It was July and a 23-year-old short brunette walked into the medical office in Midtown with sunglasses on, wearing a scarf around her neck.
A month after, the medical receptionist began receiving multiple calls and messages from her, filled with desperation, hopelessness and depression. The woman - for confidentiality let's call her Helen - was begging to refill her Ritalin prescription again. It turned out the medication was the reason she signed up to see the internist, yet another time. The doctor was not familiar with the effects of the medication and did not have the knowledge to evaluate the patient. But led by financial considerations, he let Helen get what she wanted.
Ritalin, or methylphenidate hydrochloride, is central nervous system stimulant. It is used to treat attention deficit hyperactivity disorder, which is recognized in impulsive behavior and inability to pay attention. In clinical studies, it produces behavioral, psychological and reinforcing effects similar to cocaine. Mental health professionals are the only ones who have the knowledge and expertise to treat ADHD patients.
However, a data released by the Drug Enforcement Administration shows that pediatricians write more than 50 percent of the methylphenidate prescriptions. According to the Physician's Desk Reference Family Guide to Prescription Drugs, the drug should not be prescribed to anyone experiencing anxiety, tension or agitation because it can aggravate these symptoms. If abused, it can lead to tolerance, dependence and psychotic episodes. Misuse may result in serious, possibly fatal heart and blood pressure problems.
Does Ritalin have a positive effect in ADHD treatment? Clinical trials, that looked at the effects of the drug, show there are no long-term benefits. Moreover, psychostimulants such as Ritalin can cause irreversible brain damage and dysfunction.
"I recognize I can't change the larger social and cultural factors," admits Dr. Larry Diller in his book, Running on Ritalin: A Physician Reflects on Children, Society and Performance in a Pill. "My job is to relieve suffering and Ritalin, in a short term will ease suffering."
A TIME Magazine cover story from Nov. 30, 1998 points out that the benefits of the medication are gone as soon as the medication wears off. Children need constant reinforcement through behavioral therapy, which is very expensive. Moreover, an ADHD child needs at least 50 sessions to benefit from it.
If you refer to Michael Moore's Sicko, you will see that the criteria used by officials to make health policy decisions - like shorter hospital stays - derive mainly from financial concerns. Pharmaceutical companies and health insurances not only make financial contributions to election campaigns of many politicians but also fund the research of medicines to produce only beneficial results. Sure, Ritalin helps, but doesn't the system use it only to temporarily ease a problem by creating larger potential risks?
Being a parent poses many uneasy dilemmas and the child's benefit arises as the single most important issue. Some parents confess that Ritalin has made a tremendous difference in their lives.
But according to the testimony of Drug Enforcement Administration Deputy Director Terrance Woodworth, the methylphenidate production level quota has increased from 1768 kg in 1990 to 14957 kg in 2000. The increase in the demand should make authorities wonder if the problem is being solved or if children are becoming addicts.
On Tuesday, The Washington Post informed the nation of a new study, which shows that ADHD stems from a developmental delay that can be outgrown. What this means to the 4.4 million children diagnosed with the disorder is that we need to question the effectiveness of the medication and fear the side effects. Harsh drug treatment might actually turn out to be unnecessary.
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