Are The Right Kids Getting Ritalin?

Another open question is whether the right kids actually get Ritalin. A proper diagnosis of ADHD requires interviews not just with the child but also with the parents.  Teachers need to respond to questionnaires or also to be interviewed by the doctor. Doctors under time pressures take short cuts to diagnosis and may be prescribing ADHD medications inappropriately.

Another problem may be that some children need ADHD medications for a short time, but are kept on them for years and years. An even bigger problem may be that some children who have issues with impulse control actually have other psychiatric conditions, such as borderline personality disorder, that benefit from different lines of treatment. The biggest problem with handing out Ritalin indiscriminately probably is that children fail to learn that impulsive behavior has consequences, so they rely on the medication rather than their own methods of self-control.

Years on Ritalin can lead to a phenomenon psychiatrists term “attenuated neural processing of risk.” Relying on a medication for impulse control leads to a pattern of failing to distinguish the difference between risky outcomes and safe outcomes. Intelligent children and teens can be “dumbed down” so that they make poor life choices, over and over again, and they turn to other medications, legal or illegal, to help them cope as adults.

What can parents do to avoid permanent problems from overuse of ADHD medications?

• First of all, make sure that the use of any medication for ADHD is reviewed by the doctor every six months. Don’t be afraid to ask the doctor if it’s time to come off Ritalin or Adderall.
• Be aware of long-term consequences of marijuana use in kids who have ADHD. Marijuana use in and of itself may not be the problem (medically, there may be legal consequences) so much as failing to develop coping skills.
• See your children every day and discuss their day with them. Helping your children develop good decision-making skills, regardless of drug status, is of inestimable value to their development, although your time may not be appreciated.

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There’s a light at the end of the tunnel for kids with ADHD and their parents. An increasing body of medical research shows that teens who have finally weaned off Ritalin with the development of coping skills display superior decision-making and strategic thinking. They may always have a Machiavellian, manipulative, impulsive streak. They may always be drawn to new experiences. However, using medication in the short-term and developing life skills over the long term, through a variety of structured learning experiences and psychotherapy, can bring out the unique talents and potential of children and teens who have ADHD as they overcome their liabilities.