The recent article (5/3/16 – SR Press Democrat) concerning the CDC (Center for Disease Control Study) about the overuse of stimulant medication for ADHD children (2-5) urges parents of preschoolers with ADHD to try behavior therapy first before resorting to meds. Behavior therapy encompasses a wide range of interventions from counseling to eight-week boot camps for parents to learn how to better manage difficult behaviors. Unfortunately, the article fails in some ways to accurately explain the real problem. That is, the CDC study found that 75% of preschoolers diagnosed as ADHD are receiving stimulant drugs such as Adderall and Ritalin as treatment. The article adds, “The concern comes from new statistics that show a troubling gap between recommended practices for treating our youngest Americans and what’s happening on the ground at doctors’ offices. Further, the CDC recommends that parents of ADHD children try behavior therapy first, but less than half are receiving such services.” For example, ISMP (Institute of Safe Medication Practices) identified additional drugs that accounted for 41% of serious adverse events in children due to drug medications reported to the USA Food and Drug Administration between 2008 – 2012. One study identified 45,610 adverse drug effects reported in children less than 18 years of age. Of these, 64% (29,298) indicated serious injury. Reports of children suffering from abuse of such medications grew in time from 6,320 in 2008 to 11,401 in 2012 increasing the same rate as for adult patients (ISMP – 2014). Along with Adderall and Ritalin, the list included methylphenidate, Concerta, Atomoxetine, and Strattera. Notable negative effects showed suicidal behavior, aggression and hallucinations or other manifestations of psychosis. Cardiac arrest was associated with methylphenidate, and weight loss or arrested growth was also reported for all three drugs (ISMP – 2014).
The question that needs to be asked: why were only Ritalin and Adderall cited among the drugs when other drugs are also being abused? Further, why identify only children ages 2-5 as at risk when the medication negatively effects the brains of 18 year olds also?
Further, CDC mentions the most recent US guidelines, issued by the APA in 2011. These guidelines present a movement toward non-medical interventions about the potential benefits of parent or teacher directed behavior therapy as the first line of treatment. “Only if that therapy does not provide significant improvement or the child has moderate or severe symptoms should MD’s prescribe medications.” Also troubling is that although the CDC study recommends “behavior therapy” as the number one alternative supported by the American pediatric Association, it fails to mention specifically that the American Pediatric Association recommends neurofeedback as the number one alternative to medication for ADHD children (APA, 2011). Neurofeedback is a brain-training program that has proved to be successful with ADHD children, including, RAD and PTSD clients.
Interestingly the article fails to mention that the rise of A.D.H.D. diagnoses and prescriptions for stimulants coincided with a remarkably successful two-decade campaign by pharmaceutical companies to publicize ADHD and promote the pills to doctors, educators and parents. With the children’s market booming, the industry is now employing similar marketing techniques as it focuses on adult A.D.H.D., which could become even more profitable. Sales of prescription stimulants have more than quintupled from 2 billion dollars in 2002 to 8 billion dollars in 2014 (IMF Health – 2014.)
Perhaps one reason why the CDC didn’t address the 18 and under age group and focused only 2 to 5 year old age group would be the cost to insurance companies and the medical establishments? Or neurofeedback’s success? Neurofeedback requires expensive equipment, training, and at least 20 sessions or more 2x weekly. You decide. Contact David Sortino at his blog: Santa Rosa Press Democrat – Dr.David Sortino or