The Anti-ADHD/ Anti-Ritalin Movement

1. The Anti-ADHD/ Anti-Ritalin Movement History and Discussion Mary Brinkmeyer

2. Recent Events • Statistics and Controversies • The Critics

3. Recent events • 1999: Colorado State Legislature holds hearings on psychotropic medications and school violence • Speakers include members of “watchdog” Scientology groups

4. Recent Events Cover of The Boulder Weekly, 2001 • 1999 Colorado State School Board passes resolution cautioning against use of psychotropic meds • Original intent of resolution was to ban Ritalin

5. 2000: Class Action Lawsuits • Filed against APA, CHADD, and Novartis (formerly Ciba-Geigy) • Alleged conspiracy to promote ADHD diagnosis for purpose of maintaining psychotropic drug industry. • Alleged cover-up of dangers of Ritalin • Lawsuits eventually dismissed.

6. 2001-2003: State Bans on Schools Recommending Ritalin • CT, VA, CO pass laws prohibiting educators from recommending psychotropic medications • CT, UT state that refusing to give children psychotropic medications is not medical neglect

7. Child Med. Safety Act of 2003 • May 2003: Passed by House 425 to 1 • Requires states “to develop and implement policies and procedures prohibiting school personnel from requiring a child…to obtain a prescription for a controlled substance.” • Requires tracking of prescription rates for ADHD meds • Opposed by American Psychiatric Association, American Academy of Pediatrics, CHADD, National Association for Mentally Ill.

8. Stimulant Statistics: Cause for Concern? • 500% increase since 1991 in ADHD prescriptions • Preschool ADHD meds tripled from 1990-1995. • In past 15 years: • 311% increase in kids 15-19 taking ADHD meds • 170% increase in kids 5-14 taking ADHD meds • Methylphenidate manufactured 2 ½ times the rate of a decade ago • 11 million prescriptions written each year • 2000 profits for stimulants = $758,000,000 The New York Times, The Drug Enforcement Administration, Education World

9. Stimulant Statistics: Cause for Concern? Methylphenidate Consumption (Defined Daily Dose in millions) Drug Enforcement Administration

10. Over-diagnosis and over-prescription? • Jensen’s 1992 survey of stimulant use in selected regions found only 12.5% of ADHD kids treated with stimulants. • LeFever’s 1995 survey of VA schoolchildren found rates of medication 2-3 times higher than expected, with 20% of 5th grade white boys taking ADHD meds. Rates much lower for girls and black children.

11. Over-diagnosis and over-prescription? • Angold’s 1992-1996 survey of rural NC children found almost twice as many kids on stimulants (7%) as met DSM-III ADHD criteria. Stimulant meds more common in comorbid ODD kids. • Bussing (2003) found poverty and minority status negative predictors of receiving any tx for ADHD.

12. Methylphenidate Abuse • Can be abused in following ways: • Orally (more common when used to stay awake) • Crushing and snorting tablets or dissolving in water and injecting (used to produce euphoria)

13. Methylphenidate Abuse: 2002 Stats Monitoring the Future National Survey of 420 Schools

14. Methylphenidate Abuse • 1993-1999 American Association of Poison Control Centers reported 759 cases of methylphenidate abuse in kids ages 10-19 brought to ER. • Most not prescribed the drug • Number of cases increased over time • Most not admitted, and medical outcomes good. Klein-Schwartz & McGrath, 2003

15. Methylphenidate: A Gateway Drug? • 4-year study of boys ages 15-19 • 56 medicated ADHD, 19 un-medicated ADHD, 137 controls • Rates of substance use disorder at 4-year follow up significantly higher for un-medicated ADHD • Suggested “protective” effect of ADHD meds. Biederman et al., 1999

16. CHADD: The 1995 Merrow Report (PBS) Expose • CHADD receiving hundreds of thousands in funding from Ciba-Geigy • No mention of this in brochures, educator’s manual, fact sheets, etc.

17. CHADD: The Merrow Report • No mention of Ciba-Geigy link in CHADD video distributed using grant from US Dept. of Education • Dept of Ed officials not aware of Ciba-Geigy link. • Video showed parents highly praising Ritalin without identifying themselves as CHADD leaders. • Video distributed when CHADD’s fight for decontrol of Ritalin heating up.

18. CHADD: The Merrow Report • UN International Narcotics Control Board expressed concern. • Two days after Merrow Report aired, Dept of Ed pulled video.

19. CHADD: Current Status • Still receive 17% of funding from pharmaceutical industry (2002 report) • Acknowledge this on publicly-published financial report (not that easy to find) • Discuss commitment to ethics and not allowing contributions to influence policy and statements • Discuss importance of psychosocial interventions

20. The Critics: The Good, the Bad, and the Nutty

21. Concerned Practitioners • Lawrence Diller: Running on Ritalin (1998) • Behavioral pediatrician and family therapist who regularly prescribes Ritalin • Worries Ritalin is “easy solution” for often complicated situations • Raises concerns about ADHD being misdiagnosed.

22. Concerned Practitioners • Peter Breggin, Talking Back to Ritalin • Psychiatrist, opposes all psychotropic medications for kids • Argues ADHD not biologically-based, drugs are cop-out for parents, doctors, and teachers • Says meds “crush a child's desire to socialize, to play, to escape, to be full of stuff like kids are” • Often testifies at anti-Ritalin hearings

23. Scientologists • Scientologists have opposed psychiatry and psychology since failed to accept founder L. Ron Hubbard’s theory of “dianetics” in 1960s. • Main anti-psychiatry arm: Citizen’s Commission for Human Rights (CCHR). • Celebrity spokespeople: Kirstie Alley, Lisa Marie Presley, Kelly Preston, Juliette Lewis, Jenna Elfman, Issac Hayes.

24. Psychiatry Betraying & Drugging Children - Harming Lives Psychiatry Destroying Religion - Creating Evil Psychiatry's Betrayal - Creating Racism Psychiatry Victimizing The Elderly - Denying Respect Psychiatric Rape - Betraying Women Psychiatry Eradicating Justice - Creating Crime Psychiatry Destroying Morals - Creating Chaos CCHR: Selected Publications

25. Scientologists • Dr. Fred Baughman (neurologist): leading speaker for CCHR • Website www.adhdfraud.com • Frequently quoted by anti-ADHD activists without acknowledgement of Scientology connection • Main proponent of conspiracy theory.

26. Proponents of Alternative Therapies • Hundreds of books on treating ADHD without drugs. • Range from fairly sound behavioral principles to diets, supplements, exercise, etc. • Rarely include any empirical data.

27. Questions, Discussion