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This article originally appeared in the Oct. 28 Detroit News.
A package of bills before the Michigan Legislature would prohibit school employees from recommending that any student be prescribed Ritalin, a drug as potent as cocaine, to treat a "disease"—Attention Deficit Hyperactivity Disorder (ADHD)—about which many medical professionals have grave doubts.
The measures come none too soon. It is a mystery how a diagnosis as controversial as ADHD, and its equally controversial treatment with powerful drugs, can be unquestioningly embraced by America's educational and medical establishments.
Apparently, America is suddenly afflicted with a massive epidemic affecting between 4 and 6 million children, while children elsewhere remain relatively unscathed. Michigan ranks third among states in the use of Ritalin, which child psychiatrist Carl L. Kline of the University of British Columbia calls "nothing more than a street drug being administered to cover the fact that we don't know what's going on with these children."
Michigan lawmakers are responding to impassioned letters and phone calls from parents who feel pressured by teachers or school officials to place their children on Ritalin, which is classified by the U.S. Department of Justice, Drug Enforcement Agency and the World Health Organization in the same addictive category as cocaine and methadone. The U.S. Department of Energy's Nobel-prize winning Brookhaven National Laboratory recently found that Ritalin affected the brain's dopamine system with more potency than cocaine. Psychiatrist Nora Volkow said her research team was "shocked" by results that "clearly show that the notion that Ritalin is a weak stimulant is completely incorrect."
The bills being considered would also prevent school administrators from barring a child from school because parents refused to allow the child to take Ritalin or other ADHD drugs such as Adderall. They would establish a "Psychotropic Drug Use Advisory Council" to recommend proper policies. Another bill addresses the most frightening aspect of the Ritalin controversy: Parents could no longer be turned in to Child Protective Services for refusing to give their child drugs they regard as worse than the problem they are meant to solve.
A separate bill, introduced by Rep. John Hanson, D-Dexter, would very reasonably require the Department of Education to at least review its guidelines for dispensing prescription drugs in schools.
Other states have adopted and are adopting similar laws—common-sense measures in the wake of nationwide concerns that we may be drugging millions of children to make classrooms quieter.
Why should school nurses be dispensing these drugs when the public debate is awash in medical misgivings, not only about the drugs themselves, but also about the diagnosis that gives rise to their use? Dr. Lawrence H. Diller, a specialist in behavioral and developmental pediatrics and author of "Running on Ritalin," wrote to a worried parent in 1998: "The reason why you have been unable to obtain any articles or studies presenting clear and confirming evidence of a physical or chemical abnormality associated with ADHD is that there are none."
Ken Livingston, professor in the Department of Psychology and Program in Cognitive Science at Vassar College, articulates an argument for school choice in the ADHD controversy. Livingston says there exists "no mechanism, of the sort one would find in a school-choice-based system of education, for parents to seek out schools tailored to the temperaments and capabilities of their children." Instead, he says, "it becomes necessary to find ways of making children able to perform in the environment as they find it. And, in late 20th-century America, when it is difficult or inconvenient to change the environment, we don't think twice about changing the brain of the person who has to live in it."
Michigan's schools should tailor themselves to the needs of children, not the other way around. Until clearer medical and psychiatric consensus emerges on just what sort of problem our children are having, its causes, and what an acceptable solution might be, our schools should not behave as if such consensus exists.
Lawmakers are wise to reassess ADHD and the powerful drugs used to treat it.
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