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Ritalin
As of April, 1999, it is estimated that at least 4 million American children
have been diagnosed as having ADHD (attention-deficit-hyperactivity-disorder).
These 4 million children (80% of whom are boys) have been prescribed Ritalin.
Ninety percent of the worldwide supply of Ritalin is prescribed in the United
States. The drug has been around for about 40 years and has grown in popularity
in the past decade because of its success in calming off-the-wall behaviors in
children. About one hundred years ago, when cocaine was legal, whiny or colicky
kids were given a dose of “mother’s little helper†to calm and quiet
them. The 90's version of “mother’s little helper†is Ritalin.
Ritalin is not a sedative, but a stimulant similar to cocaine. The drug has the
reverse effect on children than it does on adults. When children take Ritalin,
their actions tend to be more goal-oriented than before. They become less
aggressive, less apt to get into trouble, and more compliant. They are better
able to follow rules, making them easier for adults to handle. Parents and
teachers are very often pleased with changes they see in a child who has been
placed on Ritalin. However, the fact is that the drug usually does nothing to
enhance learning or improve academic achievement over the long term. Studies
have shown that at the end of five years, children diagnosed as having ADHD and
receiving Ritalin did not differ significantly from children who had not
received the drug. In addition, the method by which children are diagnosed as
having ADHD is questionable, to say the least. In most cases, children are
diagnosed as having ADHD by a family physician, not a psychiatrist or
pediatrician, who makes the assumption that these children have a brain
dysfunction or disease. Neurological tests are rarely, if ever, performed.
These doctors rely on the word of parents or teachers. Scales used to check for
ADHD give the appearance of scientific tests, as if the tests were measuring
something tangible, like blood sugar levels. The fact is that ADHD is entirely
defined in behavioral, not medical, terms. Studies have shown that when
parents, teachers, doctors/clinicians rate the same child, they come up with
widely varying scores. ADHD is diagnosed merely by subjective observations.
There is no true test, medical or otherwise, to diagnose ADHD. Hyperactivity is
the most widely treated non-disease since women were institutionalized for
“the vapors†(hysteria). So, who gets diagnosed with ADHD? According to the
American Psychiatric Association, children who “interrupt others, and have
difficulty following instructions,†or who have difficulty conforming to the
rules of a classroom may be diagnosed as having ADHD. Another of the criteria
for ADHD is aimed at children who blurt out answers to questions before the
question has been completed. Children may be suspected of being hyperactive if
they are “sassy,†or if they have a tendency to “want to run things.â€
Children who are especially sensitive or timid, or have their feelings easily
hurt might be suffering from ADHD. According to these criteria, it is hard to
avoid the suspicion that just about any kid who doesn’t easily fit into the
school or family system has ADHD. The Revised Conner’s Questionnaire goes so
far as to state that children who behave in a “childish†way are displaying
a symptom of ADHD. So, there you have it. That covers just about every child in
the world. Any child who doesn’t fit some Victorian norm of prim and proper
behavior is a candidate.
If, in the opinion of the teacher, a child is disrupting the classroom and that
child’s parents can’t teach him/her to behave, then the parents should do
whatever it takes to bring the child under control. After all, a teacher must
have order in the classroom. This may be true, but at what cost? Children are
expected to sit still hour after hour, and do what they are told. This is not
only frustrating for children, but it is totally unnatural. Humans are
programmed by evolution to develop and learn by touching, moving, and being
involved. Perhaps it’s time we stopped running our schools like maximum
security prisons, just for the convenience of the teachers and administrators
who work in them. A good number of schools teach little more than obedience and
conformity. Parents expect that teachers, doctors, and other professionals give
good advice on this matter due to their experience and training. It is
surprising, then, that the children of teachers and doctors receive the least
treatment for childhood behavioral disorders. And it is shocking that these
people would push onto other people’s children drugs they would not use on
their own.
In one case, Dan, a first grade student, was failing everything. Dan’s
parents went to several conferences at his school to discuss what could be
done. Teachers and counselors told Dan’s parents that Dan had trouble paying
attention and learning. Nothing they had tried to help Dan was working. The
school psychologist was brought in. She told Dan’s parents that he didn’t
meet all the criteria for ADHD, but if he did, they could get him help with
Ritalin. The psychologist gave Dan’s parents several pamphlets to read, all
pro-Ritalin. Since nothing they had tried so far had worked, and since school
officials were so reassuring, Dan’s parents gave their permission for the
psychologist to change Dan’s evaluation so he would meet the criteria for
ADHD. Then Dan’s mother was given a copy of his evaluation to take to a
pediatrician who was recommended by the teachers and counselor. Dan had never
been to this doctor before. The doctor saw Dan for less than fifteen minutes,
never even looked at the evaluation, and wrote a prescription for Ritalin.
Dan’s grades did not improve. Dan’s mother realized that she had become so
anxious for Dan to succeed that she became impatient when he didn’t know an
answer. Dan was so scared of getting anything wrong that his fear was getting
in the way of his learning. As soon as she let up on her son, things began to
improve.
His parents took Dan off Ritalin in the middle of second grade. School
officials told them they were making a big mistake. They said that once he had
a problem, he would always have a problem. Dan repeated second grade. He was on
the honor roll most of the third grade. The changes Dan’s mother made in
regard to her son’s learning environment at home helped Dan to be successful
in school. Ritalin did not. Dan’s parents made their decisions with the best
interests of their son in mind, not for the convenience of Dan’s teachers.
Many teachers, and just as many parents have a lot less tolerance these days
for just letting kids be kids. Some parents, who may be weary of the
time-consuming methods of child-rearing want quick solutions to their
children’s problems. Is a mind-altering drug the answer? What about the
emotional and psychological consequences related to labeling a child as having
ADHD and putting him/her on drugs? This diagnosis and treatment become a
permanent part of a child’s health and educational records. This does not
help the child build self-esteem and self-respect. There must be some danger in
having these children believe they have something wrong with their brains that
makes it impossible for them to control themselves without a pill. Children
also know that the most important adults in their lives, parents and teachers,
believe this too. Children cannot learn to understand their emotions and deal
with them constructively when they are told to take a drug to make them go away
or when their feelings are pharmaceutically controlled.
The long terms effects of Ritalin are not known. Most children who are
prescribed Ritalin take the drug for several years, possibly even through
college. Some begin taking it as early as five years of age, and in some cases,
as early as the age of one. Ritalin is a Schedule II Controlled Substance under
the federal Controlled Substances Act, as are cocaine, opiates, and
methamphetamine. While parents are telling their children the dangers of
becoming involved with drugs, over 4 million of those parents are giving their
children Ritalin every day, a drug that is in the same classification as
cocaine and that has similar effects as cocaine. The drug is believed to work
by activating the brain stem arousal system and cortex. It works on the
neurotransmitter dopamine. In this way, it resembles the stimulant
characteristics of cocaine. Novartis Pharmaceuticals Corporation, the company
that manufactures Ritalin, says that the drug is not addictive if used as
directed. Why would they say anything to the contrary? Ritalin is a booming
business for them. Sales had increased from $109 million in 1992 to $336
million in 1996, according to IMS America, which tracks drug sales. Even when
taken according to prescription directions, there is a risk of developing
dependence and tolerance to the drug. The manufacturer advises physicians to be
watching out for the following effects:
nervousness and insomnia
loss of appetite, nausea, and vomiting
dizziness, palpitations, headaches
changes in heart rate and blood pressure (usually elevation of both)
skin rashes and itching
abdominal pain, weight loss, and digestive problems
toxic psychosis, psychotic episodes, drug dependence syndrome
severe depression upon withdrawal
Being a Schedule II drug means that, among those substances regarded as having
medical use, it is considered to have the highest potential for abuse. Since
Ritalin is a Schedule II Controlled Substance, the federal government strictly
regulates the amount that may be manufactured. As ADHD diagnoses increased over
the past several years, the manufacturing quotas have not increased
sufficiently to allow for the increased demand, which has led to regional
shortages of Ritalin. Diversions of Ritalin into the illicit street drug trade
has increased the shortages of the drug for legitimate medical purposes.
Ritalin, nicknamed “kiddie cocaine,†“Vitamin R,†or “The R Ball,â€
is fast becoming the drug of choice in middle schools. Kids share their
prescription or sell pills to their friends, who crush them up and snort them
for a quick high. This has increased drug dealing among middle school aged
children and has caused several deaths. John Breeding, Ph.D., a psychologist,
states, “Ritalin is becoming the gateway drug that leads kids into later drug
use. We’re programming our children to think drugs are the fix for
everything.
When purchased with a valid prescription, Ritalin tablets usually cost between
25 and 50 cents each. In the street drug market, tablets sell for $3 to $15
each. The tablets are crushed and snorted or the powder from the crushed tablet
is mixed with water and liquefied, then injected. To make the 5-20 mg. dose
tablets large enough to handle, at least 100 mg. of inert ingredients are added
to the tablets. Inert ingredients found in Ritalin are lactose, starch,
polyethylene glycol, magnesium stearate, sucrose, talc, cellulose, mineral oil,
and various dyes and conditioning agents. Although these ingredients are inert
when taken by mouth, they can cause serious problems when injected or snorted.
By injecting Ritalin, many of the body’s natural defense mechanisms such as
the skin, respiratory cilia, digestive acids, etc. are bypassed. The syringe
allows anything in it (drugs, dust, bacteria, pollen, fillers, etc.) to pass
directly into blood and body tissues. The inert ingredients that the
manufacturer adds to Ritalin to increase bulk may be harmless when taken by
mouth, but talc, cellulose, mineral oil, and sugars can create serious problems
when injected directly into veins or body tissues. Some of these problems are:
blood clots from scar tissue, particles in the liquid, cotton and lint fibers
pulmonary problems (“addict’s ling,†embolisms)
skin and circulatory problems
There have been numerous reports in medical journals about permanent and
irreversible lung tissue damage related to injection of crushed Ritalin
tablets. By snorting crushed Ritalin tablets, the epithelial tissues that line
the nasal cavities and air passages may be damaged. Ritalin tablets contain the
hydrochloride salt of methylphenidate and give out hydrochloric acid when they
come into contact with moisture. Hydrochloric acid is one of the digestive
acids used in the stomach. However, in the nasal passages, the acid can
“burn†the delicate nasal tissues, resulting in open sores, nose bleeds,
and possibly deteriorate the nasal cartilage.
Who benefits from the over 4 million Ritalin prescriptions written in the
United States? Teachers benefit. Their classrooms are quieter and their
students are easier to control. Insurance companies benefit. It is cheaper for
them to cover the cost of Ritalin than to cover behavior modification
treatments for children. The pharmaceutical companies benefit, as evidenced by
the increased profits from Ritalin over the past few years. Doctors also
benefit, because what was once considered a behavioral problem in children is
now viewed as a medical one. Doctors evaluate the child and then write the
prescription for Ritalin. It is clear that the children who take Ritalin do not
benefit from the drug. In most cases, grades do not improve. Ritalin is fast
becoming the drug of choice among middle school aged children, and may even
lead to later drug use as adults.