The hysteria over ADHD meds continues. I was joking before about stockpiling my meds, but as the drumbeat against ADD/ADHD meds continues, I’m beginning to wonder if maybe it would be a good idea to do just that. Not because I’m worried that they’ll be banned outright, but if the current trend continues, they may be a lot more difficult to get — even for people who benefit from taking them. First, it was the “black label” recommendation from the FDA advisory committee. Now it’s a report, via the Washington Post, suggesting that “millions” are abusing ADHD medications.
More than 7 million Americans are estimated to have misused stimulant drugs meant to treat attention-deficit hyperactivity disorder, and substantial numbers of teenagers and young adults appear to show signs of addiction, according to a comprehensive national analysis tracking such abuse.
The statistics are striking because many young people recreationally using these drugs are seeking to boost academic and professional performance, doctors say.
Although the drugs may allow people to stay awake longer and finish work faster, scientists who published a new study concluded that about 1.6 million teenagers and young adults had misused these stimulants during a 12-month period and that 75,000 showed signs of addiction.
So, first it was a risk of heart attack that seemed to affect a small percentage of those taking the medicine that catalyzed the “black box” recommendation. Now it’s a risk of abuse by people who aren’t diagnosed with ADD/ADHD that’s ratcheting things up a bit.
I’m not that surprised by the article, honestly. I head the same basic claim last week when I listened to a webcast of the Diane Rheem show that was all about the “black box” warning. In fact, the show even featured Dr. Lawrence Miller, a California pediatrician who was also quoted in the Washington Post article.
Lawrence Diller, a pediatrician in Walnut Creek, Calif., who prescribes the drugs but is worried about their overuse, said that the new study showed the real health concerns are with diversion and abuse, not with rare side effects. “Seventy-five thousand addicts to prescription stimulants is much more troublesome than the 100 to 200 adults who have strokes,” he said. “Houston, we have got a problem because we are just in the middle of this epidemic.”
What doesn’t get mentioned in the article is that Diller is also the author of Running on Ritalin : A Physician Reflects on Children, Society, and Performance in a Pill. But you have to listen to the Rheem show to hear how close this guy comes to some of the “ADHD doesn’t exist” rhetoric. While he’s careful to make statements like “it’s not that these medicines are terribly dangerous or that they don’t have benefits,” and argues for a combination of the lowest effective level of medication along with non-drug interventions, he also makes statements about the use of “punishments” as one of those non-drug interventions. (i.e. Parents just need to beat their supposed ADHD children more often.) He’s also made statements like this:
Lawrence Diller, a behavioral pediatrician and author of the book,Running On Ritalin, looks critically at the recent rise in medicating children in the United States. He notes that children who have trouble sitting still and paying attention in school would have been handled differently a hundred years ago. Diller says we have rightly decided not to use corporal punishment, but worries that drugs may have taken its place in keeping kids in line in school. “We’re no longer willing to intimidate children into compliance, but we might just be willing to drug them into it.”
And his remarks about “including fathers” in the process of assessing children for ADD/ADHD sounds reasonable too. Sure, depending on the family configuration, both parents should be involved. But Diller’s argument seems to echo the whole “ADHD medication = feminization of boys” argument when he suggests that getting fathers involved will greatly reduce the number of kids getting these mediations (presumably because of the assumption that fathers will be more likely to apply punishment as a “non-drug intervention).
During the Rheem show, Diller also dismisses the NIMH study I mentioned earlier, which showed that alternative treatments like restrictive diets didn’t have much of an effect on something like 95% of kids with ADHD, and brushed aside the argument that ADHD medications have saved lives in some cases where treatment reduced the risk of substance abuse.
Maybe I’m overreacting to this, but it just seems to me that the one group of people getting pretty much left out or brushed aside in these discussions lately are those who have benefited from these medications. That only makes sense. After all, why spend much time listening to people who claim to have a condition that you’re pretty certain probably doesn’t exist. Sure, they benefited from medication, and maybe they have better lives than they had before medication and treatment, but that’s only because they weren’t willing to try harder and they weren’t punished enough. So, if they end up having a harder time getting medication, that might actually be good for them. Maybe a giant step backwards can also be a giant step forwards.
Maybe I’m skeptical because I’m one of those people who benefited from stimulant medication, after trying just about everything else and finding that they either didn’t work or that they had side effects that I couldn’t live with. I understand that these medicines aren’t necessarily for everyone. Some people can’t tolerate the side effects and/or don’t want to take the medications, and no one should have to take them.
So, if there are alternative treatments or “non-drug interventions” that work for some people, I’m all for them. But why make it harder for people who can and do benefit from these medicines to get them? Because that’s where the current trend seems to be headed.