mckitterick: (Default)
( Jul. 6th, 2016 11:36 am)

The Addicted Generation: Did we fail our kids by relying on prescription medication to treat ADHD?

Articles like this piss me off to no end. Sure, I understand the danger of prescribing drugs to children. Heck, making kids sit quietly in a classroom all day is a ridiculous notion. If we really want to solve classroom disruptions,  better than prescribing ADHD meds to bored kids, let them run around outside instead! Allow them creative outlets for their energy! Give them one-on-one tutors to ensure maximized, personalized learning!

But short of paying for that kind of public service (hello, anti-taxxers), I doubt we’ll clearly identify who’s really suffering from ADD or ADHD in childhood, or who’s just a bored kid with too much physical and creative energy to submit to the mind-deadening boredom that comes with school as it is today.



However, kids aren’t the only ones dealing with the disorder. Adults benefit from ADD and ADHD medications, too - perhaps even more so than kids.

I wasn’t diagnosed with ADD until my 40s, and taking Adderall has made all the difference in my health and happiness. Ask anyone who knew me before-and-after.

Before medical treatment, I’d struggle with trying to track, say, a dozen or more trains of thought running simultaneously through my mind... but, after starting the meds, it’s down to just a few threads of attention - or even just one, when I’m really involved. The difference between medicated and not-medicated is NIGHT AND DAY. (I take the bare minimum that’s medically effective to avoid developing physical resistance, and to easily clear my system over, say, a frustrating weekend of not taking any meds.)

Sure, the appetite-suppressant side-effect is real: I need to watch the clock to know when it’s time to eat. But when I think about eating, I realize I’m hungry. With kids, that’s probably more of a challenge, so they probably need a reminder to help them remember when it’s time to eat... but do you know any kid on ADHD meds who doesn’t have a smartphone close at hand? There’s apps for that. Better needing to remember when to eat than to go through life with the kind of serious disabilities that come with untreated ADD or ADHD.

Do the ableist a-holes who self-righteously decry “addiction” to ADHD medication say the same thing about heart meds for those in danger of heart attack? Insulin for diabetics? Hearing aids for those who need them? Eyeglasses?

If you can’t do the research, writer (that is, interview those most affected by the topic), talk about something you know or STFU.

Okay, I guess I have some feelings about this. /rant

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EDIT: Need to add this comment by “Heather!” that showed up right after I posted:

First of all, I just need to address how ridiculous it is to conflate ADHD symptom relapse after medication cessation with dependency and addiction. ADHD is a developmental disorder with biological origins in the pre-frontal cortex. Some people’s brains eventually catch up developmentally by adolescence or adulthood, some never do. Medications control symptoms by helping the brain function like normal brains function. Like other developmental disorders, there is no cure for ADHD, and medications are not going to make the brain normalize. They are an aid, like insulin is for diabetics or glasses are for people with myopia.

If you quit taking a medication that controls symptoms caused by inefficient biological processes, those symptoms will return, which is what is happening in the anecdotes mentioned in this article. This has nothing to do with dependency. Research shows that ADHD medication is not habit-forming when taken as directed. In fact, medication treatment before adolescence significantly reduces the risk of drug abuse and addiction in people with ADHD.

Can you imagine someone complaining about the dependency and addiction potential of insulin because high blood sugar resumes with cessation in diabetic patients? That’s how ignorant this argument is.

Besides that, this article is overloaded with myths and unsubstantiated assumptions about ADHD diagnoses, treatment, and outcomes.

Russell Barkley, PHD, has devoted his career to studying ADHD since the 1970s, has authored many studies that are used by organizations cited in this article, and has actually read all of the research and medical literature written on ADHD since the 1700’s (yes, 1970's). He has addressed the myths perpetuated by the media, including all the myths in this article, over and over again:

“If you were to average across all of these figures, it appears to be that somewhere between about 1.5 percent and about 2.5 percent of school-age children are taking medication right now for ADHD. Now, you have to look at that figure in the context of how much ADHD is there. It’s the only way you can answer the question of over-medication, and that is, what’s the reference point? We know that approximately 5 percent to 7 percent of school-age children have this disorder. If we use the conservative figure of 5 percent, and we know that about 2.5 percent of individuals may be taking medication, there’s your answer. We don’t have over-medication. Only about half of all ADHD children are ever taking medication for their disorder.

“There is controversy about ADHD, I believe, partly because we are using a medication to treat the disorder, and people find that to be of concern. But there’s also concern because ADHD is a disorder that appears to violate a very deeply held assumption that laypeople have about children’s behavior. All of us were brought up believing, almost unconsciously, that children’s misbehavior is largely due to the way they’re raised by their parents and the way they’re educated by their teachers. If you wind up with a child who is out of control and disruptive and not obeying, that that has to be a problem with child rearing.

“We can thank Freudian thinking and Watson’s behaviorism, and other ideas that are part of our common knowledge, for making us believe that behavior problems are learned. Well, along comes this disorder that produces tremendous disruption in children’s behavior, but it has nothing to do with learning, and it isn’t the result of bad parenting. And therefore it violates these very deeply held ideas about bad children and their misbehavior.

“And as long as you have this conflict between science telling you that the disorder is largely genetic and biological, and the public believing that it arises from social causes, you’re going to continue to have tremendous controversy in the mind of the public.

“Now, there is no controversy among practicing scientists who have devoted their careers to this disorder. No scientific meetings mention any controversies about the disorder, about its validity as a disorder, about the usefulness of using stimulant medications like Ritalin for it. There simply is no controversy. The science speaks for itself. And the science is overwhelming that the answer to these questions is in the affirmative: it’s a real disorder; it’s valid; and it can be managed, in many cases, by using stimulant medication in combination with other treatments.

“Saying that we’re not sure about the safety and the long-term use of the stimulant medication is nice to say. But the fact is that we know more about the stimulant medications than just about any other medication
that’s given to children in medicine... All of the research we have indicates that these drugs are some of the safest that we employ in the field of psychiatry and psychology. That’s not to say that we know everything about them. But we know a lot more than we know about cough medicines and Tylenol and aspirins and other things that children swill whenever they come down with a common cold. Nobody asks those questions about those over-the-counter medications, yet we know substantially less about them.”

YES.

If you need to see yet another "OH NOES! ADHD MEDS IZ ROONING UR KIDZ!" article, here's what I was responding to: x

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An LJ friend's post about forgetting to take his meds prompted this disclosure and discussion:

Over the last few days, I've forgotten to refill the pill-box on my desk so I can take my afternoon Adderal before class. I tell you what, I won't be doing that anymore. I've been feeling like Charlie Gordon from Flowers for Algernon.

I haven't talked about this here before, because I felt uncomfortable doing so in public. For a long time, I'd been suspecting I might have ADHD - maybe not the hyperactive part, but for sure the fragmented-attention part, so I was uncertain and avoidant. But I certainly suffered many of the symptoms, the worst of which was having great trouble focusing on one task (especially when I had many things to do, as I always do!), difficulty concentrating on things, and serious impairment in listening to one person talking in a noisy room, and so on. What I didn't realize that many of my anxiety issues also stemmed from the ADD, and overcoming this is perhaps my favorite result of the new meds: Even though I'm a light sleeper now, I used to startle awake at the slightest sound; I used to experience near-panic-attack levels of stress when I had too many things on my plate - and I've always been exceptionally good at putting too many things there. Brilliant. Imagine how emotionally straining it was for me when I was working full-time for both Microsoft and KU, plus trying to maintain my writing career, plus trying to stay in relationships. Since childhood, I've always been prepped for attacks whenever walking past people.

Are these things normal? I think not. They certainly weren't doing me any good. Of course, most of these symptoms - by nature of only existing inside my head - no one knew about, but they constantly plagued me.

Yet I felt that an ADD diagnosis would be problematic, a dirty label. Even now, I'm going back and forth whether to post this publicly or friends-only. How will the professional world, my co-workers, view me if they knew? I didn't want to be "one of those people," and I certainly didn't want to see myself like [insert names of people who are barely functional]. I despised having to admit that I have even more problems. As my suspicions rose, I asked myself, Why shouldn't I just be able to overcome this on my own? I actively avoided reading about ADHD. I mean, I lived through childhood. I've been successful in adult life. I'm smart, quick, capable of dealing with lots of crap all at once. Except I wasn't. Sure, I've always managed to deal with things. Except not very well, and it took a serious toll on me, my life, my writing, my career, my relationships... you get the idea.

So these broken-in-half little blue dextroamphetamine-amphetamine pills have transformed my life. I can now pay attention to a single conversation at parties. I can work on single projects until I'm done or reach a stopping-point. My stress level has dropped at least 90%. In class, I stay on track so well - even if a student's question redirects the discussion for several minutes - that I can return to what I was saying before. I'm WAY better at tracking time in a linear fashion. I'm more patient and less prone to frustration. When I have a dozen things to do and only time to deal with half of them, I can now tactically or strategically determine which needs to be dealt with first without the Beast Anxiety rearing up and trampling my ability to decide. And so on.

Strange that forgetting to take my pill - even at such a minimal dose - causes me so much trouble now, when I didn't even start taking them until last winter. How did I ever teach so many classes or get anything done before I started the stuff? How did I ever finish writing projects as long as novels? Most of all, how did I ever live with such stress before?

Thank you, modern medicine. Thank you for your patience, everyone who had to put up with me before. And thank you, everyone who not only supported me in pursuing a solution but also didn't think less of me when I acquired a new label.

I don't feel more broken now, bearing new scarlet letters. I feel more human. In fact, I feel superhuman at times, in control of a newly freed mind, able to focus while still retaining the hypervigilance that once wore me out. Simply taking these meds, I feel much more capable of taking control of this oft-quarrelsome mind. I mean, who doesn't have some kind of issues, right? Plus, ADD and ADHD no longer bear quite the stigma they used to. Though I'm still troubled by children getting the diagnosis, I waited too long before addressing this.

This much is certain: I won't be forgetting to refill my office pillbox anymore.

Chris
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