Wednesday, February 6, 2013

Speed: Medicated Management

Photo Credit: MotivatedPhotos.com
Introduction

Methylphenidate is a buffered form of methamphetamine (speed) used to treat symptoms of ADHD (Attention Defecit Hyperactivity Distorder) and depression, common brand names are Ritalin and Adderall. The drug is considered a controlled substance but prescribed in epidemic proportions to school-age children diagnosed with ADHD or to control students unruly behavior in class (a practice called "medicated management" or M&M's by practitioners). What follows are excerpts from interviews with scholars in the field who identify the symptoms and prescribed treatment of the disorder, but do not examine causes. Then there is the case of Adam Liebovitz who treats his ADHD successfully with exercise by riding his bike (see Riding is my Ritalin below).

Background

"The International Narcotics Control Board (INCB) has observed that world-wide use of methylphenidate has risen from less than 3 tonnes (metric ton) in 1990 to more than 8.5 tonnes in 1994, and continued to rise in 1995. The United States accounts for approximately 90 per cent of total world manufacture and consumption of the substance. 1996: 10.5 tonnes 1997: 13 tonnes  2000: 15 tonnes and 15 million prescriptions." Finally 2010: 84 tonnes.


"The United Nations released a report in February of 1996 expressing concern over the discovery that 10 percent to 12 percent of all male school children in the United States currently take the drug, a rate far surpassing that in any other country in the world. Indeed, citizens of the United States, most of them well below the legal drinking or smoking age, now consume over 90 percent of methylphenidate produced worldwide each year."

"There is something odd, if not downright ironic, about the picture of millions of American school children filing out of 'drug-awareness' classes to line up in the school nurse's office for their midday dose of amphetamine. It is this sort of image that fires the imaginations of Ritalin's critics--critics like child psychiatrist Carl L. Kline of the University of British Columbia who was reported in the August 4, 1991, New York Times Education Supplement as saying that Ritalin is nothing more than a street drug being administered to cover the fact that we don't know what's going on with these children."

OR DO WE?

Here are interviews with scholars and experts on the subject, all of them illustrate symptoms and treatment of the condition. One isolates causes as simply hereditary, but nobody blames lifestyle or environment.


As a neurobiological disorder of self-control and attention problems:
The Ritalin Explosion, Harvey Parker, FRONTLINE

As a mental disorder (APA):
Ritalin: Miracle Drug or Cop-Out, Ken Livingston, FRONTLINE

It is inevitable, prescriptions chase diagnosis:
Statistics on Simulant Use, FRONTLINE

As these disorders, narcolepsy, lethargy, depression and obesity:
Ritalin use for ADAD Children Soars Fourfold, Jamie Doward, Emma Craig, The Gardian
And the consequences, treating disorders with narcotics
Criticizing the Ritalin Generation, KJ Dell'Antonia, New York Times
"If 'accelerated' has become the new normal, there’s no choice but to diagnose the kids developing at a normal rate with a disorder. Instead of leveling the playing field for kids who really do suffer from a deficit, we’re ratcheting up the level of competition with performance-enhancing drugs. We’re juicing our kids for school."
"We’re also ensuring that down the road, when faced with other challenges that high school, college and adult life are sure to bring, our children will use the coping skills we’ve taught them. They’ll reach for a pill."

Change in Lifestyle and a Cure

Riding is my Ritalin, Bruce Barcott, Bicycling, excerpts:

In 1978, two years before the National Institute of Mental Health (NIMH) recognized ADHD as a condition, W. Mark Shipman, MD, conducted a simple test. Shipman sent a group of hyperactive kids running for as much as 45 minutes a day, four days a week. An amazing thing happened: The running kids started acting as if they were getting extra doses of medication.

After a while, the doctors who monitored the behavior of each child began lowering drug doses for most of the runners. Very few nonrunning participants had their doses reduced. The doctors who were administering the doses didn't know which students were running; the changes in behavior were that clear.

Shipman's study might have led to a boom in physical fitness programs for ADHD-identified kids. It didn't. Instead, just the opposite occurred: Doctors began writing more prescriptions.

It wasn't that Shipman's research was discredited. In fact, at least two other studies conducted in the 1980s confirmed his findings. What happened instead was a societal shift away from time-consuming natural remedies such as exercise and in favor of quick-fix solutions part of the same cultural sea change that has resulted in the nation's worsening obesity problem.

At the time of Shipman's study, few parents had heard of Ritalin. By 1988, half a million kids were taking the drug. By 1995 that figure had quadrupled. The United States was using five times as much Ritalin as the rest of the planet combined. "An increase of this magnitude in the use of a single medication," observed pediatrician and Running on Ritalin author Lawrence Diller, MD, "is unprecedented for a drug that is treated as a controlled substance."
  • "A bout of exercise is like taking a little bit of Prozac and a little bit of Ritalin," says John Ratey, MD, Harvard
  • Cycling, swimming, running are tops, soccer, hockey, baseball bottom," David Conant-Norville, MD
  • Biggest reason no one touts the benefits of exercise: There is no profit in it
  • In 2007 the Pharmaceutical industry invested $58.8 billion in research and development.
  • The bicycle industry does not fund medical studies.
  • When ADHD diagnoses were sky-rocketing '91-'95 HS students PE enrollment dropped 42 to 25%
  • Innovative PE programs turned out the fittest students in the country but also among the smartest
  • Correlation of PE programs to improved test scores "are simply too intriguing to dismiss."
Following this article there are a 102 Comments, like this one:

"I took Ritalin or Adderall for 20 years. I now realize that you cannot take prescribed speed for that long without it having serious effects on your health. So I have been off of it for 6 months. I have very little motivation. Do you think it just takes time? Any suggestions would be appreciated. I feel like I am in a whole new reality and it is scary. Thank you." -LS



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