The Australian findings
reported in the media have effectively recreated the US debate of the last decade, with some added stats which look positively lousy, even as a relatively small percentage of the prescription rate.
ADHD (Attention Deficit Hyperactive Disorder) has been controversial since the acronym was created.
There are basically three lines of argument in the ADHD debate:
1. There’s no such thing.
2. There is such a thing, and medication is necessary.
3. There is such a thing and medication isn’t necessary.
As someone who grew up before the Medicate Everything And Everyone era, may I just make the point that if 95% of kids have one behavior pattern and the other 5% fit a classification of ADHD and have totally different behaviors, there must be something
However, there’s also a fourth perspective, which is the quaint theory that:
4. There is such a thing and if medication’s required, it should work properly.
The controversy hasn’t got very far in any direction in terms of achieving change. In the US, the general belief is that medication is the benchmark practice where a condition requires treatment, but nobody’s too happy with the overall situation. Side effects are totally distrusted, and there’s been a lot of displeasure with the apparent lack of interest in side effects, as well as lack of action.
The logic of any situation where a child with ADHD can go from hyperactive to a state where they’re exhibiting fixated responses like attempted suicide as a result of medication needs a look.
Let’s assume a situation where the diagnosis is correct, there is a need for treatment, and a suicidal episode occurs.
A few natural questions arise:
Ø Why the psychotic episodes?
Ø What are the factors involved?
Ø What about dosage?
A sudden drastic change of behavioral patterns, from ADHD, which as something to live with is potentially impossibly annoying (particularly for a non-existent situation), translates as “fun” and is normal to the individual, to a sudden crash, is likely to be very disturbing. The medication has effectively contradicted their basic drives.
Anyone who’s been on psychoactive medication will know that the effects can be dramatic. Now, imagine those effects on a child. How exactly is a five year old supposed to deal with what is effectively a polarization of their natural state? Adults don’t deal with that situation too well. The kid is in quite unfamiliar emotional territory, and doesn’t have any prior experience to help them adjust.
The “normal” suicidal episodes in childhood are usually environmental. Thanks to the ever caring, ever sharing environment of the society, death looks good. There’s a rationale, wrong as it may be, but there’s some logic behind it.
The pharmacological issues are clearer. If there’s a known negative side effect, what about dosage? Any first year medical student knows that more isn’t necessarily better. Any first year pharmacology student knows that more of a psychotropic probably isn’t better. Dosages are supposed to be matched to individuals. There’s only one likely outcome of any inappropriate dosage over the correct dose.
This is definitely not rocket science, and it’s an issue which hasn’t been getting a lot of attention, as far as I can see. The pharmaceutical industry itself has an interesting case history of ADHD in terms of overlooking certain issues. The world’s media isn’t exactly being buried in information about these cases.
The fact that a percentage of kids are having these side effects has to have some bearing on pharmacology practices. Naturally, there’s been no release of any specific information regarding cases, but there’s an obvious dramatic difference in results. The major percentile of kids in treatment apparently aren’t having these effects.
A total of 827 cases, in any society which had either the brains or the genitalia to look after its kids properly, would be producing class actions, legislation, regulation, and some effective case law. Around the world, it’s producing bleatings, rationales as suicidal as any teenager’s, and euphemisms.
Are psychotic states in kids normal? Previous generations grew up without them. The total percentage of suicides and attempted suicides was a tiny fraction of current levels.
Given the total ineffectuality of public debate, and the equally ineffectual mouthwash spouted by governments, the prognosis for the future isn’t looking great.
The questions that aren’t being asked are:
Ø Why are suicidal side effects acceptable at all?
Ø Why are psychotic episodes acceptable?
Ø Wasn’t the original idea to treat a transient behavior pattern?
Ø What are the criteria for success with these medications?
Ø Have there been any studies of long term effects of these psychotic cases?
There’s one other question: “Who’s minding the store in pediatrics?”
It’s well known that many pediatricians aren’t too thrilled about the Medicate Or Die approach. Medication is often seen as “doing something”, a common curse of medical practitioners where some sort of solid response has to be given, mainly to assuage the demand for “something” from parents. Some parents having bought the script, are now reassured they’ve “done something”.
Why, exactly, doesn’t the pediatrics profession simply tell Big Pharma to stop playing with its research budgets or whatever other of its own anatomical features they find so alluring, and come up with a working therapeutic regime?
Pediatricians have more clout than they seem to realize. If the US pediatric professional associations said publicly “We won’t touch this medication”, I think you’d find a very contrite major industry paying attention. They’d get a lot of support from parents, who are perhaps the one surviving relic of a functional public interest group in the US.
Just one more thing: There’s a lot of indications that a diet based on sugar, cardboard and TV commercials isn’t a great idea, and that most parents wouldn’t know a free range vegetable if they saw one. Being a lot less expensive than medication, real food might be an option.
Another 200 year old remedy for the inability to concentrate is Calcium Phosphate. There’s even something called B vitamins, available in something called supermarkets. There was once some ritual called healthy exercise, too.
Gosh, all these innovations.