Re: Problems Caused By The Ever-Increasing Role Of Psychiatry In The Schools
We are appealing to you because we respect and honor the tremendous responsibility you have accepted to safeguard and oversee the education of our state's young people. We thank you for all the work you do on our behalf.
Our appeal comes directly from a grave concern we have about a distinctly modern and very dramatic trend we are witnessing in our schools. Our concern is about the ever-increasing role of psychiatry in the schools. Please consider the following illustrative data.
In his 1998 book, Running On Ritalin, Dr. Lawrence Diller thoroughly reviews the history of Ritalin production and consumption. In 1970, a best guess was offered that 150,000 children in the United States were taking Ritalin. In 1980, estimates were between 270,000 and 541,000; use roughly doubled in that decade. By 1990, estimates were closer to 900,000, again roughly doubled. There was, according to the Drug Enforcement Agency, a 700% increase in the production of Ritalin between 1990 and 1997, 90% of which is consumed in the United States. A conservative estimate of United States school-age children on Ritalin in 1997 was 3,500,000; another 1.4 million were estimated to be taking other amphetamines. Neurologist Fred Baughman, another thorough researcher on this topic, estimates the current number at between 5 and 7 million.(1) IMS Health, a commercial drug survey company, documents the continuing increase in Ritalin prescriptions, 13.9 million for the 1997-1998 school year, with a predicted 42% increase for 1998-1999. The IMS data also reveals that for analeptic class (stimulant) drugs used to treat ADD/ADHD, Ritalin comprised 69% of the U.S. market. Others, including Adderall, Cylert and Dexedrine, comprise the balance of 31% of the total prescriptions dispensed.(2) Production data collected by the Drug Enforcement Agency confirms that any leveling off of methylphenidate production in the last three years has been more than matched by increased production of other amphetamine-type drugs; the total numbers continue to rapidly grow.(3)
Based on this available data, a realistic estimate of the number of school-age children on Ritalin today in the United States is 5,000,000. Since Ritalin represents 70% of the total prescriptions for amphetamine-type drugs, we can add the other 30% and we have well over 7,000,000 of our school children in this country on stimulant drugs. In 1971, when estimates of Ritalin prescription use was under 200,000, our country was alarmed enough that the DEA classified Ritalin and other amphetamines as Schedule II drugs, a category that indicates significant risk of abuse. The number of children on psychiatric stimulant drugs today (7,000,000) is 40 times the 1970 number (175,000). This has to be a cause for major alarm in all adults concerned for the welfare of our children. Yet even this alarming fact is not the whole picture. We are not only giving more and stronger amphetamines like Adderall and Dexedrine to our children, we are also witnessing a dramatic increase in the use of adult antidepressants with the children.
Arianna Huffington reported 735,000 children ages 6-18 on Prozac and related anti-depressants in 1996, up 80% since 1994. This included a 400% increase in the number of children ages 6-12 on Prozac in just one year, 1995 to 1996.(4) A 1998 article by Kate Muldoon(5) reports the number as 909,000. In a more recent article, Ms. Huffington reports that, despite disturbing evidence of drug-induced manic reactions, the number of antidepressant prescriptions for children continues to soar, reaching 1,664,000 in 1998.(6)
The bottom line is that we are giving stronger and stronger psychiatric drugs to more and more children. Many of our children are taking more than one of these drugs at a time, and many of these drugs were never even tested and approved for children. Probably over 8,000,000 school-age children in the United States are on powerful psychiatric drugs today. Other than our neighbor Canada, no other countries in the world are using psychiatric drugs this way with their children; it is a distinctly North American phenomenon.
DEA data puts Texas at number 31 in a listing of 1998 retail distribution for methylphenidate and d-amphetamine, and number four on dl-amphetamine--so let's just say we're right in the middle, about average in this country. What does it mean that 8,000,000 children are on psychiatric drugs? U.S. census data reveals that the United States population for ages 6-18 is about 51,473,000; this would indicate that approximately 15% of our school-age children are on psychiatric drugs. Does this seem unbelievable? Two recent research articles clearly demonstrate there are communities, one in Virginia, the other in the Vancouver, Canada area, where the rates of stimulant prescriptions to children is 20%.(7) The International Narcotics Control Board reports that in some American schools, as many as 40% of children in a class are on methylphenidate.(8) A recent Time Magazine (10/25/99) article describing a week in a typical American high school, reported the estimate of the school social worker that as many as 20% of the school's students take psychiatric drugs. There are large disparities from school to school and county to county, but however you slice it, the numbers are amazingly high. Since the population of Texas is approximately 13% of the total United States population, that means about 1,000,000 of the children in our elementary and secondary schools in Texas are on psychiatric drugs.
Some people think that it is good that all these children are taking psychiatric drugs, that science has finally advanced to the point that our children are getting the needed treatment they deserve. These people even argue that our children are actually underdiagnosed and undertreated, given the rates of ADHD and other mental illnesses. People like Joseph Biederman at Harvard think that 10% or more of our nation's children suffer from ADHD, and that up to 10% may benefit from treatment with tricyclic antidepressants. These people believe in the tenets of biological psychiatry which hold that failures in social adjustment are due to biologically or genetically-based mental illness, best treated by drugs. The insuperable problem with this point-of-view is that it is not in any way based in authentic medical science. The legitimate scientific practice of medicine is based in the treatment of objectively validated physical disease entities. A researcher discovers consistent, physical, genetic or biological markers of disease--a lesion, a virus, a bacteria, a cellular abnormality, some kind of functional or structural abnormality common to those with certain symptom patterns. Then comes the search for helpful treatment. In contrast, the stark truth is that no psychiatric disorder has been consistently demonstrated to be of biological or genetic origin.
Regarding ADHD, this was agreed upon by a collection of experts and researchers from across the land in last year's NIH consensus conference on ADHD (11/18/98); the final statement of the conference read: "...we do not have an independent, valid test for ADHD, and there are no data to indicate that ADHD is due to a brain malfunction."(9) Dr. Fred Baughman directly asked a who's who of ADHD experts to "refer me to the one or a few articles in the peer-reviewed, scientific, literature that constitute proof that ADHD is a disease with a confirmatory, physical abnormality." Leber, of the FDA, responded: "...no distinctive pathophysiology (abnormality) for the disorder has been delineated." Haislip, of the DEA, wrote: "We are...unaware that ADHD has been validated." Swanson, of the University of California, Irvine, never replied. However, speaking to the American Society of Adolescent Psychiatry, he concluded: "I would like to have an objective diagnosis for ADHD... psychiatric diagnosis is completely subjective... we will validate it." Castellanos, of the NIMH, confessed: "... we have not yet met the burden of demonstrating the specific pathophysiology...we are motivated by the belief that it will be possible in the near future to do so." Carey, of the University of Pennsylvania, replied: "There are no such articles. There are many articles raising doubts, but none that establish the proof you or I seek."(10)
The truth is that ADHD is not a medical disease in any legitimate sense of the term; the fact that medical doctors diagnose it as a "disease," and "treat" it as one, does not alter this fact. Nor does the fact that our educational system encourages, promotes and allows it to happen. Dr. Baughman spoke the plain truth in his testimony at the aforementioned consensus conference: "It is not a matter of misdiagnosis or over-diagnosis, it is a total, 100% fraud!" There is absolutely no evidence of a disease; therefore, no legitimate justification of medical treatment.
The Effects of Psychiatric Drugs
A proper explication of the effects of psychiatric drugs requires a book. For a short version of physical effects, the standard Physician's Desk Reference is adequate. For our purpose here, suffice it to say that every organic system is affected: cardiovascular, central nervous system, gastrointestinal, endocrine/metabolic, and more. Some children die. The only proper response to the use of these powerful and highly toxic chemicals on our children is profound and grave concern.
The Zombie Effect
The psychological effects of psychiatric drugs are enormous. Regarding Ritalin, perhaps most poignant is the observation of many parents and other adults that they have somehow lost their child, that the spark is gone, the eyes are vacant, the zest and vitality are lessened. In their 1995 Comprehensive Textbook on Psychiatry, L. Eugene Arnold, professor emeritus of psychiatry at Ohio State University, and Peter Jensen, chief of the National Institute of Mental Health research branch on children and adolescents, make the following admission:
"The amphetamine look, a pinched, somber expression, is harmless in itself but worrisome to parents, who can be reassured. The behavioral equivalent, the 'zombie' constriction of affect and spontaneity, may respond to a reduction of dosage, but sometimes necessitates a change of drug."(11)
Even when not so dramatic, something is always lost due to suppression by the drug.
One thing that is always lost is the inborn right and need of individuals to develop their characters, their abilities to function and regulate themselves without being under the influence of drugs. That is always lost. Also always lost is the inborn right and need of the child to grow and develop on all levels in as wholesome a way as possible. That, too, is always lost.
There are many other profound effects besides the physical. Perhaps most significant here is the belief and conviction that one is somehow defective and inferior, that one is not ok without drugs. The feeling that goes with this is called shame, and it feels lousy.
A related additional belief is that one is not responsible; the message, even when effort is made to also give the obviously contradictory message, is that you are not responsible because you have an illness. Something goes wrong, there's a bad day, and the first question is "Have you taken your Ritalin today?" And soon enough, everyone's off on the search for a different dosage, or a different or additional drug. Do you know how many of our preadolescents and teenagers are on two to six different psychiatric drugs all at the same time? It is more than a few.
The more dramatic effects get our attention. Even the PDR lists "frank psychotic episodes" as an effect of Ritalin.(12) The American Psychiatric Association acknowledges suicide as a major complication of Ritalin withdrawal in its Diagnostic and Statistical Manual.(13) The Food and Drug Administration has received numerous adverse drug reaction reports regarding suicidal or violent self-destructive behavior while on Prozac. There is a plethora of psychiatric drug studies demonstrating a connection between suicide and violence and use of psychiatric drugs, and between psychiatric drug withdrawal and violence. We are all becoming aware of the remarkable fact that so many, perhaps most, of the perpetrators of senseless violence in the last fifteen years were taking psychiatric drugs. In 1998 and 1999, Oregon's Kip Kinkel, Colorado's Eric Harris, and California's Steven Abrams are dramatic examples. These and many more are well-documented by Bruce Wiseman.(14)
The federal government has had profound impact on our educational system. Laws passed in 1963 and 1965 opened the doors to mental health services in the schools. Section 504 of the Vocational Rehabilitation Act of 1973, which covers anyone with a physical or mental impairment that limits a "major life activity," including learning, was a determining factor in the expansion of special education since it required that schools not discriminate against children with disabilities. Funding for special education reached $1 billion in 1977. In 1990, however, an even more significant law was passed; it is the Individuals with Disabilities Education Act (IDEA), passed by Congress in 1990 as PL 94-142. The IDEA goes beyond prohibiting discrimination; it mandates that eligible children receive access to special education, and that it must be designed to meet each child's unique educational needs. In 1991, the Department of Education issued a policy clarification that ADD be included as a covered disability. Dr Lawrence Diller's opinion is that "This policy change was the spark that set off the decade-long explosion in Ritalin production and use."(15) By 1994 special education was a $30 billion per year activity, and still climbing. Also in 1994, 26 percent of U.S public school students were in special education classes, whereas in other countries the figure was 1-3%.(16) Congressional re-authorization of IDEA in 1997 renewed the trend. The rhetoric of humanistic (child-centered, focused on the whole child, including values, and social and personality development) education and special services in the schools appeals to our basic loving and caring nature. The facts are, however, that practice has not lived up to the rhetoric. The attempt to meet more of the needs of our children through special education has gone awry; upwards of ten percent of our school populations are classified as disabled, and a very high percentage of these are given psychiatric drugs. Psychiatry has pervaded our schools.
Despite the 1997 re-authorization of IDEA, there is considerable controversy about the role of special services in the schools, especially the balance between entitlement and discipline. Many feel that these laws have tied the hands of educators, limiting their ability to maintain discipline and order in the classroom. The traditional options of corporal punishment or expulsion have been taken away. Schools are mandated to keep the children, and to adapt to their needs, usually interpreted as disabilities. In the case of ADD and other psychiatric diagnoses, this means their "mental illnesses." For countless others, it is their "learning disabilities." A profound effect of diagnosis and labeling is that, once done, everyone is absolved of responsibility to keep thinking about what are the real problems, and how to solve them. The tendency is to think that the problem is explained by the diagnosis (e.g., Johnny has ADD; that's why he's having a hard time), that it's a genetic or biological problem, that he can't help it, and it has nothing to do with our system. He is entitled to our special services, and we have to cope with him. No one is really responsible, and no one can really be held accountable. The best solution, so this argument goes, is a biological treatment, drugs, to hold the "illness" at bay. Declining literacy(17), high dropout rates(18), and school discipline are major concerns. That we are resorting to psychiatric drugs to control millions of our children is in no way a solution. It is not working for the benefit of our children; it is a cause for incredible alarm. This practice must be stopped. It is our responsibility to keep thinking and searching for the deepest truth and the best solutions.
A Brief Summary Of The Issues
First, we must face the self-evident fact that every day we are giving powerful, toxic mood-altering drugs to millions of our school-age children.
Second, we must face the fact that these drugs do not really help our children. Research clearly shows that these drugs have absolutely no positive long-term effect on any criteria we value for our children--no positive effect on academic, cognitive, behavioral or social outcomes.(19) There may be short-term improvement in tests of physical strength, endurance and speed, but only while on the drug. There may be short-term improvement in school production and compliance, and this is probably why it is so popular, but it does not address significant emotional or learning problems. There is no lasting positive change on any academic, social or psychological outcome.
Third, we need not to deny or minimize in any way the truth that these drugs cause a wide variety of harmful physical and emotional effects, clearly listed in the Physician's Desk Reference, clearly demonstrated in the research. The social and psychological effects are a cause for grave concern; these include interference with the development of self-control, character and personal responsibility.
Fourth, reliance on diagnosis, labeling, and giving psychiatric drugs to our children acts to distract us from the effort required to keep thinking and come up with real solutions to the great challenges we face. It is not that biopsychiatry in the schools is our only educational problem; it is that this approach interferes with the courageous head-on facing of the problems. The fact is that biopsychiatry harms our children and makes things worse for the reasons described above.
3. 1998 report by Gretchen Fuessner, "Diversion, Traficking, and Abuse of Methylphenidate".
4. Chicago Sun Times, 6/17/98.
5. The Oregonian, 6/1/98
6. After Littleton: Antidepressants In The Bloodstream, http://www.ariannaonline.com/columns/files/050699.html
7. "The Extent of Drug Therapy for Attention Deficit-Hyperactivity Disorder Among Children in Public Schools," GB LeFever, KV Dawson and AL Morrow. American Journal of Public Health, September 1999, vol. 89, pages 1359-1364. "Boys Will Be Boys Ð ThatÕs Why WeÕve Got Them Popping Pills," Anne Rees. The Province, Vancouver, BC, August 9, 1999, pp. A14-16.
8. INCB Annual Report, Release No.4;www.incb.org/e/press/1998/e_rel_04.htm.
9. p. 3, lines 10-13.
10. The ADHD Consensus Conference: End Of The Epidemic, by Fred A Baughman Jr. MD, 12/7/98. http://home.att.net/~Fred-Alden/Es30.html.
11. p. 2307, quoted in Peter Breggin, Talking Back to Ritalin, Common Courage Press, 1998.
12. 1998, p. 1897.
13. Vol. IV-R, pp. 207-210.
14. Psychiatry And The Creation Of Senseless Violence. (Copy Enclosed)
15. Running on Ritalin, p. 150.
16. In Wiseman, Psychiatry: The Ultimate Betrayal, Freedom Publishing, 1995.
17. National Adult Literacy Survey of 1993, Wiseman p. 275.
18. According to a 12/6/99 letter from Communities in Schools, 25% of 9th graders in Texas do not finish high school.
19. See Swanson, J.S, McBurnett, K. etal., "Stimulant medication and the treatment of children with Att Def Dis: A Review of Reviews" Exceptional Children, Vol. 60, 1993, pp 154-161.