J____ W_____

UCCA 102.5

Dr. Dave Dedo

October 6, 1997

Ritalin: Harmful or Helpful

When "20/20" and "Oprah" did segments about ADD on television, many parents felt that they finally knew what was "wrong" with their kids. They rushed to the doctor’s office to find out how they could "fix" the problem. Most soon discovered a drug called Ritalin. It sounded simple. All they had to do was give their rambunctious or hyperactive child a pill three or four times a day, and magically he or she would be a perfect little angel. Most were so happy to find a cure that they did not stop to contemplate other methods of treatment, possible side effects, or get a second opinion. Dr. Sharon Collins believes this is because, "It takes time for parents and teachers to talk to kids. It takes less time to get a child a pill" (Hancock 52). Parents get stuck in the mind set that Ritalin is a cure all for hyperactive children. Many psychiatrists say that "about half of the children who show up in their offices as ADHD referrals are actually suffering from a variety of other ailments" (Hancock 52). Some doctors claim that "parents of normal children have actually asked for Ritalin just to improve their child’s grades" (Hancock 53). When parents cannot get Ritalin from one doctor, they keep searching until they eventually find one who will prescribe the drug (Hancock 53). It is not hard to find a doctor to prescribe Ritalin, because many "think that by giving a child Ritalin, the likelihood of helping him is high and the downside is low" (Hancock 53).

Ritalin has become the most prescribed drug for people with attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD). An abundance of media coverage brought Ritalin to the attention of parents, educators, and doctors worldwide and caused a drastic increase in the diagnosis of ADD and ADHD. The increased popularity of Ritalin has led to premature and improper diagnosis of ADD and ADHD and the subsequent growth of the number of prescriptions written for Ritalin. Many experts feel physicians should be more aware of the side effects of the drug and look to alternate solutions before prescribing Ritalin. Some experts also believe that Ritalin should be only part of the treatment for patients with ADD or ADHD. The drug, which now saturates the market, produces the same sensations as the narcotic speed if someone who is not ADD or ADHD takes it. Because of its narcotic nature, Ritalin is considered by law to be a controlled substance, and its dosage and intake must be carefully monitored. Parents see Ritalin as a "quick fix" and urge doctors to prescribe it for their children, thus leading to premature or improper diagnoses, more people having adverse side effects to the drug, and an increased availability of the drug for non-medicinal purposes.

Many doctors do not take the time to perform a complete evaluation of the patient who is suspected to have ADD or ADHD. They listen to the teacher or parent and assume because the child has a short attention span or is very hyperactive that the child must have ADD. The doctors do not take time to examine other possibilities for the child’s behavior "such as learning disabilities, depression, or anxiety-disorders that look like ADHD, but do not need Ritalin" (Hancock 55).

This need to find a "quick fix" has led to a sixfold increase in the number of prescriptions in the last five years (Bromfield 33). Even the manufacturer found this statistic alarming and "sent letters to doctors and pharmacists warning them to exert greater control over the drug" (Bromfield 33). These children then begin to take Ritalin and have adverse side effects. Many find that they have trouble sleeping or experience a loss of appetite. Other symptoms can include a racing heart, nausea, and headaches (Chisholm 44). Although Ritalin does help my cousin pay better attention in class, he begged my uncle to take him off of Ritalin because it made him "feel funny." He said the pills made him feel tired and lethargic. He did not "feel like himself." Serious side effects can include facial tics and muscle twitching (Price 40). Some studies have also shown that massive doses of Ritalin may cause cancer in mice (Chisholm 44). Abuse of Ritalin can lead to "psychotic episodes, violent behavior, tolerance and severe psychological dependence" (Price 40).

The increased circulation of Ritalin has caused many problems in schools. Ritalin is "fast becoming a recreational drug in high schools and on college campuses" (Bromfield 33). In some areas of the country Ritalin is known as "Vitamin R" and can be bought for "$3 to $15 per pill, to be crushed and snorted for a cheap and relatively modest buzz" (Hancock 52). Studies also show that "recent trends indicate that adolescents are giving and selling their prescription medications" (Price 40). Because of the increased abuse of Ritalin, the Drug Enforcement Agency has classified Ritalin as a Schedule II controlled substance (Hancock 52). This classification puts Ritalin in the same group as "cocaine, morphine, PCP, codeine, and methadone" (Price 39). Because of its classification, Ritalin prescriptions cannot be refilled; therefore parents have to take their children to monthly doctors visits. Parents have begun lobbying to try to ease these restrictions, but the Drug Enforcement Agency strongly opposes them and has enlisted the help of the International Narcotics Control Board (Hancock 53). In 1993, the International Narcotics Control Board found that the United States "produces and consumes five times more Ritalin than the rest of the world combined" (Price 39).

The increased restrictions on Ritalin have led to tighter security when dispensing medication. In Williamson County Schools, in Franklin, Tennessee, parents are only allowed to bring in one week worth of Ritalin for their child. Every Monday morning, parents can be seen walking into Grassland Elementary School with their children’s weekly medication. My mother, who works in the office, will then count the number of pills in the bottle and the parent or guardian must confirm the count and sign a record book. These procedures allow the school to limit the supply of the drug in the building at any given time. It also allows the school to have proof of how much medication should be in each child’s medicine bottle at any given time. These procedures help my mother tell if a child has forgotten to take his or her medicine that day. In addition to keeping close tabs on the amount of medicine in the building, she must make sure that the medicine cabinet is kept locked at all times to prevent someone from stealing the pills to sell as narcotics. Although she feels these procedures are a pain, she sees why they are necessary. They protect her and the school from allegations of misuse or wrongful dispension of Ritalin.

An incident at Grassland Middle School led to these medicine procedures in all Williamson County Schools. In 1995, a teacher at Grassland Middle School was caught stealing Ritalin pills out of the school vault. The office staff became suspicious when they noticed that several students were running out of Ritalin before they should be. They began to take a count of all of the pills in each bottle each time someone went into the school vault. Eventually, they discovered that one of the teachers was stealing the students’ medication to get high. He was arrested and taken to jail, and subsequently relieved of his teaching position. This story was aired on "20/20" as an example to all viewers of the dangers of Ritalin and to show how it can be used for non-medicinal purposes.

Attention deficit disorder can be treated by other methods as well, but none of them are as easy to administer as Ritalin. Baillie, a psychologist, believes that although "teachers are not saying it directly, many parents feel they are being pushed to try Ritalin" (Chisholm 44). He feels this is the easiest way for teachers to deal with "program cuts and bigger classes" and still obtain "peace in the classroom" (Chisholm 44). Some parents have found that if they do not go along with the diagnosis and put their child on Ritalin that they will not get any support from the school (Hancock 56).

Although Ritalin is a wonder drug for those patients it helps, there has been a steep rise in the number of people who are harmed by the drug. Doctors are giving into parents demands and prescribing Ritalin without taking the time to perform a proper diagnosis. Children taking the drug are experiencing a wide variety of side effects ranging from nausea to severe psychological dependence. The large number of prescriptions being filled has led to an increased circulation of the drug. This, in turn, leads to a greater possibility of misuse of the drug. Office staff and administrators have to come up with safety procedure to insure safe and proper dispension of the drug.

Works Cited

Bromfield, Richard. "Fad or disorder?" American Health June 1996: 32-33.

Chisholm, Patricia. "The ADD dilemma: is Ritalin the best way to treat attention deficit

disorder?" Maclean’s 11 March 1996: 42-45.

Hancock, LynNell. "Mother’s little helper." Newsweek 18 March 1996: 51-58.

Price, Joyce. "DEA restless about Ritalin: doctors are sounding the alarm about a popular drug used to combat attention disorders in kids." Insight on the News 1 July

1996: 39-40.