After a tremendous outcry from L. Alan Sroufe’s article Ritalin Gone Wrong, WOR’s Joan Hamburg took an in depth look at the hot topic. Are parents and teachers truly feeding into the societal view that “all life’s problems can be solved with a pill”? Or is there substantial proof that this medication provides an easier, more productive life for the child and family?
On Tuesday, Jan. 31st, Dr. L. Alan Sroufe joined WOR to discuss his piece in the New York Times that took an aggressive stance on medicating children who have problems in focusing. His piece claimed that no study has found any long-term benefit of attention-deficit medication on academic performance, peer relationship or behavior problems, but parents continue to consider medicine like Ritalin and Adderall as absolutely essential to their child’s functioning.
He writes, “As a psychologist who has been studying the development of troubled children for more than 40 years, I believe we should be asking why we rely so heavily on these drugs.”
Dr. Harold Koplewicz, the founding psychiatrist at The Child Mind Institute, also joined WOR to point out what he calls “disturbing” and “misleading” facts. Dr. Sroufe compares the dependency of these drugs to cigarette or coffee addiction, but Dr. Koplewicz says depriving children of psychiatric medication is like not giving them insulin or glasses.
Let’s get to the facts. Dr. Sroufe, a psychology professor emeritus of the University of Minnesota’s Institute of Child Development, says three million children in this country take drugs for problems in focusing. His research began in the 1970’s when approximately 150,000 children were on stimulant medication. That’s a 20 fold increase in the consumption of drugs for ADHD over the past 30 years.
Dr. Koplewicz, on the other hand, says, “To say three million kids are taking medicine, and maybe we’re over-medicating them, misses the point completely.” That’s because there are actually 15 million children with psychiatric disorder, proving that less than half get any help. “Help”, of course, being the operative word.
As far as the effectiveness of these drugs, Dr. Sroufe notes that stimulant medications are not effective after the first two years. He tells WOR, “It seems reasonable that the overall effectiveness of the drug would dissipate because we’ve known for a long time other side effects like loss of appetite and sleeplessness dissipate over time.”
Dr. Koplewicz responds by saying, “It’s a misleading fact…If you’re not taking the Ritalin after 8 years you’re going to go back to the baseline. [Ritalin] helps your symptoms while you’re taking the medicine.” The help vs. cure argument is also supported by the fact that it’s impossible to truly measure a child’s progress over a long period time as it’s completely unethical to put a child on a placebo for 6 years while they think they’re being treated.
Dr. Sroufe happens to see that in a different light. “There wasn’t a long term study but this new one came out with negative results that were more compelling.”
He adds, “There are advantages in certain entities in our society to not have people be aware of the lack of effectiveness that these drugs have, obviously in particular the pharmaceutical companies.”
It seemed like Dr. Sroufe’s hardest hitting point is what Dr. Koplewicz felt to be an attack on every parent who gives their child stimulant medications. Beginning in 1975, Dr. Sroufe conducted a study that followed the progress of 200 children born into poverty. His results found that the environment of the child predicted the development of A.D.D. problems. Among them are family stresses like domestic violence, lack of social support from friends or relatives, chaotic living situations and frequent moves.
He tells WOR, “I by no way belittle the difficulty that many children and their families are facing…Obviously there is not a simple solution to parents each working two jobs and being completely out of energy when they come home to a needy child…But I think our society would be capable of addressing such a problem.”
Perhaps a realist, Dr. Koplewicz tells us, “It’s nice to believe if we were better parents, gave them a better diet, made them exercise more, had better schools, and so on, all these problems would disappear, but the fact is bad parenting or bad schools don’t cause kids to have ADHD. It’s actually a real disorder.”
And in perhaps what could be an example of the doctors meeting halfway, Dr. Sroufe says, “For an individual child [medication] may be helpful. Now having said that, the reason I wrote this piece is that we need to be doing something much more. The underlying root causes, in my opinion, is the amount of the frequency of troubled children in our society has a lot to do with the kind of stress that families are under.”
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