The Ritalin Report: The Drug that isn’t Safe to use for Landfill (Part One)

Dr Vernon Coleman MB ChB DSc FRSA

1. Family doctors are these days frequently under pressure (usually from teachers and social workers who know nothing about drug therapy) to prescribe the drug called Ritalin for children who are accused of being badly behaved, reported as not doing well at school and ‘diagnosed’ as suffering from something called Attention Deficit Hyperactivity Disorder (known as ADHD).

2. For several decades now, Ritalin, and other amphetamine type drugs, has been prescribed for children diagnosed as suffering from various types of brain dysfunction and hyperactivity.

3. However, Attention Deficit Hyperactivity Disorder (and other variations on the hyperactivity theme) is a rather vague diagnosis which is often leapt upon by teachers, social workers and parents to excuse and explain any unacceptable or uncontrollable behaviour. Parents of children whose behaviour is in any way regarded as different or unusual are often encouraged to believe that their child is suffering from a disease for two simple reasons. First, it is more socially acceptable to give a child a pseudoscientific label than to have to admit that he or she may simply be badly behaved. Second, when a child has been given a label it is possible to offer a treatment. Commonly it will be one, such as a drug, which takes away responsibility and offers someone a profit.

4. ADHD (aka Attention Deficit Disorder, or ADD, hyperkinetic child syndrome, minimal brain damage, minimal brain dysfunction in children, minimal cerebral dysfunction and psycho-organic syndrome in children) is a remarkably non-specific disorder. (I am always suspicious of diseases which have lots of names. Diabetes is diabetes. A broken leg is a broken leg.)

5. The symptoms which characterise ADHD (or whatever else it's being known as) may include: a chronic history of a short attention span, distractibility, emotional lability, impulsivity, moderate to severe hyperactivity, minor neurological signs and abnormal EEG. Learning may or may not be impaired. Read that rather nonsensical list of symptoms carefully and you'll find that just about any child alive could probably be described as suffering from ADHD. What child isn't impulsive occasionally? What child doesn't cry and laugh (that's what emotional lability means)? What child cannot be distracted? By this definition Ritalin could be recommended for any child who seemed bored and restless or who exhibited unusual signs of intelligence or skill. Read the biographies of geniuses and you may wonder what we are doing to our current generation of most talented individuals.

6. Ritalin has been recommended as a treatment for functional behaviour problems since the 1960s and by 1966 the ‘experts’ had come up with a definition of the sort of child for whom Ritalin could useful be prescribed.

7. Children suffering from Minimal Brain Dysfunction (MBD), the first syndrome for which Ritalin was recommended, were defined as: ‘children of near average, average or above average general intelligence with certain learning or behavioural disabilities ranging from mild to severe, which are associated with deviations of function of the central nervous system. These deviations may manifest themselves by various combinations of impairment in perception, conceptualization, language, memory and control of attention, impulse or motor function’.

8. Other symptoms which children might exhibit and which could be ascribed to MBD included: being sweet and even tempered, being cooperative and friendly, being gullible and easily led, being a light sleeper, being a heavy sleeper and so on and on. Given that sort of list to work with, I find it difficult to think of a child who wouldn't (theoretically) benefit from Ritalin.

9. The bottom line is that it has become easy for social workers and teachers to define any children who misbehaves or doesn't learn ‘properly’ as suffering from MBD or ADHD. It’s a convenient diagnosis which excuses parents, teachers and social workers from responsibility or any sense of guilt. How can the parents or the teacher be accused of failing when the child is ill and needs drug therapy?

10. Commercially Ritalin and MBD became a huge success. By 1975, around a million children in the U.S. were diagnosed as suffering from MBD. Half of these were being given drugs and half of those on drugs were on Ritalin. (Ritalin has not always been used exclusively in the treatment of badly behaved children. When Dr Andrew Malleson wrote his book Need Your Doctor Be So Useless in 1973 he reported that the CIBA Pharmaceutical Company had suggested to doctors the use of their habit forming drug Ritalin for ‘environmental depression’ caused by ‘NOISE: a new social problem’.) Today, the use of Ritalin and similar drugs is soaring. (Ritalin is probably the best known brand name for the drug methylphenidate). Between two and three billion doses of the drug are handed out each year.

End of Part One
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