ADHD: THE NEW WORLD DISORDER

The pharmaceutical industry flourishes like never before. Prozac, Viagra, Ritalin are familiar names in daily life. The chemical revolution in our evolution has taken place. Our society can't function anymore without medicines and the pharmaceutical multinationals are the pillars of the economy. That's why we didn't enter alarm-phase one with the news that 6 million hyperactive American children are using severe medicines without having feeling ill prior. Europe tries to catch up.

They are children diagnosed with ADHD, Attention Deficit Hyperactivity Disorder. An explanation can one find in the Diagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association (APA), the bible in the world of psychiatric diseases. The fourth edition (DSM-IV) says that individuals with this disorder (ADHD, evolved from his predecessor ADD) may fail to give close attention to details or may make careless mistakes in schoolwork or other tasks (Criterion A1a). It's clear that the APA means with individuals children. Criterion A1b says: work is often messy and performed carelessly and without considered thought. They (students) often appear as if their mind is elsewhere or as if they are not listening or did not hear what has just been said (Criterion A1c). The rest of the criteria are variations on this. Annoying behavior, which can have many other causes, gets interpreted as a disorder.

Ritalin (=methylphenidate) is the most important medicine with which ADHD is fought with. The American Drug Enforcement Administration (DEA) qualified it as a 'schedule 2 drug', which other countries endorse. That's the same category as for example cocaine and amphetamines ('speed' as the Americans call it). They are drugs with a high danger of addiction and misuse. The World Health Organization came 30 years ago to the same conclusion. Ritalin has strong chemical similarities with amphetamines and has also the same side effects. Misuse of such a strong drug is evident. Ritalin stands highlisted as stolen prescription drugs in the US. In the streets it gets sold as 'Vitamin R' or 'R-Ball' and they grind it to inhale the powder or dissolve it in water. In a survey among 44,000 students in Indiana, 7 percent reported using Ritalin recreationally at least once in the previous year and 2.5 percent reported using it monthly or more often.

Hundreds of animal studies and human clinical trials leave no doubt about how the medication works. Ritalin suppresses all spontaneous behavior, which results in a decreasing curiosity, socializing and play. Children are going to behave more like robots and obey the parents and the school like never before which its success is measured by. Not the parents and the school are doubted but the child is the source of annoyance, the weakest in the conflict. The American Brookhaven National Laboratory has studied Ritalin through PET scans. Lab researchers have found that the drug decreased the flow of blood to all parts of the brain by 20-30%. Cocaine has the same effect. Stimulants like Ritalin and amphetamines cause a disturbed glucose metabolism and possibly a permanent shrinkage or atrophy of the brain. In other words: a chemical shock therapy.

Side effects of Ritalin are described in the Physician's Desk Reference (1999) and are for example: nervousness, insomnia, hypersensitivity (including skin rash), fever, anorexia, nausea, dizziness and palpitation. It also states that sufficient data on safety and efficacy of long-term use of Ritalin in children are not yet available.

ADHD (by whatever name) has grown in the US from 150,000 in 1970, to a half million in 1985, a million in 1990, and to 6 million children today. In Great Britain the amount of Ritalin prescriptions grew the past 6 years from 2000 to 90,000. In Holland ADHD has almost an epidemic proportion. Only in France there's hardly any ADHD because you want to put a child on a stimulant, you have to go to a hospital, you can't just go to a GP (General Practitioner). A report in the Clinical Psychiatric News revealed that in Michigan's Medicaid program 223 children 3 years old or younger were diagnosed with ADHD as of December 1996. 57 percent of these children were treated with one or more psychotropic drugs, including Ritalin, Prozac, Dexedrine, Aventyl and Syban. 33 percent were medicated with two or more of these drugs. The warning label on Ritalin states that it should not be used in children under 6 years, since safety and efficacy for this age group has not been established and sufficient data on safety and efficacy of long-term use of Ritalin in children are not yet available.

How is it possible for a medicine that is on the market for 45 years to cause such controversy? Back in 1970 Congressman Cornelius Gallagher already warned the Department of Health Education and Welfare against the dangers of the use of amphetamines for hyperactive children. Because of the rapid rise of use one notices abuse sooner. Desperate parents and stressed-out teachers are not critical when a doctor comes with the deliverance. To treat children on a large scale who are not ill and make them permanently confused through severe drugs is a scandalous business. In situations concerning ADHD, medicines are given to make the environment better, not the diagnosed person. Doctors are usually only familiar with the enclosed brochure from the manufacturers in which of course only positive information is written.

The manufacturers of Ritalin, CibaGeneva Pharmaceuticals, also known as Ciba-Geigy (bought by Novartis AG which merged with Sandoz) deny systematically all problems. Richard Scruggs filed a nationwide suit in October 2000. He accuses them of conspiring with the APA and the nonprofit support group called Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) to 'create' the disease known as ADHD. Scruggs, who earlier was a lawyer of the team who brought the mighty tobacco industry to its knees, claims that the definition of ADHD is stretched so one could sell more Ritalin.

It wouldn't be the first time the Swiss based corporation will be accused. Around 1960 the first cases of a mysterious disease called SMON appeared in Japan. The victims suffered from painful numbness, blindness and paralysis. In the next years it grew to epidemic numbers. At first one believed a virus was the cause but a few doctors traced the cause back to Clioquinol which had been on the market by Ciba under numerous names, for example as the popular antidiarrheal medication Entero-Vioform. In 1970 the Japanese government banned the use of all medicine which contained clioquinol. Within 3 months new cases were as good as gone. In total 11,000 SMON-patients suffered in Japan where the dose Entero-Vioform was higher than any other country where SMON was considerately less. In 1972 they went to trial in which the Swedish doctor Olle Hansson testified as an expert against Ciba-Geigy. He made it his work of life to expose abuse within the mighty firm. It became known that already in 1935 - one year after its introduction on the market - alarming reports from Argentina had landed on their desks. Animal testing with disastrous endings was simply ignored. Ciba-Geigy kept promoting its bestseller while pointing at the long harmless history of their product. After the prohibition and losing a six year lasting trial full of delaying tactics, deception and manipulation, Ciba-geigy tried to sell Clioquinol in other countries as long as they possibly could. Thanks to the resistance of Hansson and several consumer organizations, more and more countries banned the medicine from which it was incontrovertible connected to serious damage. He kept fighting until his death in 1985 to convince Ciba-geigy of the necessity of stopping the production of Cioquinol. The golden rule in the pharmaceutical industry is to sell as much as possible against the highest price. The health of people comes second place. (In 1993 Ciba-Geigy was accused with 6 other pharmaceutical houses of conspiring to fix prescription drug prices.)

The psychiatry as well is been taken under fire because of its unscientific attitude. Between 1952 and 1994, the APA's Diagnostic and Statistical Manual (DSM) grew from: 112 'disorders' and 'diseases' in 1952, to 163 in 1968, 224 in the 1980, 253 in 1987, and 374 in the 1994 edition. A manual that finds its origin during the Second World war where it was developed by Brigadier General William Menninger to codify 'deviant' behavior. The APA stated in their DSM-III that 8 of the 14 symptoms were enough to diagnose ADHD with a child. In 1994 the list was expanded till 18 and divided into two groups. Only 6 symptoms out of 9 of either group meets the diagnosis. A diagnosis with which there's no specific test for nor does it have a scientific cause. ADHD is not a brain disorder simply because there hasn't been found evidence for that. To that conclusion came the National Institutes of Health Consensus Development Conference 1998 about ADHD and the American Academy of Pediatrics (2000) report on ADHD. The psychiatry tries to present the failure of education, home and at school, as a medical disorder. In their DSM-IV one can read for example number 315.1, 'Mathematics Disorder'. The diagnostic criterion for this is a test that measures if a child is substantially below that expected given the person's chronological age, measured intelligence, and age-appropriate education. Criterion 315.2, 'Disorder of Written Expression' with which the child scores low on written tests also raises questions. According psychiatrist Peter Breggin, Director of the International Center for the Study of Psychiatry and Psychology (ICSPP), abnormalities in the brain are always almost due to prior exposure of a psychiatric medication. Also he states that withdrawal from Ritalin can cause emotional suffering, including depression, exhaustion, and suicide tendencies which can lead to new medication. Also he connects the increasing aggression and violence in schools to the use of psychiatric medicines.

The group CHADD with 650 local chapters sponsors regional conferences and monthly meetings often held at schools. It educates thousands of families about ADHD and gives out free medical advice. This advice features the drug Ritalin. It became known that CHADD had received large sums of money from Novartis (during the period 1991-1994 at least 748,000 dollar). It saw its members grow from 800 till 35 000. CHADD used part of the money for a public service announcement produced for television, which promoted the use of Ritalin. From the US Department of Education, CHADD received in 1996 a $750,000 grant to produce a video, Facing the Challenge of ADD. In there testimonials of parents are shown who claim that Ritalin helps their children. These people however are all board members of CHADD in Chicago. The Department not aware of the financial agreement has pulled the video from its distribution. CHADD who always had denied receiving money from Ciba-Geigy has in the mean time admitted and won't stop the agreement in the future. A confronting example how Ciba-Geigy manipulates the public opinion behind the scenes.

Also schools contribute to the epidemic size of ADHD. In the US are many cases known of which a school forced the parents to let their child take Ritalin and threatened with expulsion of the student. Patti Johnson, member of the Colorado State Board of Education, tells that one parent at first complied with the school's direction to have his son take Ritalin. The medicine made him however aggressive and violent. His father took him off the drug after which the principal of the school began pressuring him to resume the stimulant. So much pressure that the matter went to court and the father could forfeit parental rights if he disagrees with the decision of the court on whether or not to place his child on Ritalin. Schools are subsidized for every child with a handicap and ADHD is interpreted as such. ADHD children often have higher IQ's, which can be an indication to renew the old-fashioned school system. The American psychologist Alan Fridlund puts one of the causes for ADHD with the steep increase in restrictions on play on schools. Children were more likely to fidget and lose attention the longer they were deprived of exercise.

In 1995 150 000 toddlers of 2-4 years in the US were under the influence of stimulants, antidepressants and antipsychotic medicines. Psychiatrist Ralph Walton, Chairman of the Center for Behavioral Medicine puts the cause at the very controversial sugar additive aspartame. He claims that for years it's known that when aspartame is ingested with a carbohydrate rich meal the usual physiologic increase in tryptophan (an amino acid) is blocked, while other amino acids in the brain are increased. These changes in the balance can cause a profound effect on mood and cognition. One can feel depressed, anxiety, dizziness, panic attacks, nausea, irritability, and impairment of memory and concentration. Aspartame is in children's vitamins, chewable and flavored over-the-counter drugs, candy, marmalade and diet products. Dr. Miguel Baret of the Dominican Republic reported giving 360 children juice laced with aspartame and said most developed abnormal restlessness, lack of concentration, irritability and depression. When he removed the aspartame their symptoms disappeared in 4 to 6 days in all of them! Aspartame is brought on the market under a variety of names by another pharmaceutical giant: G.D. Searle. They can expect in the near future s similar lawsuit, which according to some can grow to one of the biggest scandals of our time.

Other causes for ADHD are given by the American psychologist Lloyd deMause In addition to what we know about the disastrous effects on the fetus of prenatal exposure to drugs and alcohol, they have now considerable evidence on how maternal stress and other emotions are transmitted to the fetus. When a pregnant mother is offered a cigarette after having been deprived of smoking for 24 hours there is a significant acceleration in fetal heartbeat even before the cigarette is lit. Maternal smoking during pregnancy has been found to triple the rate of ADHD later in the child. One mother whose husband had just threatened her verbally with violence came into the doctor's office with the fetus thrashing and kicking so violently as to be painful to her, with an elevated heart rate that continued for hours. The same wild thrashing has been seen in fetuses of mothers whose spouses have died suddenly. Margaret Fries has conducted a 40-year study predicting emotional patterns that remain quite constant throughout the lives of those studied, showing the patterns to the mother's attitude toward the fetus during pregnancy. Maternal emotional stress, hostility toward the fetus and fetal distress have also been shown in various studies with more premature births, more physical illness, higher rates of schizophrenia, lower IQ in early childhood, greater school failure, higher delinquency and greater probability as an adult to use drugs, commit violent crimes and commit suicide. This increase in social violence due to pre- and perinatal conditions has been confirmed by a major Danish study showing that boys of mothers who do not want to have them (25 percent of pregnant mothers admit they do not want their babies) and who also experience birth complications are four times more likely when they get to be teenagers to commit violent crimes than control groups. American studies also show similar higher violent crime rates correlated with maternal rejection during pregnancy. Increasing numbers of divorce and a appalling high percentage of domestic violence contribute to a emotional confused made child.

In Article 33 from the 'U.N. Convention on the Rights of the Child' and signed by almost 200 countries (for good PR because in reality most don't bother) children have the right to protection from the use of narcotic and psychotropic drugs, and from being involved in their production or distribution. Article 17 states that the State shall ensure the accessibility to children of information and material from a diversity of sources, and it shall encourage the mass media to disseminate information which is of social and cultural benefit to the child, and take steps to protect him or her from harmful materials. There's no medicine without side-effects and many hope the positive effects will dominate the negative ones. Other medicines to reduce the side-effects are no longer exceptional either. An adult should be able to make such decision himself providing he can access objective information. But how about children? Parents can temporarily relieve themselves from guilt (and therefore responsibility) by believing in a brain-disorder. But parenthood includes a sincere caring in the development of your child, which you don't want to leave to an unscrupulous pharmaceutical multinational. Drugs shouldn't be the answer to emotional problems. A society who does believe that, will get the bill presented in the future. Do we protect our modern medicine men or our children?

© 2001 Dennis Rodie
The original Dutch article appeared in Kleintje Muurkrant, March 2001