In a study released this week examining data for almost 900,000 youths who were enrolled in several states’ HMO or Medicaid programs, Dr. Julie Magno Zito and her associates at the University of Maryland found a 200 percent to 300 percent increase in use of behavior-altering drugs between 1987 and 1996. By far the largest increases occurred after 1991 — and therein may lie a valuable lesson for policymakers who are concerned about the widespread drugging of American kids.
It was in 1991 that federal funds first were made available to treat what is called attention deficit hyperactivity disorder (ADHD). Before a child gets the psychiatric drug, he gets a label — often a preliminary one of learning disabled from school authorities, and then ADHD or simply ADD from a physician. The prescription commonly given is Ritalin, a powerful stimulant that is supposed to help its users focus their mental energies.
Authorities including the National Institutes of Health recognize that the long-term (defined as two years or longer) effects of these drugs on children have not yet been proven. Ritalin’s manufacturer warns that it should not be administered to children under the age of 6, when the developing brain is continuing to undergo major changes But the University of Maryland researchers confirm that the number of children under the age of 5 being placed on Ritalin and other powerful stimulants has risen drastically since 1991.
There are other long-term risks for children who are wrongly identified as disabled. They become part of a second-tier of education, less likely to graduate high school. Often the only reason these children become labeled in the first place is that their schools did an inadequate job teaching them to read. And when state and federal funding gives schools financial incentives to over-identify children as disabled, these problems only get worse.
In coming months, Congress will be reviewing the Individuals with Disabilities Education Act (IDEA), the federal special education law that may well have encouraged the wild increases in labeling and drugging of kids. The special ed system itself has become so problematic that until it receives major changes, the problem is likely to continue to get worse.
Washington can change the incentives, but it can’t solve the problem by itself. A large part of the answer must come from parents, the medical community, and teachers and principals. Some critics believe schools pressure parents into putting their children on Ritalin so that they are more docile and teachable.
The latest research ends all doubt, if any remained, that U.S. children are going on psychiatric drugs at a frightful rate of increase. The question is what people in authority in the public and private sectors are going to do about it.
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