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Over the last 20 years, the medical world’s understanding of attention deficit hyperactivity disorder (ADHD) has changed a lot. In the 1980’s, many psychiatrists considered ADHD to be a novel diagnosis. When the drug Methylphenidate, also known as Ritalin, was approved in 1991, however, diagnoses of ADHD skyrocketed.
Experts disagree whether 300 percent, 500 percent, or maybe 700 percent more children are being diagnosed with attention deficit today than just 20 years ago. Since Ritalin is chemically related to methamphetamine, the Drug Enforcement Administration keeps statistics on its production. We know that between seven and eight times as much Ritalin was manufactured in 2014 as in 1992. American doctors wrote approximately 11 million prescriptions for Ritalin in 2014. They also wrote about six million prescriptions for amphetamine, sold under the brand name Adderall. About 5.1 percent of children aged six through twelve and 4.9 percent of teenagers still in school are given prescriptions for one of the two ADHD medications.
However, many experts believe only about half of the children who could benefit from Ritalin or Adderall actually get it.
Why Has the Use of Ritalin Exploded?
The availability of ADHD medications coincided with several trends in American culture.
- Free trade put pressure on all kinds of jobs. Students are under greater pressure to make grades to get into college or trade schools that will enable them to earn more money.
- Wages cover far fewer living expenses than they did 30, 40, or 50 years ago. It is nearly unthinkable for a family to have just one wage earner, although that was the norm until the 1970’s.
- As more and more parents have to work longer and longer hours, there are more and more latchkey children. Kids come home to empty houses and apartments and are left to their own devices to spend their time.
No similar explosion in the use of Ritalin and Adderall occurred in Europe. In the Europe Union, doctors are much more likely to prescribe anti-psychotic drugs for behavior problems in children. The downside of giving children potent medications such as haloperidol (Haldol) when they act out is that the use of anti-psychotics can lead to permanent muscle problems. Receiving anti-psychotic medication also stigmatizes children in Europe in ways that are avoided in the US.
Does Ritalin Really Work?
There is no doubt that teachers and parents favor ADHD medication. The Cochrane Database of Systematic Reviews even published an analysis of 185 clinical trials that, considered together, provide evidence that these medications result in “minimal” changes in behavior that are regarded favorably by adults.
The downside of these medications, however, is that they are not without side effects. Children and teens on Ritalin have about a 60 percent greater likelihood of developing sleeping problems and a 266 percent greater likelihood of developing problems with too little appetite. Researchers have done very little to determine whether there are long-term effects of ADHD medications. There is a potential downside of depriving a child with minimal symptoms the benefits of medication if the side effects are tolerable, but too often parent and teacher concerns predominate.