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Sarah CaverniKade ParryEnglish 1010 – 058August 6, 2013The Misconception of ADHD PrescriptionsMost people in the United States nowadays have heard of ADHD (attention-deficit hyperactivity disorder) and its treatments. ADHD is a disorder that affects the attention span of many kids and adults in our society, making it difficult for them to stay focused, affecting their academic and professional lives. It also makes more difficult to control their behavior, and it leads to hyperactivity. Since it is an attention disorder, it is treated with stimulants that help patients focus not only on school but also on their everyday tasks, giving them a better control of their actions and thought process.There is a wide range of drug selections that can be used by ADHD patients, but the most common are Ritalin and Adderall. The use of these drugs has become one of the main discussion topics for psychologists, psychiatrists and parents in this last decade. Many of them are completely in favor of these drugs since they help the patients stay more focused, but some, like Dr. Lydia Furman are more skeptical when it comes to prescribing them because it can be really hard to fully diagnose ADHD (999). One of the things that has been making more difficult for people that actually need the medication to use it, is that many high-school and college students considered to be “normal,” have been using them to achieve a better academic performance. To fully understand why this may be considered a controversial subject, different groups of people with different backgrounds and education levels, need to be consulted so a variety of opinions can emerge. Many believe that the abuse of these drugs only exist because of the pressure placed in our young ones and because of that, many people now believe that these might be “gateway drugs.” There are also the doubts that always come to mind when talking about any prescription drugs just like its long-term effects for instance. And, of course, the most well-known view-point of this topic which is the fact that instead of cutting down on prescriptions, doctors should simply take more precautions when prescribing it.Laurie Raymond M.D., an important director in the Harvard Medical School MD-PhD Program, explains that “In the last 20 years, an increasing number of children, adolescents, and adults have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD)” (1). Which is something expected considering we are now living in the era of internet and smartphones 24/7 and that makes it harder for them to focus on less “interactive” activities. However, it’s been shown that the number of “illicit [users] of these medications in all age groups” has also increased accordingly, showing that from 1995 to 2006 “the rates of non-prescribed stimulant use ranged from 5 to 9 percent in grade […] and high school-age children and from 5 to 35 percent in college-age individuals” (Raymond, 1).Some say we owe this epidemic of illicit stimulant abuse to the constant pressure that students have when it comes to getting good grades and getting accepted into good college programs. “The strive for perfectionism in society often leaves students feeling an immense amount of pressure to succeed; with increased competitiveness in the job market, college students feel the pressure to get perfect grades” (Keeler). Most students deem as impossible to succeed at today’s academic programs without some sort of “advantage” and that’s where these drugs play a major role. They use it to stay more focused while in class, to try to understand a subject better and even to spend sleepless nights studying for tests. With time, these students begin to need bigger doses of these drugs to get the same results they did before, but what they might not be aware of, is that, as shown in a study with college students in 2003, “illicit users of methylphenidate were significantly more likely to earn lower grade point averages and engage in higher rates of alcohol and other drug use” (McCabe, Teter & Boyd, 2). This could be due to the fact that once their body is used to the stimulant that it didn’t need in the first place, it starts searching for different substances to “fill the void.”It is often brought up to the public’s attention by the media that these “stimulants [can] become gateway drugs to illicit drugs” (Breggin). This is not a new debate since the majority of discussions about stimulants are of the same nature and based on the fact that Ritalin has a certain similarity to cocaine, which could lead to a possibility of abuse when adults are taken off this medication after taking it for so long.Contrary to popular views, an article published in 2006 in the “New Scientist” magazine mentions that “Children with ADHD who are not given stimulant drugs are more likely to develop problems with drug abuse and dependency than those who are, perhaps because they have to turn to illegal stimulants on which they can become hooked to get relief from their symptoms” (Aldhous). So for those that claim that ADHD medications are “the beginning of a drug-abuse pattern” or even “gateway drugs”, this seems to prove the opposite by showing that if properly administered, these drugs can in reality, protect ADHD patients from searching for help in other illicit substances.McCabe, Teter & Boyd also seem to share of the same view as Aldhous. In an article they wrote about the illicit use of stimulants, they discuss how even though these medications have a high potential for illicit abuse, if taken properly by actual ADHD patients, they protect against substance-related disorders (2). Another example is Dr. Kelly Lundberg, who states in an audio interview that although the prescription of Ritalin to young kids could lead them to a possible future of drug-abuse based on the fact that they see it as a need to take these drugs, it is not likely that this will happen if they follow their doctor’s instructions, and that there are no hard evidences on that so it cannot be called a “gateway drug”.But what about taking these stimulants for a long period of time? Does it affect your health? Or is it even worth it? “When [these drugs are] given to children over long periods of time, they neither improve school achievement nor reduce behavior problems” (Sroufe). So one may ask why doctors are prescribing them as a solution to children today which is question that most parents should have. Dr. Sroufe, a clinical child psychologist that works as a professor for the University of Minnesota, seems to think that only few parents and physicians are aware of this fact and they are also unaware of the serious side effects that these drugs can have long-term such as growth inhibition and heart related problems.There are many factors that can go into consideration when talking about the long-term effects of these drugs on the human body, “With continued use over time, a tolerance is developed to Adderall, as seen with other addictive drugs as well – the more frequently these drugs, including Adderall, are used, the greater the amount that is needed to supply a response” (Collier). What Collier is trying to say here is that, the behavior produced by drugs such as Adderall can cause long-term dependency even if you use it as directed by a doctor, simply because, just like any other drug, the human body starts creating a certain resistance to it and makes it so that more is needed to achieve the same goals as before.In an article published on “Scientific America” back in 2009 written by Dr. Edmund S Higgins, it is mentioned that “recent studies, most of them involving animals, hint that stimulants could alter the structure and function of the brain in ways that may depress mood, boost anxiety and, in sharp contrast to their short-term effects, lead to cognitive deficits.” It is true that we haven’t seen many studies on the long-term effects of stimulants in humans, but, based on the few studies available to the public in different animals, some could say that people taking any medication of this type should be closely monitored to avoid any possible damage to their physical and mental health.All of this brings us to a really important aspect of these drugs, is ADHD over-medicated or is it over-diagnosed? Edward Hallowell brings up a great view on ADHD by explaining that the perception of life of a person dealing with this disorder is like "driving in the rain with bad windshield wipers" or "listening to a radio station with a lot of static, and you have to strain to hear what's going on […] it takes a lot of adapting to get on in life" (qtd. in Henderson). This gives us an idea of how hard it can be to live with ADHD and how hard it could be for someone to go undiagnosed for their whole life. A bigger percentage of people nowadays are being prescribed stimulants for their ADHD but many will say that the majority of these patients does not actually need the medication. In a discussion at the New York Times debate website it was said, “As responsible physicians, our goal should not be to reduce A.D.H.D. prescriptions indiscriminately, but rather to evaluate children with attention problems more stringently to ensure that A.D.H.D. is the correct diagnosis before starting treatment” (Froehlich). What Dr. Tanya Froehlich seems to make it clear here is that, instead of cutting down on medication, what needs to be done is a more extensive and thorough diagnosis to ensure that all of the patients being put on stimulants are actually going to benefit from it.She also goes on to say that “Medications are not effective and well-tolerated in every child with A.D.H.D., but they may confer important benefits. Thus, our focus should be on increasing rigor in A.D.H.D. diagnostic evaluations, rather than on blindly reducing medication use” (Froehlich). Which also goes into trying to show doctors and parents that the main focus should be at the diagnosis period and not anywhere else.Having been diagnosed with ADHD myself years ago, I would have to say that even though there are parts of each opinion that I agree with in this subject, the one that completely expresses my point of view would be Froehlich’s. Although I understand the concerns with the stimulants used in the treatment of ADHD and what the abuse of these substances could do to one’s life, I think that by spending the appropriate amount of time diagnosing someone that has this disorder could potentially be a life-changing experience to the patient. I do agree that in mild cases of ADHD, medication should be the last resort with therapy and “behavioral-coaching’ being the first options.Because of the illicit abuse of these drugs by non-patients and its coverage on the media, I have seen families “force” their teenage children to go off their medication thinking that it would be of great help to them, when in reality, all it did was cause these teenagers to try and turn to illicit substances for self-medicating purposes. ADHD is something that can be quite difficult to fully diagnose without confusing it with another learning disability, however, if school teachers and counselors were better trained to spot these children and teenagers earlier on, they could be helping save their future by avoiding that they get behind in classes and possibly drop out of school.I am against, however, the use of these stimulants in children under the age of 5. I think it is nearly impossible to tell if a toddler or a preschooler actually has ADHD or if they are just being normal, healthy kids who are naturally full of energy. They should still be watched closely if they act different than others around the same age, but before the age of 5 they should be only put on medication of this type under extreme circumstances.All in all, I think that people need to rethink their misconceptions on ADHD prescription drugs and always look for professional help if they think someone in their family might suffer from this disorder. Basing their opinion solely on what the media says can cause even more distress towards the young person that might think they have ADHD, creating with that, a barrier in communication within the family that is completely unecessary.Works CitedAldhous, Peter. “Hyperactivity Drugs Are out of Control” New Scientist Vol. 190 (2006): 8-9. SIRS Database. Web. 27 July 2013. Collier, M. "Adderall: History, Uses, Side Effects, and Withdrawal." n. pag. Web. 23 July 2013.Donohue, Andrew. “Ritalin: ‘Gateway’ to addictive drugs?” Star Tribune (2000) n. pag. Web. 23 July 2013.Froehlich, Tanya E. “Strive to Diagnose Better, Not to Prescribe Less.” The New York Times: Room for Debate (2012) n.pag. Web. 27 July 2013. Furman, Lydia. “What Is Attention-Deficit Hyperactivity Disorder (ADHD)?” Journal of Child Neurology Vol. 20 Issue 12 (2005): 994-1002. Academic Search Premiere. Web. 27 July 2013.Henderson, Randi. “Relying on Ritalin” Common Boundary (1996): 22-30. Web. 23 July 2013Higgins, Edmund S. “Do ADHD Drugs take a toll on the brain?” Scientific American (2009) n. pag. Web. 23 July 2013Keeler, Meredith. “Adderall addiction: Students misuse drug to gain boost while studying.” Iowa State Daily (2012) n. pag. Web. 23 July 2013Lundberg, Kelly. “Is Ritalin a gateway drug?” n.d. MP3.McCabe, Sean Esteban; Teter, Christian J. & Boyd, Carol J. “Medical Use, Illicit Use and Diversion of Prescription Stimulant Medication.” Journal of Psychoactive Drugs Vol. 38 Issue 1 (2006): 43-56. Academic Search Premiere. Web. 27 July 2013.Raymond, Laurie. “Risks of Stimulant Misuse: Beware of Stimulant Misuse for Clinical Reasons.” Physician Health Services, Inc. n.d. n.pag. Web. 27 July 2013. Sroufe, L. Alan. “Are We Wrong to Drug Our Kids?” International Herald Tribune (2012): 6. SIRS Database. Web. 27 July 2013. ................
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