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