in memory of Kurt Cobain 1967-1994
(If you have a gifted child, you should read this (Is It A Cheetah?) at least once!)
There are a number of people who clearly have ADHD or the equivalent to the extent of not being
able to adequately function in life. This article is not intended to dismiss the use of Ritalin in
all cases.
If your child is in that category (or if you are in that category), I'm sure you won't be dissuaded
in any case. You'll probably also agree that the drug is being grossly overprescribed to those who
do not require drug therapy!
Ritalin is a tradename for Methylphenidate hydrochloride, an antidepressant stimulant. There is no
generic common name for the drug. Other antidepressant stimulants are real cocaine, novocaine, other
cocaine substitutes. Ritalin is not a classic antidepressant in the sense of Prosaic.
Street names for Methylphenidate hydrochloride are "r-ball" and "vitamin r."
While children are the obvious victims here, the same message applies to adults. If you are the
student, please excuse the third party ("your child"😉 language. The message is the same!
Legally Ritalin is a Schedule II drug in the same category as opium, cocaine and morphine. (In
contrast, Valium is not and its dispensing is only regulated under state laws.)
Myths About Ritalin
Confusion of the drug's efficacy with the effectiveness: This usually takes the form of, "It has a
physical effect; therefore it's indicated (as a proper form of treatment for the given condition).
Not so. If it didn't have a physical effect, it would be a placebo.
to the contrary ADD is such that if the child has it, you know it. The reason is simple - ADD is a
condition where the natural tendency for distractions exceeds the ability for the child to control
it. It is not the native tendency for distractions. It is not boredom in an oversized classroom.
A variation is the hocus-pocus theory: "Ritalin is a stimulant, but in the case of ADD it calms the
patient down. If the patient did not have ADD, it would have an opposite effect." WHERE did that one
come from? Not from reputable medical literature. What is this - a magic drug? This theory belongs
with beads and rattles. (Ritalin is a stimulant used to calm the patient down, much as coffee
relaxes people. That has little or nothing to do with the ADD condition.)
Specifically, there are some drugs and medications which have this effect. Heartworm preventative
medication administered to dogs testing positive for heartworm is dangerous. (The reason is that the
dying parasites of an already-infected dog can impede circulation.) Certain antimigraine drugs
should only be taken prior to the headache stage of a migraine attack. But to say that a general
purpose antidepressant/stimulant exhibits such qualities is at best disingenuous.
It helps school performance Its efficacy is in reducing a tendency toward inattentiveness. This is
quite distinct from skill development. It does have the advantage of making life easier for the
teacher, especially in a large classroom environment.
The use of an antidepressant-stimulant is required for my child to stay in school. Wrong.
The only thing the school administration can do is recommend professional consultation. It's up to
the parent to chose a professional. Then the onus is on the school to either follow the
professional's advise or legally explain why the professional is wrong.
If you chose the professional recommended by the school administrator, expect the worst.
The Oracle of the Ring The high use of Ritalin is tied to a relationship between the teacher,
"Resource Room" counselors and those psychiatrists who work with the counselors.
The teacher is encouraged by the "Resource Room" counselors to send "problem" children to the
counselors for analysis. If the psychiatrist doesn't return the child with a script for an antidepressant-
stimulant drug, the psychiatrist doesn't get further recommendations.
Oh yes -- the "Resource Room" returns to the teacher a sedated pupil!
When is it Necessary? When environmental changes (class size, food chemicals, etc.) are ineffective,
then antidepressant-stimulants may be warranted. In such cases the problems become quite apparent.
Drugs are never an acceptable form of punishment. Drugs are not a substitute for lack of educational
facilities.
When the prescribing physician needs a larger sailboat. (Pardon the cynicism here; your visit
wouldn't quite pay for the sailboat's new GPS receiver.)
When it's the Wrong Drug ADHD can coexist with some conditions, such as Asperger's Syndrone and
other autsim spectrum disorders (or conditions). Ritalin will make many people in the spectrum
worse, so it helps to obtain advise of an expert in AS or autism spectrum conditions first.
(Generally AS itself is not "treated" with drugs or otherwise; it's a personality type!)
When Facing the School Administrator I had accompanied a mother at one of these meetings. I asked if
they were prescribing the drugs. Since there was no qualified professional within spitting range,
they dropped the suggestion. (Besides, I don't think they liked the way I was dressed -- I wore a
full business suit!)
The following relates to public school systems. I believe that the incidence of administrators
"prescribing" Ritalin in private schools is exceedingly rare.
Be prepared with what you wish to ask for. Small class size. In-class teacher's assistant or
helper. Whatever.
Small class size is often a major issue because of budgetary restraints. If the administrator
objects, offer to accept an in-class assistant. Do not accept out-of-classroom sessions unless you
have reason to trust the program (e.g., recommendations from other parents).
There are alternatives to drug therapy for ADD.
Natural Therapy There are a number of approaches to this, including St. John's Wort, and others.
Just search for "Ritalin AND natural" (or "+Ritalin +natural" in AltaVista and others). Also try it
spelled "Ritilin" -- on the computer; not yourself!
Food chemicals Related to natural therapy, except this simply consists of avoiding such things as
artificial food colouring, nature-identical flavours, etc. Don't forget the school cafeteria under
the Individuals with Disabilities Education Act (USA).
Class Size Under Public Law 94-142 - Individuals with Disabilities Education Act (USA), a public
school must provide the necessary environment to meet the child's disabilities. In almost all cases,
this is either small class size or a teaching assistant. If you seek outside counseling, discuss in-
class teaching assistance with the professional.
Expect the administrators to respond to a class size request in one of several ways:
Back off. They don't want the Federal requirement for a teaching assistant or smaller class size to
be invoked by an IEP (Individual Educational Plan).
Transfer the child to a smaller size classroom or AP (advanced placement) class. This is used for
"problem children," -- except that "problem children" in this case means children whose parents know
how to make the system work in their favour!
Make threats. They're particularly skilled at that one. Just stand your ground. (but be prepared to
go to detention!) But it is possible to "cave in" by enthusiastically choosing a professional of
your choice.
Time of Use If drugs are necessary, they should be administered while supervised at home and not at
school. i.e., after 3 PM! (The problem with this approach is that it doesn't give the teacher a
sedated kid.) More to the point, if it is unnecessary to drug your child after school, it is
certainly unnecessary to drug your child during school.
Chose the Right Doctor In some parts of the country there are unethical psychiatrists who routinely
rubber stamp school administrators' prescriptions (or rather issue them). Take your kid to the
doctor, but go to a doctor of your choosing. (Hint: use your health insurance as an excuse to
override the choice of the school administrator.)
Agree Wholeheartedly This may be the easiest approach with some backwards-thinking school districts.
Then proceed to:
Enthusiastically choose your own doctor, rather than theirs. (Can you say "Managed Health Care?"😉
Point out that your doctor is one of the "best in the country."
Ask the school administrators to what extent they will cooperate with your doctor's recommendations.
Offer any suggestions from your doctor, such as smaller class size, in-classroom assistance, etc.
Take your kid to a tutoring center. It will help the native intelligence to shine through. Also
tutoring places, like their medical counterparts, make it their business to please the school. So
they will make sure your child will "do well" in school.
Before choosing a psychiatrist, interview them on the telephone concerning their philosophy of using
drugs for children referred to them with ADD. Don't bother discussing the merits -- your sole
purpose is to get their opinion on the subject.
Better yet, use a psychologist who holds a PhD or MS, rather than a psychiatrist who holds an MD.
Since psychologists are not trained as MDs they do not prescribe drugs are disinclined to prescribe
drugs through a doctor (MD), so they'll recommend a non-drug therapy if at all feasible! are
specifically trained to deal with behaviour and socialisation issues
Also note that consultation with a psychologist (as opposed to a psychiatrist) cannot later be
considered a history of treatment for mental disorders!
Do not agree to any optional school testing which requires parental consent. Use testing readily
available on the outside. Use services readily available on the outside. It's cheaper than the
alternative - eventually withdrawing your child from school for private or parochial school. If they
think you are circumspect about their motives, you've gotten your point across!
Always chose a program which gives you control of the patient-doctor confidence privilege and which
gives you control of the treatment regimen.
Tale of Two Cities When I moved to Seattle it became apparent that there were substantially less
kids given antidepressant-stimulants. I believe the reason is cultural:
The parents in Seattle are less likely to blindly accept a prescription recommendation from a school
administrator. There is a bias in Seattle against drugging kids. If pressured to have the child
treated, the parents in Seattle are more likely to go to a psychiatrist or psychologist of their own
choosing. Alternative remedies (e.g., naturopathy) are very much mainstream in Seattle. Naturopaths
generally send back prescriptions which include such items as dietary recommendations. While special
meals may be outside the Individuals with Disabilities Education Act (USA), removing food colourings
from the cafeteria could be deemed a reasonable request. (At present the Berkley, Calif. School
District is offering an all-organic meal option!) Finally, the Kurt Cobain tragedy is a too close in
the minds of Seattle parents. (The lead singer of Nirvana was a Ritalin child who eventually
succumbed to heroin abuse and suicide.)
New Law in Connecticut Connecticut is the first state in the US to pass a law to prevent schools
from "prescribing" Ritalin and other psychiatric drugs. The law was unanimously passed by the
legislature and signed into law in June, 2001.
The measure does not prevent school officials from recommending medical evaluation, but it is
intended to make sure that the first mention of drugs for a behaviour or learning problem comes
from a doctor.
Article
In August, 2002, parents in Albany, NY have used the Connecticut policy (or perhaps the information
on this webpage) to persuade their schoolboard to implement a similar policy.
If You're a Teacher Just don't do it. The quieter classroom just isn't worth what you're doing
to the kids.
Facts About Antidepressant-Stimulant Drugs Increased Likelihood of Drug Use Children administered
antidepressant-stimulants are three times more likely to become cocaine users. The reasons are
speculative but:
The threshold of taking antidepressant-stimulants is already crossed.
The prescription antidepressant-stimulant becomes a "starter drug" for street antidepressant-
stimulants (e.g., cocaine).
The kid become familiar with taking drugs for their effect on mood.
The message that "it's not okay to 'get wasted'" on street drugs but it's okay if the drug is given
for the benefit of the teacher eventually becomes hypocritical. Explain it away, but the basic
contradiction will remain.
It's possible that an ADD child will automatically (3:1 probability) become a cocaine user but this
has nothing to do with taking antidepressant-stimulants. This contradicts basic logic but it is a
possible explanation.
Antidepressant-stimulants are addictive. This is different from heroin and nicotine addiction but
there is now considered to be little question that antidepressant-stimulants are addictive. This
includes prescription antidepressant-stimulants (e.g., Ritalin), cocaine, crack cocaine and
similar drugs.
Possible Future Job Consequences The U.S. Armed Forces will not accept candidates who have been on
Ritalin unless:
the candidate has been off the drug for a prescribed period of time; and the candidate can prove
that the underlying condition has been "cured" ADHD by itself is not likely to be a disqualifying
condition.
Current FAA policy considers Ritalin to be a disqualifying drug for pilots. See FAA Guide for
Aviation Medical Examiners ch. 3, item 47. Waivers for past Ritalin use are granted by the Chief
Medical Examiner. See also article by Dr. Silberman in The Federal Air Surgeon's Medical Bulletin þ
Winter 1997.
Classroom Size Issues Realize that there are two competing issues related to classroom size. The
teacher will almost always favour smaller classes and will usually prefer to have an in-classroom
assistant. The administration on the other hand either does not want to hear the "S" word (size) or
possibly will also reluctantly work with you on the issue. In either case, you gain favour from the
teacher by raising the classroom size issue.
In any case, they may be required to oblige you under Public Law 94-142 - Individuals with
Disabilities Education Act (USA)
Links
Links - resources, netlists, information
Is It A Cheetah? by Stephanie S. Tolan ("required reading" for any parent of a gifted child)
Why I Posted this Website ("What's the Matter Here" - lyrics by Natale Merchant)
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