Should disruptive kids be medicated?
Some schools insist on drug treatment for children with ADD
(C)MSNBC
Aug. 23 — When Patricia Weathers decided to take her son off Ritalin, school officials dismissed him from school and called Child Protective Services to investigate her family for medical neglect and truancy. And she is not alone. A growing number of parents are finding themselves pressured by teachers and administrators to keep their children medicated — or keep them out of the school.
WEATHERS AND HER SON, Michael, join HomePage Wednesday to discuss their decision to take him off his medication. And their physician, Dr. Mary Block debates Dr. Peter Jensen, Director of the Child Mental Health Program at the National Institute of Health, on the use of Ritalin.
Michael, 10, began taking Ritalin at the end of first grade. At the time, his parents were going through a divorce, and Weathers was convinced her son was just acting out as a result of the turmoil in his young life. Weathers describes herself as “very anti-medication,” and wanted to try natural remedies to help Michael.
“In my eyes [medication] seems like a band-aid,” says Weathers.
But Michael’s disruptive behavior in class led to discussions between Weathers and the school principal. Weathers says school officials, though never threatening expulsion explicitly, pressured her into medicating her son, even though Weathers was already taking Michael to a psychologist.
According to Weathers, “the principal once said, ‘I know you don’t believe in medication, but the psychologist you have is not making a difference so you have to do something or we will put him in another school.’ Meaning a school for special needs kids.”
A pediatrician prescribed Ritalin for Michael, and he remained on the drug through second grade and part of third grade. But despite remarks from teachers that Michael was doing his work better, Weathers says her son became increasingly withdrawn from any social engagement and displayed other new behaviors.
“He would chew on things, his clothes, eat things — that did not happen until after the medication,” says Weathers. A family member who lives near the school playground also reported that she saw Michael standing alone to the side, shuffling his feet, for three days in a row during recess.
Yet, although Michael was removing himself from interaction and had few friends, Weathers says school officials ignored these declines in social behavior, informing her that Michael was sitting still and doing his work.
“But I said there is more than that,” explains Weathers. “I wanted a social child.”
So Weathers began her long journey down a chain of medical professionals, in search of a solution to her son’s problems. A pediatrician switched Michael’s medication to Dexadrine, but the boy was still withdrawn from his peers. So the school psychologist recommended a psychiatrist who put Michael on Paxil for treatment of social anxiety disorder. According to Weathers, the psychiatrist spoke to Michael for no more than 10 minutes before rendering her diagnosis.
But Weathers says Michael began experiencing hallucinations from the medication and she decided to take him off Paxil, leaving him on Dexadrine at the instruction of the doctor and the school.
“The school told him he must be medicated. The school psychologist says he needed medication. The psychiatrist said he needed to be hospitalized and put on neurological drugs” for the hallucinations, says Weathers. “They give kids drugs and then more drugs to mask the side effects of those drugs.”
AN ALTERNATIVE
Then Weathers met Dr. Mary Block, who stresses the need to test children extensively for underlying causes of behavior problems often classified as attention deficit disorder.
Weathers told officials that she was no longer going to medicate her son and was seeking alternative treatment. She brought in literature to prove that her son’s symptoms were all side effects from the medication he was taking.
“The school dismissed my son the next day,” says Weathers.
In addition, school officials called Child Protective Services three days before Weathers was scheduled to depart for Texas — where Michael was scheduled to undergo alternative therapy. A full investigation was launched, centering around charges of medical neglect and truancy.
Luckily, Weathers had proof that her son did not require hospitalization, a doctor’s second opinion that she had obtained in writing.
“What happens to parents who can’t afford all these evaluations,” wonders Weathers. “Should a school have the power to say you need to medicate?”
DOCTORS DISAGREE
Dr. Block says that she decided to attend medical school at age 39 because she was angry at doctors who, in her opinion, were labeling children and dispensing drugs without full medical exams or workups.
“Michael was anemic — a basic blood test would have told any doctor that. No one did it, and being anemic affects how you think and feel,” says Dr. Block. “He also had lots of allergies that had not been evaluated.”
Dr. Block believes that there is no valid or objective way of diagnosing ADD and that the limits of the medical and education systems are converging to destroy the lives of many children. She is also bothered that parents are often not told of potential side effects.
“When [doctors] prescribe a drug without telling people about the side effects, that is not informed consent,” says Dr. Block.
She argues that one of the main reasons Ritalin is so often prescribed is because of money, such as the cost of doing a blood test in Michael’s case.
“Because of HMOs, ” says Dr. Block, “doctors are tightening their belt.”
According to Dr. Block, the pharmaceutical industry takes out ads in medical journals, pays doctors to talk about drugs at their conventions and even pays for continuing education to teach medical professionals to use drugs to solve behavior problems.
In fact, says Dr. Block, “One of the largest ADHD support groups makes a ton of money from the drug company that makes Ritalin. It’s almost like a marketing front for the drug company.”
But Dr. Peter Jensen, who has a background as a researcher, scientist and clinician, disagrees. He was the lead developer of the major study that tested different combinations of medicine and counseling for children diagnosed with ADD. He says that he approached the issue as a non-believer in drug-based treatment, but found that medicine was most effective.
Dr. Jensen argues that the discussion of funding by pharmaceutical companies takes away from the real issue: Is this a disorder that can be diagnosed and treated?
“I believe that ADD can be diagnosed,” says Dr. Jensen. “We didn’t know about AIDS one hundred years ago, so as science advances, we learn more about conditions.”
As for side effects, Dr. Jensen says that they are the exception, rather than the rule, and are often dose-related.
“One in 10 children will have loss of appetite or slight changes in personality — rarely is it a dramatic change.”
He agrees that parents should be informed as to the possible side effects of drugs, and also blames communication problems between parents and doctors on managed care.
“The average time doctors spend with patients is 13 minutes for HMOs,” says Dr. Jensen, “so there is a lot of pressure.”
Dr. Jensen also warns that parents may waste a great deal of money searching for allergens and other underlying medical causes.
“There are kids out there that have an underlying condition that can be ferreted out, but most experts agree that it’s a small portion.”
Dr. Jensen stresses that these disorders are not always the result of bad parenting or overcrowded schools, and that parents have often “turned to medicine and it transforms the child’s life.”
MED-FREE
But Weathers, whose son could be one of the majority, as described by Dr. Block, or just one in 10, according to Dr. Jensen, is through with Ritalin and other drugs.
After extensive testing that exposed anemia and several allergies, Michael is now treated with a special diet and supplements. He attends Duane Lake Academy, a charter school, two days a week and Weathers home-schools him the other three.
Michael has been medication-free since Dec. 16, 1999.
msnbc.com
Dr. Block: blockcenter.com |
