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The pharmaceutical industry, working with the government and organized psychiatry, claim that such drugs as Ritalin, are a safe "treatment" for ADHD. School systems and courts have pressured and even forced parents to give stimulant drugs to their children. But hidden behind the well-oiled public relations machine is a potentially devastating reality. The problem with ADHD or ADD is already not whether or not ADHD is a subtype of ADD, but rather the problem is whether or not we should be medicating our children with drugs such as Ritalin.
Questions like the following often arise when discussing the issue: Are the side effects worth getting our children under control? Are all the children who are on Ritalin on it for just cause or are the drugs being abused? What does the future hold for these children who are using Ritalin and other stimulants? All these questions leave a lot parents wondering if they should put there young child on medications and what it will do to their future.
Millions of children are prescribed the stimulant drugs such as Ritalin, Adderall, Concerta and Metadate for Attention-Deficit Hyperactivity Disorder (ADHD) in the hope of controlling behaviors described as hyperactivity, impulsivity and inattention. These medications decrease restlessness, improve attention span, increase the ability to focus, decrease aggressive outbursts and improve social interaction. They are thought to work by adjusting the brain's chemical balance and reversing under-arousal, possibly by increasing the availability of certain neurotransmitters. About 75 % of children with ADHD respond well to stimulant medication with improved attention at school and increased academic productivity (Kidd, 2000).
Ritalin, the most commonly prescribed stimulant for ADHD, peaks 1 to 2 hours after it's taken and effects last about 4 hours. For maximum benefit it's taken three times a day, seven days a week - in order to sustain home as well as school interactions. (Some find that although the afternoon dose eases home relationships, it may exacerbate side effects such as poor appetite and insomnia.) A slow-release form taken in the morning may last the day (at least 6 to 8 hours). A few develop "drug tolerance" and need increasing doses to suppress symptoms. (High amounts may have some growth-retarding effect, requring a drug change.)
Side effects of Ritalin can include headaches, insomnia, reduced appetite and weight loss, stomach aches, occasional tics (grimaces, nail biting), a "zombie-like" stare, obsessive "over-focussing" (becoming over-engrossed) and emotional "constriction" (for instance shown by drawings where everything is miniscule or shoved tightly into a corner). Omitting the 4 p.m. dose might overcome the sleep problems but at the cost of disrupting home and family life. Most side effects can be avoided by giving smaller doses. Some children object to the "roller-coaster" feeling while on the drug, and want to feel "normal" again, leading to a drop-off in drug-taking. Some hate the idea of having their behaviour "controlled;" and some parents oppose the idea of "mind-altering" drugs for their kids (Kidd, 2000, p.20).
In any case, there are always some ideals that do persuade parents into giving their children stimulants. The one of the appeals, and usually a selfish one, is that the drug gets their child under control. Parents who are fed up with their child and their behavior think that there is no other way of getting their child to behave and automatically look for a drug to get the situation changed sometimes when the child hasn't even been diagnosed with disorder yet. The appeal greatens when guilt settles in. Parents sometimes feel responsible for their child's outbreaks and by giving him or her a drug it makes the parents feel as if something chemically is wrong, and isn't because of the child's upbringing (Brink, 2004).
But there are more reasonable and positive motives for using Ritalin for children with ADHD. A study was done by the National Institute of Mental Health (NIMH), which proved that children with ADHD and taking medication to relieve symptoms had a better chance of not dropping out school, not smoking, abusing alcohol and drugs, or going to prison compared to those who with the disorder but are not on drugs (Brink, 2004).
An experiment that was also done by NIMH seemed to further strengthen the belief that Ritalin does indeed work, is necessary, and leaves us with few alternatives. This experiment, which was conducted for fourteen months and involved 576 children, gave evidence that psychological therapy does not have a significant impact on children with ADHD and that drugs had a far bigger change in the children's behavior and lessened the symptoms more than therapy (Brink, 2004).
Besides short-term benefits for Ritalin, some studies show that there are some long-term ones as well. In 1988 scientists found improvements in cognitive functions in reading performances. Though it wasn't positive, and is also very controversial if the drug itself was creating the improvement or if it was the drugs ability to reduce the disorders symptoms, which helps the child focus, but in the end, there still was an obvious increase in learning.
Though frustration of child obedience, previously mention guilt, and hope for better grades often play a vital role in the decision of whether or not to put one's child on medication, there are some outstanding negatives that also make an impact on parents' choices on the matter.
One of the major problems with Ritalin is the side effects the medication causes its users. As mentioned before, these include effects as minor as stomach pains, sleep loss, loss or appetite and irritability. But side effects can be as serious as facial tics, anxiety, insomnia, and depression. (Hancock and Wingert, 1996) Other sever symptoms include increase in blood pressure, nausea, hypersensitivity, and temporary decrease in bone growth (White and Rouge, 2003). In February of 1996, the Food and Drug Administration released a study done on mice that showed that Ritalin might even have the ability to cause a liver cancer (Hancock and Wingert, 1996).
Also, in relation to side effects, is a lawsuit that took place in 2000 in California and New Jersey. Parents sued the American Psychiatric Association (APA) and Novartis Pharmaceutical Corporation for "failed to advise potential consumers... of the nature and extent of potential side effects... despite information in medical and scientific literature concerning these side effects of Ritalin use." The side effects that are being referred to are cardiovascular, central nervous system and gastrointestinal problems.
The suit also investigated teachers who persuaded parents to take their children to doctors who where known for giving children Ritalin (School Law News, 2000, p.1).
It is being feared by many physicians that Ritalin is being overly prescribed to children. Some doctors are seeing patients that have been told to have ADHD, but in reality have other problems such as learning difficulties or depression. Parents often even ask doctors for Ritalin, even when their child does not have a need for it, but the child's parents want to see his or her grades rise. Some doctors even admit to giving children the drug without doing much background checking of the child or any psychological tests that may prove the child has other problems. (Hancock and Wingert, 1996). ADHD is diagnosed without much hoop jumping. There are sixteen different symptoms that ADHD is connected with, and if the child has eight of them then all too often he or she is automatically considered to have ADHD; often without taking any other disorders or problems into consideration such as anxiety or depression (Donnelly, 1998).
It seems as though parents are able to get their children the drug almost at demand. If they feel their child is in need of the stimulant, there is little stopping them from receiving it. Skepticism of ADHD and stimulants continue getting more serious when taking in some of the statistics. One fact that may change someone's thoughts on the disorder is that 8 in 10 children with ADHD are boys (Donnelly, 1998) But does anyone put into consideration that girls develop and become mature faster than boys? Or is it being forgotten that kids are just kids and are not always going to act as teachers and parents desire?
Another issue relating to Ritalin is the possibilities of unknown long-term effects that have not yet been discovered. There have not been any long-term studies done on children who have taken Ritalin. Since ADHD cannot be tested by blood tests or any other kind of testing, there is always the chance that children are being misdiagnosed and receiving stimulants for a disorder that they do not have (Hancock and Wingert, 1996). Children sometimes have symptoms that seem like ADHD but aren't at all. The child can have problems such as chronic fear, mild seizures or even chronic ear infections, all of which may make adults assume the child has the disorder, but in reality has something completely different. Often problems at home make children act up as well. There maybe an abusive parent at home that makes a child be difficult in the classroom. In cases like these the child is not in need of drugs, but needs counseling (White and Rouge, 2003).
Another negative aspect of the drug is the abuse of it. Because of the increase in prescribing Ritalin, the number of high school and college students abusing the drug has also increased. The drug is often bought from other students who are either on the drug or whose brother or sisters are. Ritalin is used by it's abuses by either being snorted or injected which gives the user a six hour mellow high, often compared to the high that cocaine gives. On college campus, sixteen percent of students questioned admitted that they had used Ritalin in an illegal way. Because of the number of abusers has increased so quickly, the country of Sweden has withdrawn Ritalin from the country completely (White and Rouge, 2003)
The concept of ADHD and its medications are really hard to justify. There are some very valid reasons for putting children on the drug, especially helping them pay attention in school and having the same opportunity as the rest of the children in their classes. But the side effects are just mind boggling. I think even the slightest chance of some of these side effects mentioned would want parents to search for alternatives for their children and keep them away from the drug.
Another problem about ADHD is the fact that doctors cannot find anything psychically different from the children diagnosed with the disease from those that are "normal." Dr. Thomas Millar, a retired Vancouver child psychiatrist, goes as far as to say that ADHD is a "mythical disorder"(Donnelly, 1998, p. 2). He also says that the problem is not hyper children, but rather its poor parenting. Children that act as children do- easily excited, short attention spans, and hyper (all symptoms of ADHD)- are not considered to be acting as normal children, but rather as children with a disorder. I think Dr. Millar put it best when he said, "If Tom Sawyer was around today, he'd be Ritalin, as would any other normal boy in literature. Today, parents don't have any idea of what child behavior ought to be."
Parents who start giving their children this drug at ages as earlier as two, I think, are looking for quick fix and are being lazy. How can parent decide that a two year old is being hyperactive (White and Rouge, 2003)? Most two year olds are active and have little to no attention spans. I think this only teaches children that drugs are the answer to all our problems. By putting a child on a mind altering drug at such a young age, when he or she has not even started school yet, it leaves a parent with very little evidence or reason for their action. The child does not have schoolwork yet, and has little need for paying attention for long periods of time, so what does this child need the drug for? Because the child is difficult and more active than a parent wishes? It almost seems as if parents want to change their child's personality and make their childhood less interesting. I think it's very important that parents do not view Ritalin as the first and only way of calming their child down.
All in all, Ritalin is a very controversial drug in our country because of its side effects and the insecurities of diagnosing ADHD. The drug carries very important help for children who are struggling to pay attention and without a doubt do have a disorder. But the number of children who are on the drug for the wrong reason is a scary thought. Are we become so impatient with our children that we do not want to take the time to discipline or help them through their problems? Have our children become so bad that we are willing to risk their health so they calm down and do not embarrass us? Our society needs to learn more about this drug that too many of us are so quickly giving to our children.
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