212% Increase in Prescription Drug Abuse by US Teens_ Australian critics challen

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[sSRI-Research] 212% Increase in Prescription Drug Abuse by

US Teens_ Australian critics challenge loose prescribers

 

 

 

 

 

212% Increase in Prescription Drug Abuse by US Teens_ Australian

critics challenge loose prescribers

 

ALLIANCE FOR HUMAN RESEARCH PROTECTION (AHRP)

Promoting Openness, Full Disclosure, and Accountability

www.ahrp.org

 

FYI

 

Psychiatric prescription drugs have " run amok " : two reports (July,

August) by Columbia University's National Center on Addiction and

Substance Abuse, or CASA, confirm an epidemic of prescription drug

abuse among teenagers:

 

In his introduction to the July report, CASA Chairman and President

Joseph A. Califano Jr. zeroes in on the problem: " Particularly

alarming is the 212% increase from 1992 to 2003 in the number of 12-

to 17-year-olds abusing controlled prescription drugs, and the number

of teens trying these drugs for the first time. "

 

" The explosion in the prescription of addictive opioids, depressants

and stimulants has, for many children, made the medicine cabinet a

greater temptation and threat than the illegal street drug dealer, as

some parents have become unwitting and passive pushers. "

 

How odd that the division of Child Psychiatry at Columbia University,

is the primary pusher of a controversial, entirely subjective

screening initiative -TeenScreen-that is being unleashed across the

country's schools. TeenScreen searches for assumed undetected

psychiatric disorders in youngsters who often as not will be

misdiagnosed and promptly added to the roster of mental health

" clients " who are prescribed one or a combination of psychoactive

drugs. These are the very controlled substances that Califano warns about.

 

The risk that TeenScreen may trigger suicide ideas in previously

non-suicidal youngsters is not publicly acknowledged. However, it is

a risk, and the government has awarded a 4-year grant to Dr. Madelyn

Gould (Columbia) " for four new research projects on youth suicide. "

The first is for " a study to evaluate the iatrogenic risk of suicide

screening programs (NIMH), i.e., whether asking a youngster about

suicidal thoughts and behavior triggers subsequent suicidal ideation

and behavior. " How can one justify proceeding with mass screening of

school children before such a serious risk has been ruled out?

 

An article in The Australian reports about a heated controversy

regarding the legitimacy of ADHD as a psychiatric disorder. Without a

legitimate medical abnormality, there is no justification for exposing

children to psychostimulant drugs and drug cocktails that may alter

their brain function and impede their future. Critics note, for

example, the regional disparity in prescribing practices --much as has

been shown in the US-as evidence of the absence of an accepted

diagnostic and intervention standard. There is no explanation why

Western Australia has the highest number of prescriptions dispensed

for dexamphetamines at three and a half times the national average.

 

The Australian describes the hazards of misdiagnosing children with

ADHD: " It is one of Australia's most commonly diagnosed and

fastest-growing disorders among school-aged children. After the US -

where six million have been identified as having the disorder - and

Canada, Australia has the world's highest proportion of children

diagnosed with it. "

 

The good news is that in Australia a group of doctors are challenging

the " loose " prescribers within their profession.

 

" AT the age of 10, Brandon Frances screamed for hours on end, suffered

psychotic episodes and daily beat his mother. A pediatrician in Perth

diagnosed Brandon with attention deficit hyperactivity disorder when

he was four, and for the next seven years he was constantly medicated

with a cocktail of up to six different drugs to control his behaviour.

 

Now 13, Brandon no longer takes the medication, is behaving and doing

well at school. Eighteen months ago doctors at a Perth public hospital

clinic found Brandon did not have ADHD, but a learning disorder. His

entire treatment was changed. "

 

" Medication was killing my son, " his mother Katherine says.

" Medication was causing him to have psychotic episodes. He did not

have the disorders, the disorders developed because of the drugs he

was taking. "

 

 

Contact: Vera Hassner Sharav

212-595-8974

veracare

 

http://www.latimes.com/news/opinion/commentary/la-oe-eberstadt25sep25,0,3602544.\

story?coll==la-news-comment-opinions

September 25, 2005

 

A prescribed threat

Among the harshest critics of the child wonder-drug regimen?

Think rock icons.

 

By Mary Eberstadt,

 

MARY EBERSTADT is a research fellow at the Hoover Institution and

author of " Home-Alone America, " newly released in paperback by

Penguin/Sentinel.

 

WHEN TOM CRUISE and his fellow Scientologists took a hammering earlier

this year for their public opposition to psychiatric drugs, neither

they nor their critics could have anticipated the releases in July and

August of two weighty reports offering evidence that at least some

psychiatric prescription-writing has run amok.

 

If these two reports by Columbia University's National Center on

Addiction and Substance Abuse, or CASA, have it right, more kids than

ever have their fingers - and sometimes their noses - in somebody

else's psychiatric prescription pill bottle.

 

The July report ( " Under the Counter: The Diversion and Abuse of

Controlled Prescription Drugs in the U.S. " ) estimates that while

self-reported use of prescription drugs by people of all ages nearly

doubled between 1992 and 2003, abuse by teenagers during those years

tripled.

 

Similar increases appear in the August report, " National Survey of

American Attitudes on Substance Abuse X: Teens and Parents. " Between

April 2004 and June 2005, for example, " the percentage of teens who

know a friend or classmate who has abused prescription drugs jumped 86%. "

 

In his introduction to the July report, CASA Chairman and President

Joseph A. Califano Jr. zeroes in on the problem: " Particularly

alarming is the 212% increase from 1992 to 2003 in the number of 12-

to 17-year-olds abusing controlled prescription drugs, and the number

of teens trying these drugs for the first time. "

 

Nor does Califano sugarcoat the question of just how close to home the

problem hits: " The explosion in the prescription of addictive opioids,

depressants and stimulants has, for many children, made the medicine

cabinet a greater temptation and threat than the illegal street drug

dealer, as some parents have become unwitting and passive pushers. "

 

At a time when many doctors, teachers and parents swear by the

beneficial effects of prescription stimulants for minors, words as

unsparing as Califano's are likely to be dismissed as alarmist.

 

But these reports are not the only evidence of the harm done by these

drugs to at least some kids. If we look at what kids say, sing and

report about psychiatric medications, we learn that among the harshest

critics of the child wonder-drug regimen are some of its intended

beneficiaries and graduates.

 

Consider two music icons. The late grunge-rock guru Kurt Cobain

appears in retrospect as a kind of anti-poster boy for child

stimulants. Prescribed Ritalin from the age of 7, Cobain believed that

the drug led to his later abuse of related substances. (He committed

suicide by shotgun in 1994.)

 

Cobain's widow, Courtney Love, put the connection this way to

biographer Charles R. Cross: " Kurt's own opinion, as he later told

her, was that the drug was significant. Courtney, who also was

prescribed Ritalin as a child, said: 'When you're a kid and you get

this drug that makes you feel that [euphoric] feeling, where else are

you going to turn when you're an adult?' "

 

Marshall Mathers, a.k.a. bad-boy rap superstar Eminem, is another

prominent self-perceived child victim of the label-and-medicate

momentum. In an article in Rolling Stone magazine, Howard Stern said

that Eminem told him that his mother " misdiagnosed him with attention

deficit disorder. 'My mother said I was a hyper kid, and I wasn't,' he

said. 'She put me on Ritalin.' " One telling Eminem hit called

" Cleaning Out My Closet " includes the lyric, " My whole life I was made

to believe I was sick when I wasn't. "

 

It seems almost too perverse to be true: Cobain's and Eminem's fans

might get a stronger anti-stimulant message from their icons' examples

than from their own parents, teachers and doctors.

 

Criticism of the child-drug phenomenon also comes from writers who

self-identify as members of " the Ritalin generation. " One is Elizabeth

Wurtzel, author of the books " Prozac Nation " and " More, Now, Again. "

The latter detailed her harrowing descent into Ritalin addiction after

a well-meaning doctor prescribed the drug to help her " focus " on writing.

 

Advocates of psychiatric medication for children often argue, and

passionately, that these drugs alleviate the suffering of many

children and families. But if that positive experience is to be a

legitimate test, so too should the negative feelings and experiences

of others be acknowledged.

 

" These [stimulants] are very safe medications, " a child psychiatrist

at Harvard Medical School told a reporter in the wake of the July CASA

report. " They have been used for 70 years, and we haven't had terrible

catastrophes. "

 

Yet it doesn't take a Scientologist to wonder whether " terrible

catastrophe " is the most accurate measurement.

 

http://www.theaustralian.news.com.au/common/story_page/0,5744,16644615%5E28737,0\

0.html

 

Generation Ritalin

 

Doctors are at odds over the treatment of children affected by ADHD

.... to drug them or not to drug them?

 

Michelle Wiese Bockmann reports

September 19, 2005

 

AT the age of 10, Brandon Frances screamed for hours on end, suffered

psychotic episodes and daily beat his mother.

 

A pediatrician in Perth diagnosed Brandon with attention deficit

hyperactivity disorder when he was four, and for the next seven years

he was constantly medicated with a cocktail of up to six different

drugs to control his behaviour.

 

Now 13, Brandon no longer takes the medication, is behaving and doing

well at school. Eighteen months ago doctors at a Perth public hospital

clinic found Brandon did not have ADHD, but a learning disorder. His

entire treatment was changed.

 

" Medication was killing my son, " his mother Katherine says.

" Medication was causing him to have psychotic episodes. He did not

have the disorders, the disorders developed because of the drugs he

was taking. "

 

ADHD is loosely characterised as persistent and severe inattention,

hyperactivity and impulsive behaviour. It is one of Australia's most

commonly diagnosed and fastest-growing disorders among school-aged

children. After the US - where six million have been identified as

having the disorder - and Canada, Australia has the world's highest

proportion of children diagnosed with it.

 

Australian studies estimate between 2.3 per cent and 6 per cent of

children around the country have the disorder. Its cause is unknown,

but genetic, cognitive, neurophysiological, family and environmental

factors are thought to contribute. There are no clinical or medical

tests to diagnose it.

 

How the medical community is managing and treating ADHD is fiercely

contested. And last month it killed off the career of a pediatrician

who specialised in the treatment of children in Adelaide and Perth.

 

Harry Nash retired last month, tired of a decade-long battle with a

cluster of Adelaide doctors who repeatedly complained to the medical

board about the prescriptions he has given ADHD children. The group

represents many of those in the medical fraternity who believe the

condition is widely misdiagnosed.

 

They are also horrified about so-called polypharmacy - the prescribing

of multiple drugs in young children to treat ADHD and related

disorders. In some cases, children - such as Brandon - as young as

four have been prescribed adult doses of powerful, psychotropic drugs

for their conditions.

 

Support groups, doctors and parents are also questioning the quick-fix

solution provided by stimulant drugs such as dexamphetamine and Ritalin.

 

These drugs, prescribed to calm and focus ADHD children, are at the

frontline of treatment. Yet teachers have described students in

classrooms in a zombie-like state, stoned on drugs.

 

Between August 2003 and July 2004, 305,638 prescriptions were written

for dexamphetamine and 208,235 scripts were issued for

methylphenidate, commonly sold as Ritalin.

 

Yet there are some parents who argue their ADHD children must remain

medicated, such as Judith Naylor-Vane, the Adelaide mother of

13-year-old Timmy.

 

Nash diagnosed Timmy with ADHD when he turned three. Before Timmy

began school he was taking anti-depressants and dexamphetamine. Today,

he also takes benzodiazepine for anxiety, and Clonidine to sleep.

Concerned about dangerously high levels of drugs prescribed by his

pediatrician, hospital psychiatrists tried to detoxify Timmy a few

years ago. Doctors also complained to the medical board in the late

1990s about how Nash was treating Timmy without his mother's knowledge.

 

" They took him off the drugs but over time they put him back on

everything, " says Naylor-Vane.

 

When he was off drugs " he went straight back to panic attacks, going

into himself; you couldn't reach him " .

 

Taylor-Vane says Timmy has ADHD, features of autism,

obsessive-compulsive disorder, different phobias, problems sleeping

and many anxieties. This co-morbidity - having different disorders

alongside ADHD - is not uncommon.

 

About 50 to 80 per cent of children diagnosed with ADHD also meet the

criteria for at least one other disorder, such as oppositional

defiance disorder, conduct disorder and Tourette's syndrome, according

to the Learning and Attentional Disorders Society of Western Australia.

 

Nash says he was hounded from his job because he supports prescribing

multiple drugs for children such as Timmy.

 

" They often have depression, so you need to treat that, " Nash says.

" And if there's an anxiety disorder, that needs to be treated too. You

have to treat each disorder separately. "

 

Until his retirement, Nash was one of a small group of specialist

pediatricians around Australia operating clinics to treat ADHD.

 

Prominent South Australian child psychiatrist Jon Jureidini, head of

the psychological medicine department at Adelaide's Women's and

Children's Hospital, is one of their chief critics.

 

He led complaints against Nash before the Medical Review Board of

South Australia. " They are responsible Australia-wide for the vast

majority of poly-pharmacy and high-dose prescribing and those who

adopt that approach tend to do it in a lot of kids, " he says.

 

Doctors are allowed to prescribe so many drugs for children because

" you don't have to prescribe according to the guidelines... I guess it

shows a flaw in the medical system that that can happen, " Jureidini says.

 

He dismisses suggestions ADHD is a disorder. " I just don't think that

it is right that there are that many children around who have four or

five different things wrong with them, " he says.

 

" So when you have got a kid with ADHD and oppositional defiance

disorder and depression and anxiety disorder and stuff, what this says

is not that he has got four disorders, but that there is something

wrong with the kid and people haven't properly understood what it is

yet. " Jureidini says in some cases, abuse or neglect may be 100 per

cent responsible for children's behaviour. In other cases, parenting

has very little to do with it.

 

The president of Australia's Hyperactivity Attention Disorder

Association, Julie Appleton, reacts testily when told of claims from

child psychiatrists such as Jureidini that ADHD is not a disorder.

 

" For God's sake, which part of the Ark did he get off? " she asks.

Appleton says parents should first check children's diets for food

intolerance and allergies, many of which are not found in junk food,

but from foods with naturally occurring chemicals such as tomatoes and

orange juice.

 

Only when this has been ruled out should parents look at options such

as medication.

 

" This is 2005, we are not scared of medication, " Appleton says. " What

we are scared of is the incredible depression in children that comes

from these problems [having ADHD] because they are ostracised at

school and not socially acceptable. " The highly emotional and

controversial debate about treatment has featured at state and federal

parliamentary inquiries, among hospitals and at medical board hearings

around Australia. A parliamentary report in Western Australian last

October concluded it was not clear whether ADHD was the cause of

dysfunction in children, or whether it was the result of family or

other dysfunction. It concluded up to three-quarters of affected

children may have been wrongly diagnosed.

 

Western Australia has the highest number of prescriptions dispensed

for dexamphetamines at three and a half times the national average. A

federal parliamentary library study of prescribing rates reached no

conclusion for this disparity but said: " It appears that Australia

still has some distance to go before achieving best practice in the

prescribing of medication for the treatment of ADHD. "

 

The National Health and Medical Research Council last issued

guidelines for ADHD treatment in 1997. It recommends the short-term

use of stimulant medication as safe and effective, and part of any

management plan. But the NHMRC says medication should be used with

caution among toddlers and pre-schoolers. Expert opinion should be

sought when multiple drugs are considered to treat other co-morbid

conditions. Counselling and education for families and children should

be part of treatment alongside medicine, it says.

 

But this view is under attack. A drug effectiveness review by Oregon

State University in the US was released this week into the

effectiveness of ADHD stimulant drugs and found little evidence they

were safe, effective or boosted children's performance at school.

 

It's a view heartily endorsed by parents such as Katherine Frances,

angry she went through years of hell because her son was wrongly

diagnosed and placed on so much medication.

 

" If my child, who they [doctors] thought would always be medicated can

survive and do better without medication then I think all children

should be given the opportunity Brandon has been given, " she says.

 

 

 

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