The latest fad among elite college-bound students is snorting Adderall, an amphetamine that is routinely prescribed for attention deficit hyperactivity disorder, or ADHD. According to an article in the New York Times on June 9, 2012, pressure for grades and competition for admission to Ivy League colleges has spurred a rise in the abuse of stimulant drugs. According to the Times reporter, Alan Schwarz, these kids now take the drug by "snorting" it in powder form, instead of taking a pill, in order to obtain an enhanced ability to focus almost instantaneously. Achieving this kind of "tunnel focus" helps students get higher grades in high school and higher scores on college entrance exams such as the SAT and ACT.
Surprisingly, high school students obtain prescriptions for these drugs not only from other students who are "dealers," but also from doctors who prescribe them legally. In Suffer the Children, which was published more than a year ago, I explained how ADHD prescription drugs have replaced coffee and Coca-Cola as study aids on college campuses. College students have long known that amphetamines improve concentration and increase stamina for long hours of study. But now, as the Times article points out, the trend is spreading to high school students as well. Students often lie to their psychiatrists or primary care doctors to obtain the stimulants legally. Sometimes, according to the Times, they sell some of their pills to their classmates.
Many students, as well as parents, assume that because Adderall and other stimulants are legal for prescription use, they must be safe. Almost 21 million prescriptions for these drugs are written each year for children ages 10 to 19, up 26 percent since 2007, according to the Times article. Yet, surprisingly, the stimulant drugs that doctors prescribe to children are actually Class 2 controlled substances, "the same as cocaine and morphine" according to the Times article. They "rank among the most addictive substances that have a medical use." Yet in our culture, parents have grown so comfortable with giving stimulants to their children that they think of them as though they were in the same category of medication as allergy pills. And parents, teachers and doctors have become as comfortable with the ADHD diagnosis as though it were a just another variety of the common cold. Children in ever-increasing numbers line up at summer camps and schools for their daily doses of amphetamines.
Although the pharmaceutical company Shire, the manufacturer of Adderall's extended release capsules, say studies show no link between prescribed use of stimulants and later abuse, there is some evidence to the contrary. In Suffer the Children, I cite a study by a professor at the University of California at Berkeley, which finds a correlation between taking stimulants over a long period of time in childhood with addiction to cocaine in late adolescence or early adulthood. The Times reporter interviewed an addiction counselor, Liz Jorgensen, who came to the same conclusion from her own experience running a small rehab center. Ms. Jorgensen has seen teenagers land in rehab "directly from the stimulants." After taking ADHD medications for years, these kids, in her view, "grew comfortable with prescription drugs in general." Some of them went on to abuse OxyContin.
Joel Bakan, professor of law at The University of British Columbia and author of Childhood Under Siege: How Big Business Targets Children, has serious concerns about the burgeoning use of stimulants among children. Bakan comments: "It is a real concern, especially because of the adverse health effects on young people. And even while Big Pharma insists they don't condone such diversionary uses, the trend is part of a culture they invest heavily to create and expand -- namely, one in which we, including young people, are expected to meet life's challenges by taking potentially dangerous pills. The only clear winner here is Big Pharma."
Lately, however, I have seen some signs of hope, as parents are waking up to what ADHD drugs actually are. Recently, a father came into my office loudly asserting that he was not going to give his 10-year-old daughter "speed" for some "fad diagnosis." Her doctor had recently diagnosed his daughter with ADHD on the recommendation of her school and had prescribed Adderall. He sought me out because a friend of his had recommend family therapy as an alternative to medication. A 13-year-old boy who had also been diagnosed with ADHD used the Internet to inform himself about the medication his doctor had prescribed for him. "I don't want to become a drug addict," he told me.
More articles like the one in the Times are needed to inform parents about the consequences of putting excessive pressure on their kids and readily giving them powerful psychiatric medications to improve their focus and their grades. Our country's children deserve better -- well-established therapies that are safe and effective alternatives to long term drug use.
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