The Overmedication of American Children

We in America tend to take medications for almost any problem we have, from headaches to gastrointestinal pain, to more serious chronic disorders such as depression and attention deficit disorder. While many of the uses of such medications may be necessary and legitimate, many are not, and due to this fact, many people become dependent on medications, mentally, and or physically. This problem is not simply the fault of the individual; in fact, the blame can also be placed upon the medical community, and the pharmaceutical companies who produce the drugs. How often can one turn on the television to see advertisements for Claritin, Aspirin, Pepto-Bismol, or even Zoloft or Ritalin? The pharmaceutical industry is motivated by monetary gain, not purely by the well being of those using their drugs. These companies have aggressive advertising campaigns, and representatives who travel to medical practices to promote the company’s products. Pharmaceutical representatives are rewarded generously for increases in the prescription of their drugs, causing them to be highly motivated to convince medical professionals of the worth of prescribing their products. The use of medications, prescription or not, should be based on one factor alone, necessity, and if necessity is not the reason for the drug’s use, then in effect, the drug is being abused. One particularly troubling case of overmedication is that of Attention Deficit Hyperactive Disorder.

During the first three quarters of the twentieth century, the average American had never heard of two troubling conditions: Attention Deficit Disorder and Attention Deficit Hyperactive Disorder (ADD and ADHD). Today these disorders are so common place that they have practically become household names. They are becoming more common by the year, and if the commonality of their diagnosis continues, promise to unleash an epidemic of massive proportions on The United States.

Symptoms, today classified as ADD and ADHD, were first observed at some level in children during the early 1900s. In the 1902, the disorder was described as a “defect of moral control” by a British pediatrician, who was among the first to believe that there was a medical cause rather than a spiritual cause behind the disorder. In 1937, doctors first began testing amphetamines (highly potent, addictive, psychoactive stimulants) to treat impulsive and hyperactive behaviors. In the 1950s, doctors began to use stimulants, including amphetamines and methylphenidate (today marketed as Ritalin), to treat hyperactivity and impulsivity. In the 1960s, Stella Chess, a researcher, introduced the term “Hyperactive Child Syndrome” to describe the symptoms of ADD and ADHD. Following this, the use of stimulants to treat ADD and ADHD, became a widespread practice in the United States. In 1980 the American Psychiatric Association (APA) termed the grouping of inattentive and impulsive behaviors as Attention Deficit Disorder (ADD). Their exclusion of hyperactive behavior from the grouping led to a second classification, introduced to include hyperactive behaviors (ADHD), but to differentiate between normal ADD and its hyperactive component. During the 1980s and 1990s, children labeled as ADD or ADHD were given stimulant medications two or three times daily in order to control their behaviors. In the year 2000, the first 12 hour slow release medication was introduced, named “Concerta”. The advent of this medication comforted many who were worried by the rush induced by a sudden introduction of large amounts of stimulant into the bloodstream; however the benefits varied little from previous medications.

In October of 2001, The American Academy of Pediatrics (AAP) published a set of guidelines for treatment of those diagnosed with ADD and ADHD; these guidelines focused on primary care physicians, and established 5 clear guidelines. These guidelines are still in use today and state that physicians should develop an individual treatment plan for use in their practices, which recognizes ADD and ADHD as a chronic disorder. Furthermore the disorder should be targeted on a daily basis by all parties affected by the disorder, including the child, the parents, the doctor responsible for the child’s treatment, and school officials. Appropriate goals should be set by these parties in order to guide the management of the disorder. The guidelines also state that doctors should either prescribe stimulant medication or behavior therapy in order to reach the outcomes desired by the parents. If the original treatment plan fails, the guidelines state that doctors should “evaluate the original diagnosis, the use of all appropriate treatments, whether the treatment plan was followed properly, and the presence of coexisting conditions”. The doctor should also provide follow up consultation with the child, parents, and teachers in order to track the child’s progress and identify