Are we over-prescribing ritalin and similar drugs to our children? One study, Are Stimulants Overprescribed? Treatment of ADHD in Four U.S. Communities, found that 5.1% of children would fully meet the criteria for ADHD. Of which, only 12.5% of children were receiving medication. They concluded
Medication treatments are often not used in treating ADHD children … suggesting the need for better education of parents, physicians, and mental health professionals about the effectiveness of these treatments
The results of the study suggest that there are over three million children and teenagers who have ADHD. Of which just under 400,000 are using prescription medicine. Depending on the type of drug therapy used, costs range from $41 (Ritalin) to $94 (Strattera) for a month supply. But for how long do these drugs have to be taken? The drugs are not design to treat or cure ADHD, they simply reduce the symptoms. In some children this respite from symptoms may give them the time to normalise their behavior so they can remain in control after they stop taking the drugs. However the majority of children face a long-term dependency on these drugs that will carry on through college, university and into the work place. There is very little research on long-term usage of methylphenidate based drugs like Ritalin but a study earlier this year found evidence that it is a carcinogen. This study was too small to give definate answers so futher study is need.
In addition to any direct health risks, there is contradictory evidence on whether Ritalin users face a higher risk of drug abuse, either illegal drugs or legal ones such as smoking or alcohol. An article on PsychiatricTimes.com covers two different studies. The first showed a risk:
Childhood use of [Central Nervous System] stimulant treatment is significantly and pervasively implicated in the uptake of regular smoking, in daily smoking in adulthood, in cocaine dependence, and lifetime use or abuse of cocaine and stimulants. The severity of ADHD and early onset of tobacco use are significant risk factors for adult use and dependence on substances with stimulant properties, namely tobacco, cocaine, and stimulants.
However the other study found:
Treating the underlying disorder, even if with stimulants, significantly reduces the probability they will use drugs later on
The rise of stimulant usage for ADD / ADHD (its currently a $2.7 billion industry) has an effect on non-sufferers. There is rising concern over the non-prescribed use of ritalin and other stimulants by college and university students. A study, Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey found about 5% of students had used prescription stimulants illegally. (See also Ritalin, Use and Abuse [PDF]).
A straw poll conducted in forum for students with ADD / ADHD revealed that many had used stimulants for some years and foresaw using them indefinitely. There was some concern over the long-term effects but generally the ability to overcome their ADD / ADHD symptoms was far more important than any long-term health risks. About half reported that they had been approached by others asking for some tablets.
So are we over-prescribing ritalin and similar drugs to our children? There is no easy answer. Spending $2.7 billion on drugs that do not treat the underlying problem is worrying. So are the questions of the long-term health risks and the rise of the stimulant-usage culture in schools. Yet. for the most part, the people who take the drugs are happy to escape from damage done by ADD / ADHD, regardless of the cost to their finances or health.