We hear in the media about the problem of teens selling prescription medications on the street, including those used to treat ADHD. How serious is this concern and what can society do?

Weekly Reflection 5

1. Should ADHD-PI be considered a separate disorder from ADHD-HI and ADHD-C? Have students research some of the studies that have demonstrated or suggested that ADHD-PI is a completely separate psychological disorder. Ask students to decide whether the research has swayed them in either direction, and why.

2. Some commonly followed treatments for ADHD have not been scientifically substantiated, including restricted or modified diets, treatments for allergies, treatment for inner ear problems, treatments for yeast infections, megavitamins, chiropractic adjustment and bone alignment, eye training, special colored glasses, and biofeedback. Have students research some of these unsupported treatments, as well as the literature that questions their empirical use.

3. Can a diagnosis of ADHD be used as a defense when an individual has committed a crime? It appears to be used more and more, but does it work? Have students research this topic and provide case examples in which ADHD has been used to argue mental illness (see “Admitted robber gets 17 years in jail for diner stickup”, Staten Island Advance, September 25, 2003).
What are the implications of a successful defense for the field of mental health and society in general?

4. How much influence should schools have in deciding whether a child should be placed on stimulant medication? There are several recent cases in which parents have been charged with educational neglect for choosing not to give their children Ritalin. For an example see “Parents lose fight to take 8-year-old off Ritalin: Child’s hyperactivity disrupted classes, school officials say” The Sunday Gazette Mail, October 22, 2000, Charleston, West Virginia (http://www.wvgazette.com). Have students search the internet for related legal or ethical cases.

5. In 2000, lawsuits were filed against the manufacturers of Ritalin and the American Psychiatric Association in California, New Jersey, and Texas. The lawsuits alleged that the drug manufacturers and the psychiatric association conspired to “create” a disease/disorder and hype the benefits of Ritalin as the mode of treatment. For a news article on the suits see “Maker of Ritalin, psychiatric group sued”, The Wall Street Journal, Thursday, September 14, 2000. Can a disorder be “created”? Is it possible that there may be political, economic, or other “hidden” agendas involved in the diagnosis and treatment of ADHD and other problems of childhood? If so, what may some of these be?

6. There are numerous myths and concerns regarding stimulant use for the treatment of ADHD in children. Have students research some of these misconceptions or other common myths and concerns regarding stimulant use for the treatment of ADHD (see National Institute of Mental Health (1994). Attention Deficit Hyperactivity Disorder: Decade of the Brain. NIH Publication No. 94-3572, for a discussion of some of the more common misconceptions).

7. As indicated in the text, it is estimated that about 1.3 million children in North America take Ritalin on a regular basis. Children as young as 2 years of age are currently receiving prescriptions for methylphenidate, even though the drug has only been tested and approved from children 6 years of age and older. Is it ethical to subject preschoolers to clinical trials of Ritalin? Have students research and identify some of the ethical issues in conducting these kinds of studies on young children (see “Scandal! They haven’t tested Ritalin on the children it’s prescribed for! Scandal! They’re going to test Ritalin on the children!,” The Washington Post, January 2, 2001).

8. A great deal of hype is now surrounding the new ADHD medication Strattera™. Have students research this medication and why physicians, pediatricians, teachers, and parents are so interested in it as the new “wonder drug”. Compare and contrast it with other common ADHD medications (see “New drug for attention deficit, hyperactivity, gains, as school starts”, Miami Herald, September 6, 2003).

9. Many different computer tests have been created to “simulate” ADHD-like difficulties with attention and impulsivity (e.g., CPT). How do these tests compare to paper-and-pencil tests? Have students research some of the widely used tests of attention and compare and contrast them in terms of usefulness.

10. We hear in the media about the problem of teens selling prescription medications on the street, including those used to treat ADHD. How serious is this concern and what can society do? Have students research the extent of this problem and identify some possible solutions to the issue (see “Figures showing problem widespread”, The Tennessean, September 22, 2003).