A comprehensive new report examines the problems of overdiagnosis of ADHD and overuse of stimulant medication in Queensland and throughout Australia. The story of John, a 5 year old Queensland boy, is disturbing, but unfortunately not at all atypical:
John is a 5-year old boy who was diagnosed as having Attention Deficit Hyperactivity Disorder (ADHD) when he was 3 and ½. He took Ritalin for many months until his mother became alarmed about his severe weight loss, and since he has been given “trials” with several different types of stimulant medication, including dexamphetamine.
John was born at 28 weeks gestation and had significant neo-natal health problems. He had difficulty sleeping, and has continued to have problems sleeping. Not surprisingly, John was very difficult for his young mother to deal with. His father did not want any part of John and quickly withdrew from him. Marital conflict escalated. By the time John was 3 and ½ practically the only time Mom wasn’t fighting with Dad was when she was disciplining John. Virtually the only interaction John had with Dad was when Dad was disciplining John. John learned in his dysfunctional family that he could temporarily stop the fighting AND get desperately needed attention from his Dad by misbehaving. John was trying to get his needs met.
Frustrated, John’s Mom took him to see their physician complaining that John didn’t listen, didn’t sleep and was very active. The physician did not say that there was marital conflict that needed to be addressed. The physician did not say that John’s Dad needed to be more involved with his son. The physician did not say John was reacting normally to a very bad situation that wasn’t his fault. The physician said that this 3 and ½ year old boy was sick; he had a disease called ADHD and needed to take stimulant medication. The physician admitted he didn’t have any “proof”; in fact, that he didn’t even know what caused ADHD. But he put John on stimulants nonetheless.
Mom was happier, because John was much more docile and compliant. Dad was happier because he could completely withdraw and concentrate on John’s younger sibling, with whom he got along well. John’s baby sitters were happy with his improved compliance, and when he starts school his teachers will be happier, too. The physician was happy, because he had another “satisfied customer” and John would come back periodically for med checks. The drug companies manufacturing stimulants, and the pharmacies selling them, were VERY happy because they could add to their amazing profits. But there was a victim in all this. The victim was John, an innocent little boy.
By age 5 John already has experienced deficits in growth, and may never attain the same growth he might have without the stimulants. Who knows what effects the drug may have had on his developing brain? We do know John has already learned to identify himself as “sick”.
It is a profound tragedy when normal, healthy children are exposed to the potentially devastating physical and emotional damage that can be caused by this diagnosis and treatment. It is a public health issue when a significant percentage of Australian children are being drugged into "zombie-like" states with prescription amphetamines, and when those drugs are being swapped and sold like candy in Australian schoolyards. It is a national disgrace when families are denied informed consent and Australia emulates the United States where drug companies reap huge profits through perpetuating the "Big Lie" that when children's behaviour doesn't please their parents or teachers it means the children have some sort of "disease".
It has been estimated that more than 50,000 Australian children are presently taking prescription drugs for "Attention Deficit Hyperactivity Disorder". Between 1991 and 1998 prescriptions for dexamphetamine, the most popular stimulant used for ADHD in Australia, increased by 2400 percent! The New South Wales Commission for Children and Young People has been conducting an inquiry into the use of prescription and over-the-counter medications on NSW young people, and the South Australia Parliament conducted an inquiry which was completed earlier this year. The Brisbane Courier-Mail reported in July of this year that more children take psychotropic drugs in Australia than in the United States, in an article with the ominous headline: "Australian kids first in mind medicine."
The report issued by YANQ, entitled "Queensland Children at Risk" highlights the following points:
- Controversy over the diagnosis of ADHD: Despite millions of dollars spent on research over the past twenty years, much of it subsidized by hopeful drug companies, no one has yet been able to identify this "disease" called ADHD. Many highly qualified professionals, including psychiatrists, neurologists, psychologists and educators, have come to believe that "ADHD" does not even exist. There is absolutely no objective test to determine if someone does or does not qualify for the diagnosis, so it is completely arbitrary and subjective. When you consider some of the shocking criteria: "makes careless mistakes in schoolwork", "often loses things", "is often 'on the go'" it becomes clear that virtually any child could qualify for this diagnosis.
- Stimulants don't help, and they are very dangerous: Dexamphetamine and methylphenidate (Ritalin) are the two most common drugs given to children deemed "ADHD". Both drugs are central nervous system stimulants listed in Schedule 8 of the Poisons List, and both drugs have been associated with very serious short and long-term side effects. At least two children in the United States recently died from Ritalin use, despite taking it exactly as prescribed. The fact that these powerful and dangerous drugs are given to children is horrifying enough, but made even more outrageous by the overwhelming evidence that they do not help the children. The only effect is creating more quiet, docile and compliant children. There is no evidence of improvement in schoolwork or in greater success in the future.
- Use in children under 6: Despite the fact that even the prescription information warns that these drugs are not tested as safe in children under 6, they are routinely prescribed throughout Australia for young children. One Queensland child this summer was prescribed dexamphetamine at 18 months of age, and another parent was once offered a prescription at 12 months (she wisely refused)! Experts agree that we do not know what damage stimulants do to a developing child, especially in terms of brain development, yet infants and toddlers are being placed at risk in alarming numbers.
- Legal Issues: Although it is an axiom of competent medical practice that patients must be provided informed consent, parents are not typically told of the controversies surrounding "ADHD". Very seldom is a parent told that the doctor cannot confirm the diagnosis and, in fact, cannot even show that ADHD exists. Very seldom are parents told that their children may suffer serious long-term side effects, including growth deficits and heart problems, and will almost surely suffer the "zombie-like" syndrome that controls their activity but dampens their spirit, creativity and energy. Consent without information is not consent at all. Additionally, children are virtually never given the opportunity to consent, although Australian law is clear that a competent child is entitled to a voice in his or her own medical treatment. In addition to violating domestic law, the endangerment of Australian children through this questionable diagnosis and use of stimulant drugs is probably in violation of international law, including the Convention on the Rights of the Child (CRC).
The damage to children diagnosed as "ADHD" and drugged with stimulants is not just physical. These children learn to rely on drugs and are often at risk of substance abuse later in life. They also learn that they do not have to accept responsibility for their own actions; they can blame it on some phantom "illness". The YANQ report discusses this issue in detail, as well as other issues including the growing problem in Australia of the recreational use of these prescribed stimulant drugs, and the many safe and effective alternative interventions for families experiencing difficultly involving child behaviour.
Finally, the report looks at why this diagnosis and treatment is so widely accepted despite the controversies. The answers are as simple as they are tragic. When a child is misbehaving, and they can be identified as “sick” and drugged into compliance, the parents no longer have to feel guilty or inadequate, the teachers no longer have to struggle with constant problems in the classroom, the physician has an ongoing customer and the drug company has branded another cash cow. Everyone is happy, except for the child. The child is blamed within the family as the source of the problems, stigmatized and disempowered by the diagnosis, and has to suffer the powerful short-term side effects and possibly the scary long-term side effects of the medication.
Children don't have the political or economic clout to speak up for themselves, and as long as everyone else is happy the drugging continues. The YANQ report is a plea to all concerned Australians to take a hard and honest look at a controversial issue. It is a plea to protect our children who cannot protect themselves from these harmful and needless labels and drugs. Finally, it is a plea to celebrate the creativity, spontaneity and energy of childhood and to embrace the unique beauty of every Australian child.