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How to Treat ADHD with Ritalin and Other Stimulants

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Goldberg: Taking Sides, Issue 12 debates whether or not children with ADHD should be treated with Ritalin and other stimulants. The “yes” article, or the liberal side as the author Michael Fumento calls it, makes a point of disputing the claims of the “no” (conservative) side using research and personal anecdotes. The conservative article, written by Lawrence Diller, instead discusses the societal impacts of treating ADHD with Ritalin and other stimulants. Diller argues that stimulants don’t treat ADHD so much as it merely masks a bigger problem. Both sides have their merits, but Fumento makes a stronger case by addressing conservative concerns.

I firmly believe that Ritalin and other stimulants are a perfectly acceptable way to treat ADHD in children. Both Michael Fumento and Lawrence Diller question the safety of drug use, and while Fumento insists Ritalin and other stimulants are perfectly safe, Diller is skeptical. Diller states that there have been no long-term studies on the drug—that the longest study was only about two to three months (Goldberg). Fumento also attests that there is no long-term research, however he sheds a more positive light by claiming there is no catastrophic effect to be found. Using stimulants to treat ADHD is a multifaceted, complex issue, and with this particular layer of the argument, I do side with Diller to some extent. I may not share his cynical view of research, where he says, “It seems in America that if there isn’t money to be made, no one will do the work necessary to find out if any drug is safe or works long-term” (Goldberg). I like to believe that there are researchers out there who are willing to put in the work simply for the sake of scientific advancement and the betterment of the public. However since the morality of researchers isn’t contained within the bigger question, I digress. There do need to be studies on the long-term effects of stimulants used to treat ADHD. Both Fumento and Diller state that the short-term effects of stimulants make the most difference in ADHD sufferers’ lives, but are the long-term effects costly? It’s certainly something worth looking into.

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Another major question discussed within the article is the societal effects resulting in treating ADHD with stimulants—and thereby leading into the smaller, but no less important questions of whether or not stimulants cause addiction and the question of whether or not ADHD is being over diagnosed. The issue summary brings up a very interesting statistic. It states that American children consume 90 percent of all Ritalin produced (Goldberg). It goes on to say that European children are much less likely to be treated with Ritalin. Why is that? Fumento brings up societal awareness. He states that, for America in particular, there is an increase in awareness and watchfulness for children who suffer ADHD. Is the “fear” of hyperactive and disobedient children a cultural thing? Are European children and American children given different expectations in regards to upbringing and those differences lead to such high diagnosis rates? It’s certainly something worth exploring.

Following that, I definitely believe that ADHD is being over diagnosed. Fumento states that some facets of society are being diagnosed enough—in this case white middle class families—while there are other groups—African Americans in particular—that are being under diagnosed. Diller says that “childhood” is being diagnosed as ADHD and that there is a line between children being children and children with genuine hyperactivity. I definitely think Fumento is right in that there is a socioeconomic divide in diagnosis. Much of the reason for this can be attributed to the fact that health care and long-term medication is expensive. Most lower class families will only go to the doctor if it’s a true emergency—even then, some are still willing to take the risk of getting better without any kind of aide. That being said, Diller isn’t entirely wrong. He says that ADHD is over diagnosed due to lazy parents or teachers. While that certainly could be true, he actually brings up another, better point to this argument: competition.

Fumento largely overlooks competition, and I think that is a mistake. As stated earlier, treating ADHD is a multifaceted issue, and competition plays a large role. Parents want their kids to behave and pay attention in school so that they have better odds in getting a good job in their adult life. Abuse of stimulants is largely seen on college campuses and during high school years—the most stressful time in young adult life. There is pressure to get into good colleges or graduate schools or jobs, and there is the cultural acceptance that in order to get the best, one must be the best. Even above average students struggle with the idea of being the best, so the stress for average and below-average students is nearly insurmountable. Ritalin and other stimulants seem like the best way to even the playing field. While this is certainly cheating, there is no vice versa to the issue. Some will argue that Ritalin gives an unfair advantage for those who suffer from ADHD, but all it does is make concentration and learning possible for these students. The unfair advantage comes from “normal” kids who take the drug illegally.

Is there an addictive component to Ritalin and other stimulants? Fumento says no while Diller says yes—particularly Adderall and other stimulants with an amphetamine base. However Fumento does say no with the caveat that there is a chance of mental dependence on the drug, and in that I am in agreement with him. There is certainly a psychological side to taking a stimulant that a person knows will boost concentration and productivity. Since long-term research is lacking on these drugs, it can be assumed that there is no concrete evidence that there is a physical addiction to taking these stimulants. This can certainly change in the future, but more than anything mental dependence is the issue. To help counteract this, I think Diller was certainly on to something when he talks about the case of Annie. While he uses this story to make a point of drug therapy being the only therapy, I certainly think a good way to help reduce dependence the drug might cause is to also apply behavioral modification.

In short, while there are many layers to the issue, Ritalin and other stimulants should continue to be used to treat ADHD in children. These drugs are not a Band-Aid for a larger problem, rather they are merely a result.

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