from only a handful of children being on meds in our county system, when I started there in 1980, until now when almost 100% of the hundreds of children and teens served are on meds.
Under the disease model system of care, 15 percent of high school students in the US are now diagnosed with ADHD, and most are only offered medication. The over-medication of children and teens in foster care – instead of providing them with needed psycho-social supports like counseling – is a national disgrace.
Robert Whitaker has documented how many of the children who are started on amphetamines like Adzenys or other stimulants as young children will go onto being diagnosed with a bipolar disorder as teenagers and young adults.
So, when all the factors mentioned above are added up, the stakes are very high when loving parents anxiously sit down across from a child psychiatrist who has completed an ADHD evaluation of their child. All of the parents’ high hopes for their precious child’s well-being and future happiness are pressing on the parent’s heart and mind. The psychiatrist leans to the side, reaches into a drawer, and lifts out a life-size model of a human brain for the parent or parents to see.
The little five-year-old sitting on the floor playing stops and looks up at a model of his or her brain as the psychiatrist breaks the bad news.
And the question is formed right then in the little boy or little girl’s soul that may haunt the child for the rest of their lives – “Why is there something wrong with my brain?”
How grateful I am when that family and child may finally sit in my room and I start to offer another story that doesn’t break the parents’ hearts again and doesn’t further close off the sacred light in the innocent child’s eyes.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.