Doctors are prescribing prescription pills like Adderall to low-income kids even if they don't "need" drugs to function because it's often the only realistic way to help them do well in school.
"I don't have a whole lot of choice," one doctor who treats poor families outside of Atlanta, Georgia, told the New York Times. "We've decided as a society that it's too expensive to modify the kid's environment. So we have to modify the kid."
It's easy for those of us without kids struggling to succeed in inadequate schools to act horrified about the way A.D.H.D diagnosis rates are rising as school funding drops — because it is horrifying to imagine a bunch of elementary schoolers hopped up on speed that's doing god knows what to their little brains (well, we know that some reported side effects include growth suppression, increased blood pressure and psychotic episodes; we'll get to that in a second) — but it all depends on how you measure success. Is the end goal a perfectly clear blood stream or good grades against the odds? Some parents (and doctors) would choose the latter.
"We as a society have been unwilling to invest in very effective nonpharmaceutical interventions for these children and their families," Dr. Ramesh Raghavan, a child mental-health services researcher at Washington University in St. Louis and an expert in prescription drug use among low-income children, told the Times. "We are effectively forcing local community psychiatrists to use the only tool at their disposal, which is psychotropic medications."
The negative effects on the kids in this story, both emotionally and physically, are heartbreaking. "My kids don't want to take it, but I told them, ‘These are your grades when you're taking it, this is when you don't,' and they understood," said one parent who added that Medicaid covers almost all of her prescription costs. (Too bad they don't cover tutors or therapy instead...) And then there's this terrible anecdote about 11-year-old Quintin, one of five children who take more types of pills (Adderall, Risperdal, Clonidine) than the women inValley of the Dolls:
When puberty's chemical maelstrom began at about 10, though, Quintn got into fights at school because, he said, other children were insulting his mother. The problem was, they were not; Quintn was seeing people and hearing voices that were not there, a rare but recognized side effect of Adderall. After Quintn admitted to being suicidal, Dr. Anderson prescribed a week in a local psychiatric hospital, and a switch to Risperdal.
After that, Quintn's parents flushed all of their pharmaceuticals down the toilet and vowed never to give their kids prescription speed ever again. Just kidding! They actually kept giving their 12-year-old daughter and 9-year-old son Adderall, to help their grades and because their daughter was "a little blah." Her dad acknowledged that this was a "cosmetic" fix (I'll say; I've heard better justifications from cokeheads), but said, "If they're feeling positive, happy, socializing more, and it's helping them, why wouldn't you? Why not?"
That's exactly how I felt about taking Adderall in college. I'd pop one every few months or so, usually during finals if I had a long paper to write because Adderall made the process so much easier and so much more enjoyable. Every time I took it, I'd eventually get swept up in an inner debate about performance-enhancing drugs (made much more intense from said drugs, of course): if Adderall was so helpful, why didn't I get my own prescription and take it on a more regular basis? Why was to say I didn't need it? What did "need" really mean, anyway?
I never got one, because I hated the way I always eventually crashed after an Adderall-fueled writing session — as productive as those were — and I didn't want to become dependent on something I knew was bad for me and that I could do without. But at least I was a 20-year-old adult at the time able to make my own decisions, not a little kid with a developing brain. That's exactly what Dr. William Graf, a pediatrician and child neurologist who works with poor families, said he was concerned about: the "authenticity of development."
"These children are still in the developmental phase, and we still don't know how these drugs biologically affect the developing brain," he told the Times. "There's an obligation for parents, doctors and teachers to respect the authenticity issue, and I'm not sure that's always happening."
But, again, how can we expect parents whose children are flailing in deficient schools to prioritize the intangible concept of "authentic development" over the quick fix offered by drugs like Adderall? Realistically, we can't.
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