The Drugging Of The American Boy

http://www.esquire.com/features/drugging-of-the-american-boy-0414

by Larx-3 • 12 years ago

91 101 12 years ago

eruditely6• 12 years ago

Why don't you read a fucking ADHD support forum and wonder whether the suffering caused by poor executive functioning/nervous system disorder is real?

Why didn't they mention how many more times you are likely to die in a vehicular accident than non-adhd users?

http://scholar.google.com/scholar?start=10&q=adhd&hl=en&as_s...

Google scholar for ADHD, why don't you realize that these ADHD articles are more akin to anti-vaccination articles?

jonah3• 12 years ago

Why don't we try to get to the root causes of these "behavioral issues" instead of treating the symptoms.

gizmo686• 12 years ago

Isn't that what ADHD medication tries to do. If the root cause is a chemical imbalance, then treating is as a behavioural problem is only treating the symptoms.

com2kid8• 12 years ago

Thank you.

As I've stated before, either ADHD is real, or psychologists have found the world's best predictive test for auto accidents.

People with untreated ADHD have 3x the likelihood of being in an auto accident. 56% rate of substance abuse. Think about that for a moment.

56%. Holy shit.

These are the people who instead of getting help, were told that they are "lazy" and "needed to get up off their asses." Except that advice didn't work, what it does lead to is depression and dependency issues.

Oh then there is the fact that there are large structural brain differences.

I won't disagree that ADHD is over-diagnosed at times. I am horrified with how easily some people get an ADHD diagnosis, your general MD should not be making that call. There are multitudes of proper psychological tests for ADHD that should be chosen from, a 30 minute patient interview should not be the sole determining factor.

gress13• 12 years ago

Perhaps the tendency to call people "lazy" and "need to get up off your ass", is a personality disorder that should be treated with strong medication.

legutierr• 12 years ago

Oh then there is the fact that there are large structural brain differences.

Are these structural differences used in diagnosis?

mattchew2• 12 years ago

I'd like to read more about the structural brain differences, if you've got links.

DerpDerpDerp2• 12 years ago

Your response doesn't actually address the article, which acknowledges that ADHD is a real condition, but suggests that fewer than 1 in 5 boys have it, and that a large number of misdiagnosed cases is bad, considering that they're given serious drugs because of it.

In fact, the only number it suggests as being inaccurate (based on an old study) is 25% of cases - that 1 in 4 cases is misdiagnosed. However, given the number of total cases, that means something like 5% of boys are being given serious drugs for potentially no reason.

I think that deserves serious consideration, and not your knee-jerk, strawman response.

gress13• 12 years ago

Also it's worth pointing out that if 1 in 5 boys have it, it's not a disorder. It's part of the normal range.

eruditely6• 12 years ago

Your response is vague apologism for irresponsible journalism justified on a minor technicality. The articles is so stupidly charitable to it's own worldview(in the sense of lying) and omitting so much from the other side that it is ridiculous.

You are wrong to think that these people deserve "serious consideration", when the article is written itself to produce knee-jerk reactions "The drugging of the american boy....", as if we had IV Heroin plugged to these kids. Article allows for the opposition, most people who have random opinions about ADHD for no apparent reason other than to have an opinion.

http://www.ncbi.nlm.nih.gov/pubmed/23382575 (Is ADHD a Risk Factor for High School Dropout? A Controlled Study.) tells us that " Conclusion: Participants with ADHD were significantly more likely to repeat a grade"

Do you know the cost of high school drop outs or grade repeats to society? What about to the kid, who suffers massive self-esteem loss and under-values himself? Why is the author not more responsible? The modern era brings us new journalism-contrarian-chic, stylstic articles that irresponsibly lend fuel to very harmful world-views(such asADHD is not serious)

What drugs, exactly, and to which boy? Is the cost of not-treating much greater than the cost of treating? The article is merely an appeal to pop-trash trendy world-views, and does not deserve much of a response at all

sheepmullet• 12 years ago

Nobody is saying that ADHD is not a real condition. The article is suggesting a lot of American boys are diagnosed with ADHD when they don't in fact have it. Imagine if 30% of people undergoing chemo for cancer treatment had never even had cancer.

I'd like to see what the rates are compared to other western countries. If its 5% in Canada and 20% in the US it suggests something is wrong

andyl• 12 years ago

A few years ago teachers complained that both my boys were too intense on the playground, 'diagnosed' with ADHD. Docs were eager to prescribe meds to make them conform.

There is something in our society wants to redefine normal behavior as pathology. Maybe to get you hooked and build revenue streams, maybe just to make you more pliable.

Fuck that.

Yes there are legitimate cases. But I've only experienced people who want to mis-apply the meds.

aidenn0• 12 years ago

Count me as a legitimate case.

That being said, all the research I've done into it on my own shows that the ability of the system to diagnose ADHD is crap. As in huge numbers of both false positives and false negatives. The over-diagnosis is a huge problem, and it results in not only large numbers of children being prescribed stimulant medication mistakenly, but it causes parents of kids who could benefit from such medication to rightfully have second thoughts when a doctor recommends it.

In particular a lot of those who make ADHD referrals kind of have this mapping of "Problem Kid" => "Likely ADHD" when that doesn't seem to be a particularly good mapping.

There are even significant downsides to kids with ADHD taking stimulant medication, but in that case, it appears that the likely benefit does outweigh the likely harm.

Now that I'm a parent, I also wonder if the increased diagnosis of boys is partly due to the differences in the school system. I see more homework and deskwork at a younger age than when I was a kid, but combined with less of a "boys will be boys" tolerance for destructive behavior than when my dad was a kid. Of course I have no numbers on this, so it may merely be nostalgia thinking that that is the trend.

eruditely6• 12 years ago

You've only experienced people who want to mis-apply the meds? What criteria for mis-apply are you using here? "Docs were eager to prescribe meds to make them conform", awkward appeal to malicious agency. It is doubtful that doctors were "Eager to make them conform".

"Something to redefine behavior as pathology... maybe to get you hooked and build revenue streams", ah yes. That's it. Never mind the much higher incident of high school drop out, repeated grades, 1/4th as likely as other kids to pass college, more likely to go to jail, and get in a car crash.

yequalsx• 12 years ago

My girlfriend is a psychiatrist and we've had discussions about over medication. One thing she said to me stuck with me and may be of help to you in your current situation. She says stimulants work right away (unlike medication for depression) and she said that if the drugs do work you'll see this within a few days. If they do work then talk with a psychiatrist about long term plans and long term health affects of the medication.

The teachers are not professionals and their opinions do not constitute a diagnosis.

buzaga413• 12 years ago

but what is "work"? Seems to hit the point of 'make conform'

fit2rule2• 12 years ago

The only purpose for pharmaceuticals as a solution to this problem is to establish a viable industry. These drugs are not ever a solution - if they were, you could grow them in your own home. As it is, however, you have to join the right club, sign up with the right team, be a member of the right cult - to get your meds every month.

Legalized drugging of culture, is all it is. Utter, literal brainwashing.

(A real solution wouldn't require a prescription.)

chimeracoder2• 12 years ago

Instead of just talking about the dangers of a false positive, let's talk about the dangers of false negatives - of ignoring ADHD in children who do actually have it. ADHD is very treatable, but untreated, it can easily lead to other comorbidities that are much more difficult to treat (such as depression)

The most dangerous part of this is that it seems to imply ADHD is over-diagnosed in men (boys), when it's just as possible that ADHD is under-diagnosed in women (girls).

Girls diagnosed with 314.10 (Attention Deficit Disorder, predominantly hyperactive-impulsive) tend to exhibit fewer "traditional" symptoms of hyperactivity than boys with the same diagnosis. This isn't to say that the diagnosis is wrong - it's just that hyperactivity manifests in many ways - physical restlessness, "bouncing off the walls", etc. is only one.

The interesting thing is I never asked any of these people whether ADHD is real. But their defensiveness is understandable. ADHD isn't strep throat—there's no culture, no test. To find out if you have it, or if your son has it, or if your daughter has it, you just need a human being to say so—a physician or a psychiatrist—and that makes some people skeptical

This describes the entire field of psychiatry. While there are certainly some people who are who would distrust the field, I would be very wary of throwing the baby out with the bathwater.

And of all disorders, ADHD is actually significantly easier to test for systematically than most psychological/psychiatric disorders (such as depression). The main problem is that the tests to do so are very expensive (well into the thousands of dollars), and most insurance plans won't cover it.

Ned Hallowell once famously said that stimulants were "safer than aspirin," a statement he has since backed off of. ("That's almost a preposterous statement for anyone to say," says Saltarelli.)

So, we have a complete lowbrow dismissal of what is actually a very reasonable statement. In the end, it's impossible to compare any two drugs for safety because there are so many factors that come into play, but to the extent that one can make a pairwise comparison, this is actually a very well-supported statement.

foolinaround• 12 years ago

ADHD is very treatable, but untreated, it can easily lead to other comorbidities that are much more difficult to treat (such as depression)

This claim needs citation.

The overall point is that the cost of the false positive overweighs the cost of the false negative

torkins3• 12 years ago

Which article did you read? Not only was there no discussion of the cost of false negatives, there was very little treatment of the actual cost of false positives, just a nebulous assertion that its bad for kids to be on pills.

I would say the point of the article is here is a list of reasons why it might be over-diagnosed, some people on both sides of that, 50% puffed up with human interest pap about the Boy Whisperer

com2kid8• 12 years ago

http://www.psychiatrictimes.com/adhd/comorbid-depression-and...

Is 13% to 27% sufficiently co-morbid for you?

That is just one of the first results for "adhd depression". I've seen studies with cited numbers far higher than that for people who are untreated.

ryanmarsh• 12 years ago

Next can we talk about SSRI's? My little brother was prescribed Paxil as an adolescent. Now he's in prison for murder. Now Paxil is not allowed to be prescribed for adolescents and children but my brother will die in prison. He behaved exactly how kids prescribed this medicine behave, in a murderous rage.

khuey• 12 years ago

Wow, that's so tragic.

Andrex• 12 years ago

He killed someone as an adolescent but was still tried as an adult? That's rough, man.

chewychewymango• 12 years ago

So long as the chemical imbalance myth is perpetuated and one in ten Americans are on anti-depressants, all SSRI prescriptions are sacrosanct. Sadly, society isn't ready to have this discussion.

fit2rule2• 12 years ago

True, that. Its really hard to talk down addicts from their high.

curiousDog• 12 years ago

To me, as an adult, getting a diagnosis on ADHD was a godsend. However, after a couple of years, I see the drug's affects waning. I can also see how damaging this dependency creation can be for children.

Fortunately, when I was a child back in India, ADHD was virtually unknown (probably the case today as well). Most of the time, my parents chalked off my inattention to "lack of discipline" and were happy as long as my grades were good. I found the coursework very easy (despite studying for only 1-1:30 hrs a day) and topped most of my classes.

University here in he U.S wasn't hard either. My problems started once I started working. Couldn't code continuously for more than 15-20 mins at a time. Things got boring very quickly once I got the "aha". I couldn't hold a lot of program state in my head. I was always searching for that "flow" people often talked about.

Adderall really helped me. I use it very sparingly these days (especially on days that I have to code some important pieces) though.

Bottomline, looks like this is purely genetic and fixing the dopamine pathways isn't exactly like curing malaria, you can juice things up but the brain will want more. Parents can choose to give it to their children but they'll suffer some time down the road. I'd rather let the kid enjoy childhood and help him in other ways (exercise, note-taking, engaging activities etc) and put him in a reasonably good path to success. Let them take drugs if necessary once they've wised up as adults.

eruditely6• 12 years ago

Again vague appeals to solutions that simply do not work as well as stimulant medications.

http://www.nami.org/Template.cfm?Section=ADHD&Template=/Cont... T

1. Thirty two percent of students living with ADHD drop out of high school compared to 15 percent of teens with no mental health diagnosis (UC Davis Health System, 2010)

2.Three times as many adolescents living with ADHD as those living without ADHD have failed a grade, been suspended or been expelled from school. (Barkley, 2000).

You're right though, let them exercise and make them note-take, that will work(while you ignore that this simply is not effective, as studied in the current literature)

"Fixing dopamine pathways isn't exactly like curing malaria", profound.

http://pediatrics.aappublications.org/content/115/6/e749.lon... (Treatment of Attention-Deficit/Hyperactivity Disorder: Overview of the Evidence)

Conclusion: "Other evidence documents the long-term nature of ADHD in children and its classification as a chronic condition, meriting the application of general concepts of chronic-condition management, including an individual treatment plan with a focus on ongoing parent and child education, management, and monitoring. The evidence strongly supports the use of stimulant medications for treating the core symptoms of children with ADHD and, to a lesser degree, for improving functioning. Behavior therapy alone has only limited effect on symptoms or functioning of children with ADHD, although combining behavior therapy with medication seems to improve functioning and may decrease the amount of (stimulant) medication needed. Comparison among stimulants (mainly methylphenidate and amphetamines) did not indicate that 1 class outperformed the other."

gress13• 12 years ago

What is the objective diagnosis for ADHD?

ddoolin3• 12 years ago

I actually was never diagnosed with ADHD as a child or an adult. I exhibit a similar coding pattern as you did, and still do, since high school. I get bored very, very quickly and kind of live off of the "aha" moments, from one to the next. It's not that it's not genuinely challenging or interesting to me, but I just can't focus much of the time. This is true for just about everything I do these days. Thoughts and ideas come, I act on them, and they leave again just as quickly as they came. It definitely makes it hard to get much of anything done at work or home, despite having quite an agenda at times.

I've only taken Vyvanse offhandedly (without Rx) and it worked miracles for me. I quickly learned to ration it and use it sparingly as you do, partly because of the negative effects on my appetite and general well-being. I'm still debating going to see a doctor but I think they might write me off as an addict since I'm in my 20s but still quite young and a lot of kids come out of college abusing the stuff to get through exams and maybe never really drop the habit.

eruditely6• 12 years ago

What does "abuse" mean in your context? "Abusing it to get by", very anti-humanistic mentality here.

"The kids with polio abused vaccines to get by" "The kids with hunger abused food to get by"

What does "abusing to get by" even mean? You mean, USING it to get by, and thus preventing failure of the negative kind? You mean ... the desire-able outcome?

jpendry• 12 years ago

This sounds an awful lot like imposter syndrome, but with your own health instead of programming ability.

See a doctor. Be honest. Let them do their job and then trust their diagnosis.

joesmo4• 12 years ago

Any stimulant will increase your perceived ability to concentrate while it's active. That doesn't mean that it's curing anything or that you have any sort of condition. It doesn't even mean that your perception is correct, though it can be. It just means you're having a normal reaction to the stimulant.

davyjones• 12 years ago

http://en.wikipedia.org/wiki/Vitamin_R_(Leading_Us_Along)

"The song was written about a friend of the Loeffler brothers, who was misdiagnosed with ADHD, and developed an addiction to Ritalin. As a result, he would often do crazy and odd things, such as drive around aimlessly for hours, determined to hear a specific song on the radio."

:-(

joesmo4• 12 years ago

ADHD isn't real. It didn't exist in many previous generations. Surely, the behavior of children hasn't changed much over the last few generations so how come this "disease" didn't exist previous to the current couple of generations and how come it still doesn't exist in many places on the planet? Could foreign kids somehow be better? Of course not. As the article points out, this is a ploy by pharmaceutical companies to get children hooked not only on ADHD drugs but on drugs in the future.

What do these kids do when they turn 18? I asked on pediatrician I respected what she does for the children. Does she taper them off? Does she transition them to other doctors? Does she transition them to other medicines? Nope. "That's not my problem," she said. Of course not. In a culture where doctors are not responsible, where making hundreds of dollars an hour is "not enough" to have them actually perform their duties in full, duties such as making a full investigation into their patients' cases, and spending more than 10 or 15 minutes before "diagnosing" them with a condition they do not have and putting them on drugs for essentially the rest of their lives, only in such a culture is ADHD real.

When it comes down to it, it's the responsibility of the parents to keep their kids off drugs. The body doesn't care wether you're snorting amphetamine or Adderall because Adderall is amphetamine. Parents who allow their kids to be "diagnosed" with ADHD and allow them to take drugs are encouraging their children to take drugs. They are unconscionable parents. Any child can make a mistake and start doing drugs, but now we have whole classes of drugs that are encouraged. Some drug abuse and addictions have become ingrained in life. Do you think the children will stop because they've now turned 18? Do you think they'll stop at Ritalin or Adderall when those things stop working? Addiction knows no bounds.

How many more lives will have to be ruined before people realize the psychiatric industry and the doctors pushing these drugs are only doing it for the money, money they do not need? Talk about about scummy drug dealers. Yeah, we're looking at the multi-billion dollar corporations, the "psychiatrists," the DSM writers, and the rest of the doctors who can't even be bothered to spend ten minutes with a patient before deciding on a horrific fate for them. When will people learn that the medical industry cannot be trusted, that the hippocratic oath is bullshit, and they need to be responsible for their own selves and their own children? Those parents allowing their kids to be put on this should be put in jail next to the child murderers they irresponsibly strive to be.

sliverstorm2• 12 years ago

PTSD didn't exist in previous generations either.

Well, except it did- but our name/diagnosis has changed.

Shell shocked, battle fatigue, combat exhaustion, stress response, hysteria, ...

joesmo4• 12 years ago

Likewise, ADHD used to be called "being a child," and still is in most parts of the world.

silencio2• 12 years ago

My parents didn't want me on ADHD meds - which is hysterical because my father very obviously has undiagnosed symptoms of ADHD too - so I didn't get any and had to rely solely on behavioral techniques and societal pressure until I picked my own damn therapist. Me at 16 in college with dinky checklists compared to me at 25 right now with the same checklists and Adderall is like night and day.

As much as I love my parents, I occasionally get angry when I think about what could have been compared to what happened because they didn't like the idea of me being on drugs (like I wasn't on other drugs). Not missed opportunities that were impossible to begin with, but a lot of reachable goals and dreams I had that I tried working my ass off towards and it just wasn't happening because I spent just as much time struggling with myself as I did working towards said goals. I'm trying to play catchup still, years later. I suspect there are some goals that I will never be able to do anything about now because there was some age/time component to it.

Speaking of other drugs, there are plenty of them - yes, maybe even "dealt" by "drug dealer" doctors that are actually terrible - that significantly improve quality of life. Drugs are not inherently bad. It's a constant balance of whether or not the tradeoffs are worth it, that's all. Like right now I'm juggling 6-7 different meds and their side effects to fix my bronchitis+asthma right now because I do not want to end up in the ER or worse, dead. Is that so terrible? Am I a drug addict for not wanting to suffer when I have a choice to not suffer? Even if you want to label me as such, what, are you a firm believer in survival of the fittest? Because if we can keep people from suffering and dying, I would do it. Screw that fittest bullshit.

unclebucknasty• 12 years ago

I'd encourage you not to be too hard on your parents when looking back. Very difficult decision to make and it took a lot of guts to buck the system and pressure to medicate; opting instead for behavioral approaches.

Giving a growing brain a psychoactive drug is serious business.

Also, of course, you are looking back with perfect hindsight. What if you'd had a serious adverse event, psychosis, or otherwise negative outcome? No one could have known, and that was a risk your parents had to weigh. In fact, your brain now is different than then. Perhaps your parents helped you to dodge a devastating bullet by withholding psychoactive drugs at a younger age.

joesmo4• 12 years ago

You didn't get any drugs as a child other than the ones you put yourself on? It's a tragedy.

buzaga413• 12 years ago

Watch out for the downvotes bomb, this is real taboo topic these days...

But yeah, I'm with you, I'm yet to find any convincing evidence ADHD exists and I think the consequences of this unscientific+dogma approach is a damn tragedy. All the pain and suffering that it causes, the pressure and agony parents go through because, obviously, they want the best for their child, this is not quantified(I bet the money is though)

I'm curious to what will history say about this.

I was a problem child and it makes me cringe that I could have been put on this kind of shit since young, it's absurd.

com2kid8• 12 years ago

Read the other posts in this thread.

People diagnosed with ADHD are three times more likely to be in a car accident. 56& of people diagnosed with adhd who are untreated have substance abuse problems.

Either ADHD is real, or psychologists have found the world's best car insurance filter.

Then there is evidence of structural brain differences,

http://www.kennedykrieger.org/overview/news/brain-imaging-st...

I've seen multiple adults who grew up in previous generations where ADHD was just "being lazy" who have spent their entire life depressed, knowing that they never lived up to their potential because they quite literally could not focus.

It isn't a lack of willpower, it is a physical lack of ability. The fact that the physical lacking is in a missing neurotransmitter doesn't make it any less real.

wmgries2• 12 years ago

My third grade teacher apparently had every boy in her class tested. As a boy, and frankly as a boy who was independent, mouthy and unlikely to do work in school unless I wanted to, I'm glad I had great parents and a great pediatrician. My pediatrician had my parents and teacher run an experiment: my mom would choose a pill with active ingredient or a pill with nothing in it, and my teacher, without knowing which I took that day, would record notes on my behavior. Turns out, no correlation between the two.

I don't doubt there are people in this world for who ADHD is a real thing. But I think we are too quick in the modern age to drug without thinking. Parents demand antibiotics for illnesses which are just small bugs... guess what, now we are having problems with drug resistant bacteria. Lawmakers, administrators, and teachers (in that order) want to turn classrooms in to machines which churn out educated people like clockwork. Turns out, humans are animals, not machines, so we load everybody with some stimulants to make children just sit still.

I'm not anti-medicine in any way. I have personally seen Ritalin work on a friend who actually had ADHD growing up. And I have also seen another friend buy Vyvanse illegally so he could study for 15 hours a day. I believe in prescription drugs. I just don't always believe in the prescription.

prutschman2• 12 years ago

I like the idea of the experiment! Is it generally accepted that one would see same-day behavior changes when switching between an ADHD drug and a placebo?

wmgries2• 12 years ago

That's a good point, I'm not sure. The friends I've seen use the drug as a study aid certainly respond to it quickly but the scientific rigor of the experiment didn't much matter: I think my parents were skeptical that I really had a problem anyway, and lo and behold, I'm an adult now and I never did actually have a problem. When you tell the parents of every boy in the class their kid has ADHD, the claim becomes pretty weak.

frozenport• 12 years ago

I don't believe in ADHD but I suspect the drugs do something with utility. How does society confront pills that make people more efficient?

ScottWhigham2• 12 years ago

For those who don't know Esquire, it's basically a supermarket tabloid-for-men style magazine. It's not a science mag, so for anyone to get too upset about it is, well, just not really smart. [0]

That said, the horrific FUD writing style is insulting. The comments by HN users - I can't even identify with the people here.

Now imagine that he is suffering like this because of a mistake... If you have a son in America, there is an alarming probability that this has happened or will happen to you.

Absolute bullshit. Total and utter crap. That does not happen. I have two ADHD kids and it was (a) my choice to take them to a doctor, (b) my choice of which doctor they went to, and (c) my choice as to whether there was a diagnosis of ADHD. It's farcical for me to read the opening paragraphs of this "article" and its presumption that doctors are evil and really just want to incorrectly diagnose kids. Atrocious.

[0] http://en.wikipedia.org/wiki/Esquire_%28magazine%29

Camillo2• 12 years ago

(c) my choice as to whether there was a diagnosis of ADHD

Wait, what?

ScottWhigham2• 12 years ago

Did you not understand or did you have a legitimate follow-on question?

The Drugging Of The American Boy

Related Stories