Ending Addiction for Good

Diagnosis: Human

Are children and teens being over-prescribed medication for ADHD?

A recent blog post written for the New York Times by Ted Gup, an author and fellow of the Edmond J. Safra Center for Ethics at Harvard University, recounted his experience with his son, David’s diagnosis of ADHD at a young age. David’s experience with doctors that prescribed medication without even meeting him or refusing to see him until he was medicated resulted in prescriptions for Ritalin, Adderall and other drugs. Gup feels this was the beginning of the out of control spiral of drug and alcohol abuse that prematurely ended David’s life in 2011. His father admits that David was the one ultimately responsible for his behavior and choices, but also pleads with us to understand and to consider that the situation that David created and responded to was one that mirrors our society of easy access to medication.

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About 11% of school age children are diagnosed with ADHD. For some, medication can vastly improve their lives. For others, it can lead to anxiety, addiction and occasionally psychosis. These diagnoses have increased 16% since 2007 and 41% in the last decade. Doctor and patient advocates applaud the increased diagnosis rates as evidence that the disorder is being better recognized and accepted. Others are concerned that the diagnosis is being used to simply control behavior and enhance school performance.

“There’s no way that one in five high-school boys has A.D.H.D.,” said James Swanson, a professor of psychiatry at Florida International University and one of the primary A.D.H.D. researchers in the last 20 years. “If we start treating children who do not have the disorder with stimulants, a certain percentage are going to have problems that are predictable — some of them are going to end up with abuse and dependence. And with all those pills around, how much of that actually goes to friends? Some studies have said it’s about 30 percent.”

Trading or selling prescription ADHD drugs is becoming another rising problem. About a third of students who have been prescribed these medications have been asked to trade or sell them to other students. The dangers of a student taking these medications is very real and very deadly.

The C.D.C. director, Dr. Thomas R. Frieden, likened the rising rates of stimulant prescriptions among children to the overuse of pain medications and antibiotics in adults.

“We need to ensure balance,” Dr. Frieden said. “The right medications for A.D.H.D., given to the right people, can make a huge difference. Unfortunately, misuse appears to be growing at an alarming rate.”

Gup’s concern about over diagnosis and permissive drug use goes beyond hyperactivity. The Diagnostic and Statistical Manual Mental Disorders (DSM), expands depression to include some forms of grief. But its description of this form of depression is actually the definition of grief itself. We live in a society that claims that there is a drug to fix everything that we may experience…does that include life itself? Is being human a condition? We need to enhance our resiliency skills so that we do not require medication every time we have a feeling. But instead, we sometimes undermine ourselves and seek shortcuts that do not really exist.

Gup concludes with:

The D.S.M. would do well to recognize that a broken heart is not a medical condition, and that medication is ill-suited to repair some tears. Time does not heal all wounds, closure is a fiction, and so too is the notion that God never asks of us more than we can bear. Enduring the unbearable is sometimes exactly what life asks of us.

But there is a sweetness even to the intensity of this pain I feel. It is the thing that holds me still to my son. And yes, there is a balm even in the pain. I shall let it go when it is time, without reference to the D.S.M., and without the aid of a pill.

 

 

http://www.nytimes.com/2013/04/03/opinion/diagnosis-human.html?_r=2&

 

http://www.nytimes.com/2013/04/01/health/more-diagnoses-of-hyperactivity-causing-concern.html?pagewanted=all&_r=0

Constance Scharff, Ph.D. is the Senior Addiction Research Fellow and Director of Addiction Research at Cliffside Malibu Treatment Center.

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