Monday, September 18, 2000

Popping pills

Talk about mothers with attitude. Two New Jersey moms are suing the makers of Ritalin, the anti-ADHD wonder drug, claiming that the company conspired with the American Psychiatric Association to make the definition of attention deficit disorders impossibly broad and then conspired with the parent advocacy group CHADD to promote the heck out of them. And why did they cause a large percentage of American boys to be classified as clinically challenged? To bring peace and order to our classrooms? To allow families to gain control of unruly members? No, the suit alleges a much more prosaic reason: To create a wider market for its medication.

Nice work, that. Not peddling enough pills? Convince a large portion of the populace that they’ve gotta have ‘em, even if there’s no real compelling proof that they do. Better still, convince them that the pills will make their children behave. Can’t resist that. Throughout the land, parents and educators devote countless hours to persuading young people to Just Say No to drugs. But when it comes to this particular drug, the message is: Just Try It. No harm. No side effects. No wait for results. You can go off it any time you want. Why not just try it. A schoolyard drug dealer couldn’t make any more seductive pitch.

It’s hard not to look at the definition of ADHD in the "Diagnostic Statistical Manual of Mental Disorders”--the book that psychiatrists use to diagnose the disorder, and the book in which the drugmakers are accused of planting it--and wonder if they’re not just pathologizing childhood. Amongst the behaviors that can get a youngster a diagnosis and a perscription are fidgeting, squirming, difficulty waiting turn, losing things, interrupting, and ignoring adults. All sound like fairly typical, if not mandatory, childhood behaviors. (Many are fairly typical adult behaviors, too.) When did traits that annoy parents and teachers go from matters of discipline to matters of medication?

And yet I’ve heard plenty of testimonials to the drug on parenting e-mail lists, from parents who’ve agonized over the decision, delayed it as long as possible, then wished they’d done it sooner. They feel that it has given them back their child and their family. I respect their opinions, and know that no amount of legal maneouvering will ever convince them that their children’s affliction is not real. At the same time, I have a very active small boy whose fidgeting, squirming, interrupting, and ignoring are causing me no undue distress. We’re coping fine, he’s learning fine, behavior modifications are working fine--and I’ve been having to beat off drug-offering doctors with a stick. Five minutes of observation is usually enough to convince them that he needs Ritalin, quick. And if I want to wait, I’m holding him back.

Proponents of ADD/ADHD will tell you that it’s a medical malady, a chemical imbalance in the brain, and medications like Ritalin simply right that imbalance. Yet no doctor has ever said, "I can see with my chemical x-ray vision that your son's level of serotonin is insufficient to cause the appropriate firing of neurons in his cerebral cortex. Please allow me to give him some medication that will boost his serotonin levels." No, it's more like "Geez, does that kid ever sit still? Give him a pill already." The diagnosis seems to be purely observational, and often the opinion of a few peeved adults is enough to get a kid on drugs. That sort of lack of objectivity is bound to lead to trouble. And in this day and age, trouble naturally leads to lawsuits.

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