Are Schools Pushing Ritalin?

From the WebMD Archives

Oct. 2, 2000 (Washington) -- Are schools wrongly encouraging the use of Ritalin and other psychiatric drugs on disruptive children? With Ritalin already on the legal hot seat, congressional Republicans held a hearing on the education issue last week and are promising more next year.

At a session of the Education and Workforce Committee's oversight panel, Rep. Bob Schaffer, R-Colo., says, "Our children will be better off if the correlation between financial public incentives and the frequency of psychotropic drug use among schoolchildren is more fully understood."

According to Schaffer, the Department of Education has made "hundreds of special education dollars available to schools every year since 1991 for each child labeled with ADHD [attention deficit hyperactivity disorder]."

Parents have come forward with "horror stories" about intimidation by schools to get kids onto drugs. At the hearing, Patricia Weathers testified about her son, whom school authorities in Millbrook, N.Y., encouraged to take Ritalin and other medications to curb his disruptive behavior. But the drugs caused hallucinations, and she refused to keep him medicated, leading school officials to pursue protective custody of the child. She asks, "What concerns me is the intimidation tactics that a school can use on a parent to coerce them to drug their child." Weather finally put her son in a private school.

Earlier this month, class action suits were filed in California and New Jersey against both Ritalin's maker, Novartis, and the American Psychiatric Association (APA), alleging a conspiracy to manufacture the condition ADHD for the purposes of lucratively marketing the diagnosis.

The hearing featured several outspoken critics of Ritalin, which has been available for decades. Psychiatrist Peter Breggin, MD, says he believes that Ritalin and other psychiatric drugs may do serious long-term harm to kids. Fred Baughman, MD, a pediatric neurologist, testified, "We've got a parasitic industry that is appending itself to our schools."

According to Schaffer, the issue is "overidentification" and "overdiagnosis" of hyperactive children. For schools seeking federal subsidies, he says that the dynamic appears to be a classic case of "follow the money."

An estimated 3% to 5% of children suffer from ADHD, according to the APA. Research published this year in the Journal of the American Medical Association shows that the use of some psychotropic drugs as much as tripled between 1991 and 1995.

Other experts at the hearing say that the Ritalin controversy is really about broader medical and education issues. According to APA official David Fassler, MD, good quality mental health care should involve a one- to two-hour "comprehensive assessment" of a child. But he notes that most kids with ADHD are not seeing psychiatrists, or indeed any mental health professionals. He also noted that kids are often prescribed psychiatric drugs by family doctors and pediatricians, who lack a full background in other mental health treatments.

Judith Heumann, an Education Department official, contends that schools need more money to be more sensitive to the individual needs of children. Then, they can hire more psychologists and have smaller classes.

But Weathers angrily responded, "I do not think for one minute that schools need additional psychologists." Recalling her son's public school psychologist, she says, "She is the one who is pushing all these disorders."

Heumann acknowledges that decisions to medicate children "must be made by families and physicians, not by educators." But she also notes that recent studies indicate that medications can help many children.