The federal government has scheduled a major conference on ADHD and psychostimulants that seems bound to further escalate the use of psychostimulants to control the behavior of millions of America’s children. The “Consensus Development Conference on the Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder” is set for November 16-18 in Bethesda, Maryland at NIH. While this writer has accepted an invitation from NIMH and NIH to be the scientific presenter on the subject of “Adverse Stimulant Effects,” the conference as a whole remains very unbalanced.

Suppressing the Behavioral Signals of Unmet Needs

Approximately 4-5 million children in the United States are already being diagnosed with ADHD and prescribed Ritalin to control their behavior. By 1995 the International Narcotics Control Board (INCB) estimated that 10-12% of American boys were being prescribed Ritalin. Meanwhile, the numbers have continued to rise.

Most recommendations for psychostimulants originate from the schools. Almost all the official criteria for ADHD are behaviors that result from boredom, frustration, or lack of discipline in school, such as restlessness, talking out of turn, interrupting, and failing to pay attention. When these normal developmental behaviors are exaggerated in the classroom, it usually indicates the need for increased and improved adult attention, including smaller classes, more consistent and rational discipline, and more individualized and inspiring educational activities. When these same exaggerated behaviors are displayed in the family, then the children are in need of more informed and constructive attention from parents and other caregivers.

It is possible in the short run to reduce these, or any other, spontaneous behaviors in children by administering a number of different classes of psychiatric drugs. Instead of identifying and meeting their needs, drugging the children suppresses the expression of their distress and exposes them to serious adverse drug effects.

Psychostimulants Encourage Conformity

Ritalin’s sought-after therapeutic effect, “compliance” in school and the family, is in fact an adverse drug effect. This drug-induced docile behavior is caused by chemically blunting or subduing the child’s higher brain function. That part of the child’s brain requiring creativity, freedom, play, energetic activity, consistent discipline, and inspiring educational activities will be blunted. The drug effect has nothing to do with any supposed disorder in the child. Psychostimulants will suppress the spontaneous behavior of healthy animals and children alike.

Psychostimulants will also suppress emotional expression. The bright child who is bored, the shy child who is being bullied every recess, the energetic child who is especially interested in socializing, and the impoverished child who is suffering from hunger every morning—all will express less feeling about their condition while under the influence of a psychostimulant.

By suppressing needs and their expression, psychostimulants encourage conformity. This is a sought after outcome for many institutions but it is not good for the physical and emotional development of children.

Asking The Right Questions

When faced with such a dramatic new phenomenon as the widespread use of drugs to control children in school and at home, questions must be raised about the failure of our families and schools to meet the basic needs of our children. We must examine the professional, political, cultural, and economic forces behind the movement. Ultimately, we must examine the values that encourage us to drug our children rather than to improve the capacity of our families and schools to meet their individual normal developmental needs.

Why Ritalin Is Medically Contraindicated In Children

Psychostimulants always disrupt pituitary function and growth hormone production, frequently stunting growth. Ritalin advocates never discuss the most threatening aspect of this gross suppression—it affects the entire body, including the brain.

On the basis of growth hormone disruption alone, Ritalin is medically contraindicated for children. But as I discuss in Talking Back To Ritalin, there are many other reasons not to give Ritalin to children, including developmental neurotoxicity—the disruption of multiple neurotransmitter systems during their formative stages of growth in the child’s brain.

After more than forty years of use, there is still no convincing evidence for long-term improvement in any aspect of a child’s life. This, of course, is not surprising. It is farfetched to imagine that giving variations of “speed” to children is going to benefit them in the long run. Short-term, overall behavior is suppressed without an improvement in learning or academic performance.

The Thrust Of The Upcoming Consensus Conference

The upcoming Consensus Development Conference was planned by NIMH under the supervision of NIH. Nearly all the presentations will be based on a medical model that diagnoses presumed disorders in the child. Teachers and parents alike will be further mislead into believing that there is a “disorder” that can be “treated” with drugs.

Some children do suffer from genuine medical conditions—such as lead poisoning, head injury, or thyroid disorder—that can cause undesirable behaviors. In these cases, the children will be given a real medical diagnosis rather than ADHD. Most children diagnosed with ADHD have nothing wrong with them. They are children with normal brains who are responding to environments that have unrealistic expectations and that fail to meet their needs.

Consensus Development Conferences are intended to bring together experts from across the spectrum of a controversy to testify before a panel or jury whose duty it is to arrive at an “objective” evaluation. Tragically for America’s children, the panel will not be presented with sufficiently diversified testimony to come to a balanced decision. To come to a critical viewpoint of ADHD and psychostimulants, it would have to access to viewpoints and data withheld from them by the organizers of the conference.

What Kind of Data?

The conference emphasis on presenters who generate “scientific data” is also highly misleading. The organizer of the conference, Peter Jensen, has told me that I am the only exception to his policy of limiting the scientific presentations to people actively involved in formal research projects that are generating “data” on ADHD and drugs. His arbitrary decision effectively confines the testimony to a group of investigators who have made careers out of their advocacy of ADHD and Ritalin.

Nearly all the data to be presented at this conference has been generated by advocates of ADHD and psychostimulants with research funding from NIMH, drug companies and others who favor a “medical” approach. Furthermore, it was generated in very narrow parameters, usually short clinical trials that attempt to assess reductions in behaviors that adults have defined as undesirable. The data says little or nothing about the origin of these behaviors or the rationality or human cost of chemically suppressing the undesirable behaviors of children.

Meanwhile, a great body of evidence and data, some of it reviewed in Talking Back to Ritalin, will be left out of the conference. There are studies, for example, showing that the quality of both family and school life affect the development of children in regard to nearly all of the behaviors included in the ADHD diagnosis. There is strong evidence that improved schooling can reduce or eliminate the need of teachers to recommend their children for behavioral evaluations and psychostimulants.

The issue transcends that of scientific data when a nation turns to drugging children as the major solution to their academic failure, lack of discipline, unrest, frustration, boredom and resistance to authority. The issue becomes one of values and requires social analysis. The conference would benefit from much more critical analysis by individuals familiar with the broader ethical, educational, familial, and societal implications.

CH.A.D.D. Influencing Conference

Conference organizer Peter S. Jensen, NIMH’s Associate Director for Child and Adolescent Research, is a staunch Ritalin advocate. Jensen has enlisted the aid of CH.A.D.D.—the drug company funded parents group—in picking the “objective” panelists. As I document in Talking Back to Ritalin CH.A.D.D.’s policies are sometimes more extreme than those the drug companies in advocating a biological and pharmacological viewpoint.

NIMH’s Jensen Confirms The “Zombie Effect”

Jensen should know better than to advocate drugs for the control of children. As documented with quotes in Talking Back to Ritalin, he was senior author of a study showing how children given Ritalin tend to lose their sense of personal responsibility and self-determination, and how the adults in their lives tend to withdraw interest from them once the medicating has begun. He never published the paper and does not cite it in his recent reviews. Instead, in a column written for CH.A.D.D.’s newsletter in the Spring of 1998, Jensen ridicules and dismisses critics of Ritalin. He rejects the idea that Ritalin changes the personalities of children and can make children into “zombies.” Yet he himself co-authored a book chapter in the 1995 Comprehensive Textbook of Psychiatry in which he described Ritalin as having a “zombie” effect. The zombie effect is merely the extension of the drug’s “therapeutic” effect, the dulling of spontaneity with the production of docility and compliance.

Radical Experiments On Inner City Children

As the Associate Director for Child & Adolescent Research, Jensen is responsible for funding oppressive violence initiative research projects aimed at experimenting on inner city children in search of biological and genetic explanations for their behavior. Two of the worst of these NIMH-funded projects have recently come under criticism by the US Congress and national media.

Opening The Inner City Market For Psychiatric Drugs

The fenfluramine experiments are part of the previously discredited “violence initiative” search for genetic and biological explanations for inner city youth violence. It is victim blaming at its worst. Ultimately, the research will justify the use of drugs like Prozac that affect the serotonergic system. Through this research, NIMH is funding the interests and aims of the drug companies who are currently eager to increase the market for drugs among children, especially the undeveloped market of inner city children. At the 1998 American Psychiatric Association meetings, the Global Alliance of Mental Illness Advocacy Networks (GAMIAN) urged “aggressive treatment in childhood and adolescence,” according to PR Newswire.

With so many relatively affluent suburban children already on psychostimulant drugs, that market is becoming saturated. Inevitably, poor and minority children will be the next large scale target for the drug companies and organized psychiatry. We have documented this marketing strategy in more detail in P. Breggin and G. Breggin, The War Against Children of Color (1998).

One Voice Is Not Enough

I will do my best as a scientific presenter at the conference to enlighten the panel about the dangers and irrationality of prescribing Ritalin for the control of children. But with several dozen others presenting from a pro-Ritalin perspective, my impact will be relatively limited. To reach a genuine “consensus” requires a much more balanced program involving greater participation from concerned citizens, advocacy groups for children, educators, experts in the social sciences, and health professionals who understand the real needs of our children and how to meet them.