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The Anti-ADHD/ Anti-Ritalin Movement
History and Discussion
Mary Brinkmeyer
Recent Events Statistics and
Controversies The Critics
Recent events
1999: Colorado State Legislature holds hearings on psychotropic medications and school violence Speakers include members of “watchdog”
Scientology groups
Recent Events
1999 Colorado State School Board passes resolution cautioning against use of psychotropic meds Original intent of resolution
was to ban Ritalin
Cover of The Boulder Weekly, 2001
2000: Class Action Lawsuits
Filed against APA, CHADD, and Novartis (formerly Ciba-Geigy)
Alleged conspiracy to promote ADHD diagnosis for purpose of maintaining psychotropic drug industry.
Alleged cover-up of dangers of Ritalin Lawsuits eventually dismissed.
2001-2003: State Bans on Schools Recommending Ritalin
CT, VA, CO pass laws prohibiting educators from recommending psychotropic medications
CT, UT state that refusing to give children psychotropic medications is not medical neglect
Child Med. Safety Act of 2003
May 2003: Passed by House 425 to 1 Requires states “to develop and implement policies
and procedures prohibiting school personnel from requiring a child…to obtain a prescription for a controlled substance.”
Requires tracking of prescription rates for ADHD meds
Opposed by American Psychiatric Association, American Academy of Pediatrics, CHADD, National Association for Mentally Ill.
Stimulant Statistics: Cause for Concern?
500% increase since 1991 in ADHD prescriptions Preschool ADHD meds tripled from 1990-1995. In past 15 years:
311% increase in kids 15-19 taking ADHD meds 170% increase in kids 5-14 taking ADHD meds
Methylphenidate manufactured 2 ½ times the rate of a decade ago 11 million prescriptions written each year 2000 profits for stimulants = $758,000,000
The New York Times, The Drug Enforcement Administration, Education World
Stimulant Statistics: Cause for Concern?
Methylphenidate Consumption (Defined Daily Dose in millions)
Drug Enforcement Administration
Over-diagnosis and over-prescription?
Jensen’s 1992 survey of stimulant use in selected regions found only 12.5% of ADHD kids treated with stimulants.
LeFever’s 1995 survey of VA schoolchildren found rates of medication 2-3 times higher than expected, with 20% of 5th grade white boys taking ADHD meds. Rates much lower for girls and black children.
Over-diagnosis and over-prescription?
Angold’s 1992-1996 survey of rural NC children found almost twice as many kids on stimulants (7%) as met DSM-III ADHD criteria. Stimulant meds more common in comorbid ODD kids.
Bussing (2003) found poverty and minority status negative predictors of receiving any tx for ADHD.
Methylphenidate Abuse
Can be abused in following ways: Orally (more common when
used to stay awake) Crushing and snorting tablets
or dissolving in water and injecting (used to produce euphoria)
Methylphenidate Abuse: 2002 Stats
Monitoring the Future National Survey of 420 Schools
Drug
Grade
Ritalin
%
Alcohol
%
Cocaine
%
Heroin
%
MDMA
%
Pot
%
8th 3 39 2 1 3 15
10th 5 60 4 1 5 30
12th 4 72 5 1 7 36
Methylphenidate Abuse
1993-1999 American Association of Poison Control Centers reported 759 cases of methylphenidate abuse in kids ages 10-19 brought to ER. Most not prescribed the drug Number of cases increased over time Most not admitted, and medical outcomes good.
Klein-Schwartz & McGrath, 2003
Methylphenidate: A Gateway Drug?
4-year study of boys ages 15-19 56 medicated ADHD, 19 un-medicated ADHD,
137 controls Rates of substance use disorder at 4-year follow
up significantly higher for un-medicated ADHD Suggested “protective” effect of ADHD meds.
Biederman et al., 1999
CHADD: The 1995 Merrow Report (PBS) Expose
CHADD receiving hundreds of thousands in funding from Ciba-Geigy No mention of this in brochures, educator’s
manual, fact sheets, etc.
CHADD: The Merrow Report
No mention of Ciba-Geigy link in CHADD video distributed using grant from US Dept. of Education Dept of Ed officials not aware of Ciba-Geigy link. Video showed parents highly praising Ritalin without
identifying themselves as CHADD leaders. Video distributed when CHADD’s fight for decontrol of
Ritalin heating up.
CHADD: The Merrow Report
UN International Narcotics Control Board expressed concern.
Two days after Merrow Report aired, Dept of Ed pulled video.
CHADD: Current Status
Still receive 17% of funding from pharmaceutical industry (2002 report)
Acknowledge this on publicly-published financial report (not that easy to find)
Discuss commitment to ethics and not allowing contributions to influence policy and statements
Discuss importance of psychosocial interventions
The Critics: The Good, the Bad, and the Nutty
Concerned Practitioners
Lawrence Diller: Running on Ritalin (1998) Behavioral pediatrician and family therapist who
regularly prescribes Ritalin Worries Ritalin is “easy solution” for often
complicated situations Raises concerns about ADHD being
misdiagnosed.
Concerned Practitioners
Peter Breggin, Talking Back to Ritalin Psychiatrist, opposes all psychotropic
medications for kids Argues ADHD not biologically-based, drugs are
cop-out for parents, doctors, and teachersSays meds “crush a child's desire to socialize, to play,
to escape, to be full of stuff like kids are” Often testifies at anti-Ritalin hearings
Scientologists
Scientologists have opposed psychiatry and psychology since failed to accept founder L. Ron Hubbard’s theory of “dianetics” in 1960s.
Main anti-psychiatry arm: Citizen’s Commission for Human Rights (CCHR).
Celebrity spokespeople: Kirstie Alley, Lisa Marie Presley, Kelly Preston, Juliette Lewis, Jenna Elfman, Issac Hayes.
CCHR: Selected Publications
Psychiatry Betraying & Drugging Children - Harming Lives Psychiatry Destroying Religion - Creating Evil Psychiatry's Betrayal - Creating Racism Psychiatry Victimizing The Elderly - Denying Respect Psychiatric Rape - Betraying Women Psychiatry Eradicating Justice - Creating Crime Psychiatry Destroying Morals - Creating Chaos
Scientologists
Dr. Fred Baughman (neurologist): leading speaker for CCHR Website www.adhdfraud.com Frequently quoted by anti-ADHD activists
without acknowledgement of Scientology connection
Main proponent of conspiracy theory.
Proponents of Alternative Therapies
Hundreds of books on treating ADHD without drugs.
Range from fairly sound behavioral principles to diets, supplements, exercise, etc.
Rarely include any empirical data.
Questions, Discussion