Today, we have concluded a national conference
of experts from the fields of research, medicine, public health and law enforcement
brought together by the U.S. Drug Enforcement Adminstration (DEA) to examine
issues concerning the prescribing of stimulants to school-age children for
the treatment of Attention Deficit Hypertensive Disorder (ADHD). The principal
drug used for this purpose is methylphenidate, commonly known as "Ritalin".
Like many others, the DEA has become alarmed by
the tremendous increase in the prescribing of these drugs in recent years.
Since 1990, prescriptions for methylphenidate have increased 500 percent,
while prescriptions for amphetamine for the same purpose have increased 400
percent. Now we see a situation in which from 7-10% of the nation's boys are
on these drugs at some point as well as a rising percentage of the girls.
When so many children are involved in the daily use of such powerful psychoactive
drugs, it is important for all of us to understand what is going on and why.
The DEA has a responsibility to the nation to control such abusable legal
drugs and to insure that their use is confined to legitimate medical need.
Certain things have become clear from our deliberation of the last several
days, and the public, parents and decision-makers need to hear them.
First, let me say that medical experts agree that
these drugs do help the small percentage of children who need them. But there
is also strong evidence that the drugs have been greatly over prescribed in
some parts of the country as a panacea for behavior problems. These drugs
have been over-promoted, over-marketed and over-sold, resulting in profits
of some $450 million annually. This constitutes a potential health threat
to many children and has also created a new source of drug abuse and illicit
traffic. The data shows that there has been a 1,000% increase in drug abuse
injury reports involving methylphenidate for children in the 10-14 year age
group. This now equals or exceeds reports for the same age group involving
cocaine. The reported numbers are still small but experts feel that this is
only the "tip of the iceberg."
I do want to emphasize that medical authorities
do believe that ADHD is a distinct health problem affection some children
who can be helped by these drugs when prescribed after careful diagnosis.
In those cases, parents should work closely with their children, the family
physician and school authorities to insure proper administration and control
of the drug. But on the other hand, when we see that in some localities as
many as 15-20% of the children have been put on Ritalin or similar stimulant,
there is good reason to conclude that this is "quick-fix," bogus medical practice
which is nevertheless producing large profits. This far exceeds any professional
estimates of actual need.
Parents need to understand that we are talking
about very potent, addictive and abusable substances; a potency that can help
in the right situation but can destroy in the wrong situation. Above all,
parents need to educate themselves and protect their children by adopting
an attitude of proper parental caution. Regrettably, much of the literature
and promotion of the drug in recent years has ignored or understated the potency
and abuse potential of methylphenidate and Ritalin. This appears to have mislead
many physicians into prescribing the drug as a quick fix for problems of school
and behavior.
I want to emphasize that matters of this kind are
vital but cannot be simplified. There is a legitimate place for these drugs,
but we have become the only country in the world where children are prescribed
such a vast quantity of stimulants that share virtually the same properties
as cocaine. We must find a better balance. We must turn down the flow which
is rapidly becoming a flood.
In conclusion, I want to cal upon the drug industry,
the parent support groups, the researchers and medical authorities to get
a better, more accurate message out to the public. I want to call upon law
enforcement authorities to root out this new illicit traffic before it spreads.
And I want to urge parents to educate themselves, protect their children and
teach them a healthy respect for both the good and evil which drugs can do.
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