Kuro5hin.org: technology and culture, from the trenches
create account | help/FAQ | contact | links | search | IRC | site news
[ Everything | Diaries | Technology | Science | Culture | Politics | Media | News | Internet | Op-Ed | Fiction | Meta | MLP ]
We need your support: buy an ad | premium membership

[P]
Controversy and Legislation Over Ritalin and Other Drugs

By ubernostrum in MLP
Sun Aug 19, 2001 at 03:49:54 PM EST
Tags: News (all tags)
News

This article in the New York Times (click here to read it sans NYT registration) explores some recent issues surrounding Ritalin and other drugs commonly prescribed for treatment of ADD and/or ADHD. There's some noticeable bias in the writing, but overall it's a good read and covers a lot of ground for a two-page article.


Among other things, several states have passed or are considering legislation which bars schools from recommending or requiring the use of drugs to treat certain "learning disorders", and the companies which manufacture the drugs have broken a long-standing "treaty" (an agreement which apparently isn't backed by any applicable law) in which they agreed to market to doctors, and not directly to parents and families. In fact, they're placing full-page, heart-warming ads in magazines like the Ladies' Home Journal.

There's a lot going on here: the perceived overdiagnosis of ADD and ADHD and an associated over-prescription of Ritalin and similar drugs; the dynamics of the market for ADD/ADHD drugs and the different drugs on the market (some of which have more lasting effects than Ritalin, removing the need for storing drugs at school and visiting the nurse for a mid-day "booster"); the dangers of a controlled substance of this power being so widely available; the ethics of letting people who may not be technically qualified to make decisions about treatment make or heavily influence decisions about treatment anyway; and the perception that our schools and our society look for the "quick fix" rather than making an informed decision, and although there is a noticeable slant against the drug companies and the schools, the NYT does a good job of introducing it all.

Sponsors

Voxel dot net
o Managed Hosting
o VoxCAST Content Delivery
o Raw Infrastructure

Login

Related Links
o This article
o here
o Also by ubernostrum


Display: Sort:
Controversy and Legislation Over Ritalin and Other Drugs | 21 comments (20 topical, 1 editorial, 0 hidden)
ADHD (3.82 / 17) (#1)
by Signal 11 on Sun Aug 19, 2001 at 06:06:12 AM EST

I was discussing ADD/ADHD with my mom, who is a psychologist. She, and many of her colleagues, don't believe it really exists. That begs the question, of course, of what they're diagnosing then.

I think that ADD/ADHD is a confirmation of what many of us have suspected of psychology - that there is no disease. There is a problem, however, in that we are trying to drug boys up to turn them into girls. The incidence rate for ADHD is something like 5-10x higher for boys than girls. If this was a real disease, a neurological disease, then it wouldn't be linked to the Y chromosome - nobody has dared to say intelligence is linked to gender, but here we have a disease very obviously contradicting our best understanding of the human brain... yet few notice that fact.

ADD/ADHD, IMO, is an excuse for society to pathologize boyhood. In this politically correct era, the youthful energy of boys is often looked on as bad. It wouldn't be so "bad" if there was a war to fight, but right now, it's politically a bad time to be a boy with a lot of energy. I think that this "disease" is the direct result of political circumstance...

By the way, what the hell are you doing up at 5:00am submitting articles? :^) Oh wait... what I am I doing posting this comment at 5am? hehe.


--
Society needs therapy. It's having
trouble accepting itself.

A slight correction.... (4.12 / 8) (#2)
by nads on Sun Aug 19, 2001 at 06:18:18 AM EST

... I think you mean to say that it shoudl be linked to the Y Chromosome (males carry XY, while females are XX). Note, very few genes are actually stored on the Y chromosome, tis small, the info to determine sex, as well as a region to pair it to the X chromosome, and a few other genes. Once sex is determined, biochemical compounds change concentration levels (testosterone, estrogen, etc..). These levels effect production of other biochemical compounds, which in turn could effect neurological development. In other words, just because it's not linked to the Y chromosome, doesn't mean that men are not more prone to get it. It can be linked to men through other more convuluted means.

I agree with you when you say that the disease might not exist. In my opinion, most of abnormal psych is on very philosophically dubious ground. Of course thats way off topic. I'll also throw in a me too on the emasculation of boys. Oh and while we are being pro-male (patriarchal I guess!), might as well mention that females outnumber males at most universities (not that I mind :D), and the gap is likely to grow.

[ Parent ]

females at unis (4.66 / 3) (#7)
by Psychopath on Sun Aug 19, 2001 at 02:29:42 PM EST

>.. mention that females outnumber males at most > universities
unfortunately not the case at most technical universities. At least where i'll go to not..
;(
J.
--
The only antidote to mental suffering is physical pain. -- Karl Marx
[ Parent ]
Obviously... (4.00 / 1) (#13)
by dgwatson on Sun Aug 19, 2001 at 11:25:27 PM EST

You go to the wrong university!

Doncha know, the main purpose of going to college is to pick up chicks!

(says the chick-less straight-A student who goes to a major state uni ;)

[ Parent ]
In fact (4.00 / 3) (#8)
by plastik55 on Sun Aug 19, 2001 at 04:03:13 PM EST

Most genetic disorders that afflict men more than women (red/green color-blindness is the most common example) are linked to the X chromosome.

This is both because the Y chromosome doesn't do very much, and because of how recessive traits are inherited.

In order for a woman to exhibit a recessive X-chromosome trait (and most genetic disorders are recessive), she must inherit the defective gene from both her mother and her father, which is rare. A man needs only to inherit the one X chromo from his mother to exhibit the disorder.

So when we say that a disorder is linked to the X chromosome, it is because the gene which causes it is known to be located on the X chromosome. There may be a high correlation between the disorder and the presence of the Y chromo, but that does not mean the Y chromo is at fault.
w00t!
[ Parent ]

5 AM? Look again... (3.16 / 6) (#3)
by ubernostrum on Sun Aug 19, 2001 at 06:19:26 AM EST

05:54:36 AM EST. That's six minuties til 6. I guess I have some undiagnosed disorder that makes me do my most brilliant writing at (what other people consider to be) obscene hours.

And in a week I start fall classes, 9:10 AM, 9:40 AM, alternating days. Oh, how that will be fun...


--
You cooin' with my bird?
[ Parent ]

early morning sucks... (4.00 / 1) (#4)
by Delirium on Sun Aug 19, 2001 at 02:08:23 PM EST

...and in two weeks I start fall classes, 8:00 AM, 8:15 AM, alternating days.

=(

[ Parent ]

Gender differences (4.60 / 5) (#9)
by plastik55 on Sun Aug 19, 2001 at 04:34:49 PM EST

If this was a real disease, a neurological disease, then it wouldn't be linked to the Y chromosome - nobody has dared to say intelligence is linked to gender, but here we have a disease very obviously contradicting our best understanding of the human brain... yet few notice that fact.

What are you smoking?

On the contrary, plenty of people have "dared" to make a link between intelligence and gender. Most of them were easily refuted.

But are you really saying that "our best understanding of the human brain" is that its function is entirely gender-agnostic? Hmm. A quick citation search on "gender difference and brain" turns up more articles than can be listed. Women have higher dopamine D-2 receptor binding potentials [1]. Schizophrenia starts to affect women later in life than it does men [2]. Response times to sound as recorded in the auditory brain stem differ between males and females [3].

And of course, if the brains of males and females worked in exactly saame way, there's be absolutely no reason for "drugging up boys to turn them into girls," because their "youthful energy" wouldn't be any different at all!

I mean, come on. I think ADHD is mostly bogus myself. But nothing saddens me more than seeing someone who is ostensibly on my side of a debate justifying his position with utter nonsense.

[1] Sex differences in extrastriatal dopamine D-2-like receptors in the human brain Kaasinen V, Nagren K, Hietala J, Farde L, Rinne JO AMERICAN JOURNAL OF PSYCHIATRY 158: (2) 308-311 FEB 2001

[2] Main risk factors for schizophrenia: increased familial loading and pre- and peri-natal complications antagonize the protective effect of oestrogen in women Konnecke R, Hafner H, Maurer K, Loffler W, an der Heiden W SCHIZOPHRENIA RESEARCH 44: (1) 81-93 JUL 7 2000

[3] GENDER DIFFERENCES IN COCHLEAR RESPONSE-TIME - AN EXPLANATION FOR GENDER AMPLITUDE DIFFERENCES IN THE UNMASKED AUDITORY BRAIN-STEM RESPONSE DON M, PONTON CW, EGGERMONT JJ, MASUDA A JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 94: (4) 2135-2148 OCT 1993
w00t!
[ Parent ]

Question (4.50 / 2) (#12)
by physicsgod on Sun Aug 19, 2001 at 09:34:16 PM EST

What would you call a set of psychological symptoms that made a person unable to function in society?

People, especially children, with ADHD cannot "just sit still" any more than somebody with depression can "just cheer up" or you can "just levitate". ADHD is not just constantly running around, it also can consist of an inability to concentrate on one thing after a certain amount of time.

--- "Those not wearing body armor are hereby advised to keep their arguments on-topic" Schlock Mercenary
[ Parent ]

You're right as far as you go... (3.66 / 3) (#14)
by Kasreyn on Sun Aug 19, 2001 at 11:44:34 PM EST

...but you don't mention the fact that there IS a difference between boys and girls in the first place. These people, usually quite well-meaning, have come to see youthful energy (as you put it), as "hyperactivity", a disorder in which the child is too playful and energetic to be easily handled and controlled.

I personally feel this "condition" is dreadfully over-diagnosed. This is a direct result, if you ask me, of drug companies marketing directly to consumers. True, they have to go to a doctor to get a prescription; but all too many doctors' ethics fall by the wayside when they are faced with the choice of prescribing what the people want or losing their clientele! Medicine advertisements have been happening for years now. Obviously the pharmaceutical corp.'s are profiting from the ads, or else they'd have given up on that. They are profiting because people believe a commercial, and a massive cultural programming blitz, over the years of training their family practitioner has earned.

However, you fail to realize all they are doing is seeing "hyperactivity" and trying to stop it. WHY do they see it more in boys? Here we can look to societal and cultural factors. Boys are brought up to be more aggressive and active. Girls are brought up more along the old lines of, "children should be seen and not heard". Girls are taught to be demure and quiet, while boys are taught to be raucous and volatile at times. And then we medicate them back in the opposite direction!

The solution is twofold, if you ask me. First, stop requiring a double standard of boys. Stop raising them to be rowdy, and then medicating them to stop it! Secondly, I really honestly believe that medicine ads should be outlawed, or at least severely restricted. The original purpose of the medical prescription was to ensure that only trained professionals like doctors would be able to issue often-dangerous drugs. I believe that the companies advertising drugs should be prosecuted for practising medicine without a license (they are advising one use a medicine, and also giving a kind of prescription by causing the market pressures that lead to over-prescription of these drugs). To me, that amounts to practising medicine without a license, because they are taking upon themselves the duty of doctors, which is to advise people what medicines to take.


-Kasreyn


"Extenuating circumstance to be mentioned on Judgement Day:
We never asked to be born in the first place."

R.I.P. Kurt. You will be missed.
[ Parent ]
I must respectfully disagree with this (5.00 / 2) (#15)
by romanpoet on Mon Aug 20, 2001 at 03:10:08 AM EST

I'll start this off simply, I am diagnosed with ADHD and I have been since 2nd grade. Recently, the current trend seems to either be "ADHD is everywhere" or, "ADD/ADHD does not exist at all."

To this point of ADHD not existing, I can only speak for my personal experience and other friends of mine that have been diagnosed.

ADHD is a fairly significant factor in my life. I know those of you that are laughing, but I really do have to fight basically every school day to pay attention to something that I am not especially interested in. Granted, I CAN pay attention without my drugs, but it is a constant uphill battle to do so. Without my medication, a thought comes in and out of my head about every 2-3 seconds, sometimes a bit more if I'm excited. Sadly, since these thoughts are usually dramatically more interesting than my school work, I often tend to focus on them instead of my work. As you can imagine, this creates all sorts of problems in understimulating/boring environments such as most schoolastic instuitions. (not bashing here, but it's basically true, they're kinda drab places)

Even to this day, I can still tell a fairly sizable difference as to when I am drugged, and not drugged. And I must say that the drugs do greatly help me stay focused! Sadly though, they do seem to decrease the speed at which I think, (and the speed at which thoughts enter my head) but I consider this a minor sacrifice for the ability to focus better in boring environments.

(which I still put up with probably for the rest of life)


I know you could say many people are this way and I am simply to mentally undisciplined to control the thoughts entering my head. There is actually some truth to this, I am certain, that with time I could eventually force myself to focus purely through mental discipline. But, for me focusing seems dramatically harder than most people. And for whatever it's worth, I have ALOT more mental discipline than the majority of my classmates who seem to have a much easier time paying attention than I do.

Anyway, that is just my badly written general take on it.
-Romanpoet Romanpoet.org
[ Parent ]
Unscientific diagnosis (5.00 / 1) (#16)
by swr on Mon Aug 20, 2001 at 05:26:12 AM EST

Recently, the current trend seems to either be "ADHD is everywhere" or, "ADD/ADHD does not exist at all."

I think the problem here is the subjectivity of it all. There are some people you can point to and say "this person has ADHD", and others you can point to and say "this person does not have ADHD", but the real issue is the whole world of people who fall in between.

The symptoms are subjective enough that if interpreted improperly, any kid could be seen as having ADD. That, combined with the awareness/publicity there is about the disorder, and the apparent desire to label anyone who doesn't fit within the system as having a disease... Should we really be suprised if the disorder is abused as a catch-all for anyone who has a hard time in school?

[ Parent ]

ADHD As Emasculation (4.00 / 1) (#19)
by Karmakaze on Mon Aug 20, 2001 at 02:22:30 PM EST

As an adult female diagnosed with ADD, I'm not quite sure what to make of the idea that the whole idea is a plot to emascukate little boys.

Of course, I've also been diagnosed with clinical depression. I've never been completely sure that the attention problems are a separate disorder or just another symptom of the main disorder. The attention deficit is a notably separate phenomenon, though (as opposed to, say, hypersomnia, negative ruminations, etc.). The medications that have helped me most are also commonly indicated for ADHD.

I do find that a lot of the people who think thier children have ADHD are the same ones who think they have anxiety disorders because work makes them stressed, and who think anti-depressants are "happy pills".


--
Karmakaze
[ Parent ]

Practicing medicine without a license (4.00 / 6) (#5)
by K5er 16877 on Sun Aug 19, 2001 at 02:13:29 PM EST

Last month, Minnesota became the first state to bar schools and child protection agencies from telling parents they must put their children on drugs to treat disorders like attention deficit hyperactivity disorder, or A.D.H.D.

This raises as interesting question. If a school staff member requires medication for a child to attend school, they are requiring a specific treatment. This could very easily be seen as practicing medicine. If that staff member does not have a license to practice medicine and prescribe drugs, then they could be in serious trouble. I would predict a lawsuit against the school district.

I agree completely, well almost (4.25 / 4) (#10)
by hillct on Sun Aug 19, 2001 at 06:56:59 PM EST

It does seem that schools have come dangerously close to practicing medicine. Perhaps this might open them up for medical malpractive claims...? in cases where it is determined that in fact the child in question in not in need of such medication...

I don't know that much about medical malpractice law, but do they need to define a course of treatment, or simply mis-diagnose an illness and require one of a set of potential courses of treatment (which is more consistant with what is being done here by educators)?

--CTH


--Got Lists? | Top 31 Signs Your Spouse Is A Spy
[ Parent ]
Please.. (3.50 / 2) (#11)
by Rainy on Sun Aug 19, 2001 at 08:37:46 PM EST

I'm sure what's happening is that a school says "go to this doctor and take whatever he tells you to". Practicing medicine is NOT that. Practicing medicine is giving the drug yourself. According to your logic, anyone who ever "Oh my sister and law had just the same problem and Dr. Znudtis gave her Zarkas <tm> and she says it's great. You should go see him" are practicing medicine without licence and must be incarcerated immediately :-). The real issue is whether the drug is good or not, and if it's not, whether doctors should be accountable. (I think they ought to be..). Sometimes I think that if you're sane, you can't possibly study well in the school. It's just not likely that you'll ever need it. Just imagine, you're 15 and there's 0.00001 chance that you'll become a chemist but you have to memorize Table or the Elements and spend a year in chemistry class.. that is just so bizarre... Whoever gets good grade in school should automatically be suspect and should probably be put on some sort of medication.. mdma perhaps? :-).
--
Rainy "Collect all zero" Day
[ Parent ]
Suggestion vs. Requirement (none / 0) (#18)
by K5er 16877 on Mon Aug 20, 2001 at 01:05:41 PM EST

Your comment agrees with my point. There is a marked difference between suggesting a child go to a doctor and requiring a specific treatment. There is nothing (legally) wrong with suggesting a child attend a psychiatrist. If they require a specific treatment for the child to attend school, however, then they may be practicing medicine. The Minnesota law directly addresses requiring, not suggesting.

[ Parent ]
Requiring to ask a doctor? (none / 0) (#20)
by Rainy on Tue Aug 21, 2001 at 02:22:34 AM EST

You talk about Suggesting to see a doctor vs. requring to take a specific medicine, but what if they *require to see a doctor and do what he says*? From what I understand, that's what they do, and that's not practicing medicine.
--
Rainy "Collect all zero" Day
[ Parent ]
Something I've noticed (4.00 / 1) (#17)
by wiredog on Mon Aug 20, 2001 at 08:36:25 AM EST

I'm in AA and people that I know in AA seem to have been diagnosed ADHD at a much higher rate than the people I know who are not in AA. At the meetings I go to it seems to be around 10% to 25%. Any psych grad students out there looking for a Masters thesis might find that interesting.

There's also a high rate of manic/depressive or bipolar or whatever it's called these days, and schitzophrenia, etc. The alcoholics with those problems are generally considered to have been self medicating. Could be the same problem here.

I was diagnosed ADD in 1972 or so, before it was trendy.

If there's a choice between performance and ease of use, Linux will go for performance every time. -- Jerry Pournelle

Maybe the education system is the problem. (4.00 / 1) (#21)
by seitz on Wed Aug 22, 2001 at 11:05:42 AM EST

Sit in phalanx of chairs/desks, listen mostly passively as the same message is pushed at the same rate to all 25 students in the room, don't get too interested because the bell will force you to drop your interest, etc.

There's plenty of ADHD literature on behavioral practices for coping. But many can't really apply to the school day itself...

Controversy and Legislation Over Ritalin and Other Drugs | 21 comments (20 topical, 1 editorial, 0 hidden)
Display: Sort:

kuro5hin.org

[XML]
All trademarks and copyrights on this page are owned by their respective companies. The Rest 2000 - Present Kuro5hin.org Inc.
See our legalese page for copyright policies. Please also read our Privacy Policy.
Kuro5hin.org is powered by Free Software, including Apache, Perl, and Linux, The Scoop Engine that runs this site is freely available, under the terms of the GPL.
Need some help? Email help@kuro5hin.org.
My heart's the long stairs.

Powered by Scoop create account | help/FAQ | mission | links | search | IRC | YOU choose the stories!