Columnist Sandra Thompson: Kids’ prescriptions are often just a quick fix

Sandra Thompson

Sunday, Feb. 27, 2000 | 9:53 a.m.

Sandra Thompson is vice president/associate editor of the Las Vegas Sun. She can be reached at 259-4025 or by e-mail at thompson@lasvegassun.com.

What does a drug dealer typically look like? A shady figure on a street corner; a rotund man in a white suit who runs the Colombian drug cartel?

There is growing concern that he may be your pediatrician or psychiatrist.

According to a study released last week, the use of Ritalin and anti-depressants to treat children ages 2 to 4 has doubled or tripled from 1991 to 1995. An article in Insight Magazine estimates that nearly 6 million children ages 6 to 18 are taking mind-altering drugs for "alleged mental illnesses."

Some experts describe this alarming national trend as the "doping of our kids."

Dr. Norton Roitman, a psychiatrist who conducts evaluations for the Clark County School District through its Medical Consultant Clinic, calls it the "medicalization of psychiatry. The trend is toward psychopharmacology."

In other words, we are asking our children "to swallow instead of grow," he says.

The vast majority of drugs such as Ritalin are being prescribed to children who exhibit symptoms of Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD). Symptoms include not paying attention in school, not listening when spoken to directly, failing to follow directions, losing things, being easily distracted and forgetful, fidgeting with hands or feet, talking excessively, blurting out answers or having difficulty awaiting one's turn.

There is considerable national debate over whether these symptoms are indications of a brain disorder or mental illness, or are behaviorial and stress-related problems.

"A lot of children manifest symptoms of a fragmentation of our society, so we treat them as if they have a mental or brain disorder," Roitman says.

A good number of children involved in contentious custody battles have been diagnosed with ADD or ADHD. In one case, all three siblings in the family are on medication for the disorders.

"Symptoms of ADHD often look just like the symptoms of the effects of family turmoil on a child, of a child's emotional upheaval due to divorce, autism, physical illness, death of a grandparent. Even children who are merely spoiled exhibit symptoms that look like ADHD," Roitman says in a series of articles he authored called "Beyond Behavior."

Another category of problems that causes symptoms of attention deficit syndrome, he says, includes demoralization, moods and despair with anxieties, which in extreme cases can be seen as mental illness.

Roitman says medicating children for ADD and ADHD should be done with doubts and with consideration of other methods. He suggests individualizing treatment plans that fit the circumstances and values of the child and family. Psychological, neurological and hormonal factors should be considered when making a final diagnosis.

Drugs are the treatment of choice for ADD and ADHD. It's easier to pop a pill to change behavior. Insurance companies, particularly HMOs, are more inclined to pay for drugs than therapy. Studies touting the effectiveness of these drugs sometimes are suspect since they are funded by private industry, particularly the drug companies themselves.

One local pediatrician believes teachers are too quick to recommend Ritalin for troublesome students. An 8-year-old boy was referred to him because he wasn't paying attention in class. It didn't take the pediatrician long to discover the reason wasn't ADD. The boy was depressed because his father recently died.

While there are true cases, ADD and ADHD are overused diagnoses. The quick fix is to give kids drugs to make them pay attention and behave. By all accounts, the drugs work. But what about the long-term effects?

It's something to think about before filling that prescription for your 6-year-old.