Adonis Diaries

Posts Tagged ‘Ritalin

Attention deficit hyperactivity disorder…Diagnosis of grieving Human

The news that 11% of school-age children now receive a diagnosis of attention deficit hyperactivity disorder — some 6.4 million — give the chill.

Ted Gup, an author and fellow of the Edmond J. Safra Center for Ethics at Harvard University, published this April 2, 2013

“My son David was one of those who received that diagnosis.

In his case, he was in the first grade.

Indeed, there were psychiatrists who prescribed medication for him even before they met him.

One psychiatrist said he would not even see him until he was medicated.

For a year I refused to fill the prescription at the pharmacy. Finally, I relented. And so David went on Ritalin, then Adderall, and other drugs that were said to be helpful in combating the condition.

In another age, David might have been called “rambunctious.” His battery was a little too large for his body. And so he would leap over the couch, spring to reach the ceiling and show an exuberance for life that came in brilliant microbursts.

As a 21-year-old college senior, he was found on the floor of his room, dead from a fatal mix of alcohol and drugs.

The date was Oct. 18, 2011.

No one made my son take the heroin and alcohol, and yet I cannot help but hold myself and others to account.

I had unknowingly colluded with a system that devalues talking therapy and rushes to medicate, inadvertently sending a message that self-medication, too, is perfectly acceptable.

My son was no angel (though he was to us) and he was known to trade in Adderall, to create a submarket in the drug among his classmates who were themselves all too eager to get their hands on it.

What he did cannot be excused, but it should be understood.

What he did was to create a market that perfectly mirrored the society in which he grew up, a culture where Big Pharma itself prospers from the off-label uses of drugs, often not tested in children and not approved for the many uses to which they are put.

And so a generation of students, raised in an environment that encourages medication, are emulating the professionals by using drugs in the classroom as performance enhancers.

And we wonder why it is that they use drugs with such abandon. As all parents learn, and to their chagrin, our children go to school not only in the classroom but also at home, and the culture they construct for themselves as teenagers and young adults is but a tiny village imitating that to which they were introduced as children.

The issue of permissive drug use and over-diagnosis goes well beyond hyperactivity.

In May, the American Psychiatric Association will publish its D.S.M. 5, the Diagnostic and Statistical Manual of Mental Disorders.

This voluminous book is called the bible of the profession.

Its latest iteration, like those before, is not merely a window on the profession but on the culture it serves, both reflecting and shaping societal norms. (For instance, until the 1970s, it categorized homosexuality as a mental illness.)

One of the new, more controversial provisions expands depression to include some forms of grief. On its face it makes sense.

The grieving often display all the common indicators of depression loss of interest in life, loss of appetite, irregular sleep patterns, low functionality, etc. But as others have observed, those same symptoms are the very hallmarks of grief itself.

Ours is an age in which the airwaves and media are one large drug emporium that claims to fix everything from sleep to sex.

I fear that being human is itself fast becoming a condition. It’s as if we are trying to contain grief, and the absolute pain of a loss like mine.

We have become increasingly disassociated and estranged from the patterns of life and death, uncomfortable with the messiness of our own humanity, aging and, ultimately, mortality.

Challenge and hardship have become pathologized and monetized.

Instead of enhancing our coping skills, we undermine them and seek shortcuts where there are none, eroding the resilience upon which each of us, at some point in our lives, must rely. Diagnosing grief as a part of depression runs the very real risk of delegitimizing that which is most human — the bonds of our love and attachment to one another.

The new entry in the D.S.M. cannot tame grief by giving it a name or a subsection, nor render it less frightening or more manageable.

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.

A version of this op-ed appeared in print on April 3, 2013, on page A27 of the New York edition with the headline: Diagnosis: Human.
Note: And billion of people go hungry, suffer malnutrition…and die of curable diseases before the age of 5.
An ethics issue: Physicians dispensing drugs for healthy people?  And for kids to study?

 
The American Academy of Neurology now says: Stop that.

Adderall and other ADHD medications, a disorder characterized by problems with attention and hyperactivity, are used as “smart drugs” or “study drugs” by students who find the pills give them a mental edge.  These drugs are among the most prescribed drugs in America.

Adderall is the only drug class that showed increased use in 2012, the federal survey reported.

 Nancy Shute posted on Shot this March 14, 2013 under “Neurologists Warn Against ADHD Drugs To Help Kids Study”

Ten milligram tablets of the prescription drug Adderall. The drug is used to treat ADHD and is used by some students to boost their academic performance.

Ten milligram tablets of the prescription drug Adderall. Jb Reed/Bloomberg via Getty Images

The brain docs are directing that advice first and foremost to their fellow physicians, the ones who have been writing all those scrips for people who don’t have ADHD, or who perhaps don’t think about all the pills their patients sell on the student black market.

“We don’t believe that doctors are supposed to be drug dispensers for healthy people,” says William Graf, a professor of pediatrics and neurology at the Yale School of Medicine. “This is an ethics issue.”

But the message is also being sent to teenagers and their parents, some of whom who might think that giving their child a little leg up for a big test isn’t such a bad thing. The buzz term for that? “Pediatric neuroenhancement.”

Prescribing ADHD drugs to children who don’t have the disorder is “not justifiable,” according to the American Academy of Neurology’s new position paper: Children’s brains are still developing, the paper says, and they don’t have the ability to weigh the risks and benefits of medication.

Prescribing study drugs is “inadvisable” in teenagers, a word chosen to reflect both teenagers’ growing autonomy, and the fact that the Academy can’t tell doctors what drugs they can and can’t prescribe.

The number of children diagnosed with ADHD rose 24 percent from 2001 to 2011, according to a study published earlier this year. Over the same time, the number of prescriptions for Adderall and other ADHD drugs has soared exponentially.

More pills in circulation means more pills that can be bought, borrowed, or snitched.

Various surveys report that 8 to 35% of college students say they have used stimulant pills to improve school performance.

The neurologists are not saying that stimulant drugs shouldn’t be used to treat ADHD, “We’re not touching that here,” Graf told Shots.

What they are saying is that doctors have a moral obligation to protect the best interests of the child — who doesn’t yet have legal control over health care decisions — and to prevent the misuse of medication.

Amphetamines like Adderall and Vyvanse can be addictive, which is why they’re classified as Schedule II controlled substances, along with Oxycontin and morphine.

Side effects can be as simple as insomnia, or as serious as sudden high blood pressure, irregular heartbeat, and seizures.

Other popular ADHD drugs like Concerta and Ritalin are methamphetamine  and are considered less risky. But they can cause a wide range of side effects including insomnia, aggression, mood and behavior changes, twitching, and shaking.

About 15% of 12th graders say they misuse prescription drugs, according to the 2012 Monitoring the Future survey, and about 6% say they’ve misused Ritalin or Adderall.

“As a society we have a pill for everything,” Graf says. “It’s one thing if you’re taking something from the Vitamin Shoppe. It’s another thing if you’re talking about amphetamines.”

Doctors should talk with patients and parents about why they feel the need for academic performance enhancing drugs. They should point out that there are other ways to deal with competition and anxiety.

“We have to get back to the basics,” Graf says. “Sleep, exercise, and social interaction.”


adonis49

adonis49

adonis49

October 2020
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