“A few years ago a single mother who had recently moved to town came to my office asking me to prescribe the stimulant drug ‘Adderall’ for her 6th-grade son. The boy had been taking the medication for several years, and his mother had liked it’s effects: it made homework time easier and improved her son’s grades.
At the time of this visit, the boy was off the medication, and I conducted a series of cognitive and behavioral tests on him. He preformed wonderfully. I also noticed that off the medication he was friendly and playful. On a previous casual encounter, when the boy had been on Adderall, he had seemed reserved and quiet. His mother acknowledged this was a side effect of the adderall. I told her that I did not think her son had attention-deficit hyper activity disorder (ADHD) and that he did not need medication. That was the last time I saw her.”
Dr. Edmund S. Higgins (2009, p. 39)
Excessive medication use is a significant problem in this country, especially the overmedication of children. Overmedication can involve a child being put on medications they don’t need, or it may mean they are given a regimen of too many medications at once. Frequently these problems coexist together, since many of the medications children are put on have little benefit.
It often starts innocently enough: Parents or teachers, concerned about a particular aspect of a child’s mood or behavior, put them on a drug to see if it will help. It may not work or it may produce some desirable effects, and so the doctor prescribes another medication alongside it to compliment the first. Or they might prescribe other drugs to deal with the unwanted side effects caused by the first. Before you know it, a child is a walking chemistry experiment, taking 4, 5, or 6 medications all at once.
Dr. Ronald Fieve describes the case of one girl, Brienna, who by the time she was 9, “was taking three medications: the Ritalin to treat the ADHD and remain alert during the daytime hours, a sleeping pill at night, and an antidepressant to boost her depressed mood.” (Fieve, 2006, p. 214) None of these medications were getting to the root of her problems, and she had been on and off of various ones for several years.
Children are often falsely diagnosed and medicated because parents or professionals think put thing their kid on medication will help them excel or do better in school. Or they might want to take the edge off little Johnny so that he’s easier to handle. “It is widely known (and accepted) that schoolteachers and psychologists are prone to recommending Ritalin and similar medications for any child or adolescent exhibiting restlessness, trouble focusing, or hyperactivity,” states Dr. Fieve. (2006, p. 214) Daniel Pine, a National Institutes of Mental Health (NIMH) researcher who directed the revisions for the DSM-5, gave the following scenario to Roy Richard Grinker:
“A mother and father bring their 12-year-old son to you because, as they report it, ‘he is doing poorly’ at an exclusive private school with a demanding curriculum. When you look at the boy’s transcript you notice that the boy received mostly grades of B. Teachers report that he is somewhat fidgety, doesn’t pay attention quite as often as other kids, and sometimes seems irritable, but they don’t say he’s disruptive, outside the norm, or in need of any kind of educational or cognitive assessment. He just isn’t an A student and he is facing a tough middle school curriculum at a tough school.
“Now, you know this kid shouldn’t really have a diagnosis of ADHD – as a researcher you’d never classify him as ADHD – but you ask yourself as a clinician: wouldn’t a little Ritalin or some other stimulant actually help him? It might. He might do better at school. And the parents are pushing you to do something …And so maybe you medicate him, and to medicate him and have insurance reimburse for it, you give a diagnosis of ADHD, and suddenly you’ve got a kid with this label. See how easy it can happen?” (Grinker, 2007, pp. 134-35)
This is a frightening statement, made all the more terrifying by the fact that it was made by someone holding a leadership position in the field of child psychiatry. If you’re not deeply concerned, go back and reread it. Here we have a clinician who openly admits that a child is not abnormal, does not fit the criteria for a diagnosis, shouldn’t need medication, but yet is medicated anyway because the parents are pushing it in the hopes that it might help him keep up with the demands of a private school’s rigorous curriculum, thus turning some respectable Bs into Straight As. (A promice that is very much in question) And he gives this example as if it’s a benevolent story of a good psychiatrist doing the right thing. In this statement, Daniel Pine confirms every fear that critics have of his dope-up-a-child industry – kids are routinely medicated not because they are abnormal or in need of medication, but because it suits the needs of adults.
Ritalin is a powerful stimulant. It’s in the same class of drugs as cocaine. Teens and college kids use it at parties to get high (as well as to cram for finals). There are concerns about how such stimulants alter the brain in a developing child when given on an ongoing basis, potentially impairing the brain’s reward systems later. (See our section on ADHD medication) The example he gives – the more socially acceptable version of a parent wanting her child to excel at school – may not seem very sinister in nature. (Society seems to be fine with kids being on drugs so long as it contributes to academics and achievement as opposed to pleasure. I wonder if Daniel Pine would take the same approach to giving a child “a little” speed as a party pleasure, which is what ADHD drugs are.) Yet the reality is that this type of thing is happening for all sorts of disorders and all kinds of reasons.
Maybe little Johnny is a little too much work to handle, and so mom wants a drug that will knock him down a notch. So she bugs her doctor about it, and the next thing you know little Johnny is being sedated so that mom can relax and doesn’t have to work as hard. See how easy this can happen? The chemical abuse of millions of children (not to mention a little bit of felony-level insurance fraud on the side), and a leader at the NIMH is openly dismissing it as common practice. Unbelievable!
Medication as a crutch A number of parents and other caregivers are using medication as a crutch to deal with normal child behavioral problems that they find difficult to deal with, either because they don’t have the time or they struggle with discipline. In my years working in child care, I can’t even begin to tell you how many kids I’ve seen doped up for dubious reasons. The same child who is a perfectly well-behaved youngster in the stable setting of our preschool suddenly comes in with ADHD or antipsychotic prescriptions because his or her parents lack the skills to manage her at home.
Some of these instances were literally shocking to behold: I’ve seen some of the most well-behaved and perfect little kids in my class get medication referrals for behavioral issues because the parents either didn’t know how to manage their child or had unrealistic expectations about child development, and were trying to medicate away normal childlike behavior.
Aside from the physical harm caused by this, such approaches avoid addressing the underlying conditions that are creating the problem, so they ensure children and their families don’t actually get the help they need.
Doping up foster kids
Nowhere is this phenomenon more obvious than when it comes to the drugging and overmedication of foster kids. As one nurse reports: “Almost all kids coming into care these days five or over are on at least one psychiatric medication, which is of huge concern to me. I don’t think the seriousness of this is totally appreciated by the non-medical portions of DCYF…I’ve had five year olds come in on antipsychotic medication and these children aren’t psychotic.” (Kaufman-Kantor & Blease, 2006, p. 10)
What’s happening to many foster kids is a perfect example of people using medication as a crutch rather than working on what would truly help a child. Being placed into foster care is a traumatic experience – typically more traumatic than any abuse or neglect children might experience in the home. Needless to say, kids who have had their entire life yanked out from under them are prone to acting out and exhibiting mental health issues. These problems aren’t created by chemical imbalances in the child, they are a reaction to what they’ve been through.
Yet rather than addressing the root of the problem, state workers and foster care agencies, having already abused a child once by tearing them from their home, abuse them again by doping these kids up to mask their psychological distress and make them easier to handle. I’ve seen some foster kids who were medicated into a virtual coma so that their providers didn’t have to deal with them. The poor kid slept all day long, and was cranky and irritable when you roused them from this drug-induced slumber.
The overmedication problem is just another symptom of society’s misplaced belief in medication as the cure all for our problems, and the tendency to look for a cure that comes in pill form. Until we solve this problem, kids will be continue to be put on medications they don’t need.