THREE MILLION DOPE HEADS
AT THE SCHOOL HOUSE--
Verrrrrry good for business!
From: David Gould email@example.com
Subject: Why Ritalin Rules
Post Number 34: Why Ritalin Rules Here is information which is very timely
at this time. There are a number of discussions going on in various groups
about public schools and home schooling. For what it is worth, here is my
opinion; you can not be a Christian, and send your children to be indoctrinated
in public schools.
I do not take drugs. Let me be sure you understand what I just said: I
do not take ANY drugs, be they illegal or legal under the laws of man. THEY
ARE DRUGS! An artificial construction designed for profit, and not for
anyoneís good. So, why are these drugs being given to millions of
children on a daily basis? Could the sole reason be profit? And the
allways-present taxpayer to pick up the tab under the tax-farming principles
so firmly established ìwithinî the United States?
If you really want to understand add (attention deficit disorder), study
nutrition, and in particular, study so many of the things called food, and
which are not, but which are addictive in their own right. Start with white
flour, white sugar, and pop. If you want a crash course in this subject,
and in law, Law, cancer and many other subjects, just read my series. David
Published by The Heritage Foundation: Why Ritalin Rules By MARY EBERSTADT
There are stories that are mere signs of the times, and then there are stories
so emblematic of a particular time and place that they demand to be designated
cultural landmarks. Such a story was the New York Timesí front-page
report on January 18 appearing under the tame, even soporific headline, "For
School Nurses, More Than Tending the Sick."
"Ritalin, Ritalin, seizure drugs, Ritalin," in the words of its sing-song
opening. "So goes the rhythm of noontime" for a typical school nurse in East
Boston "as she trots her tray of brown plastic vials and paper water cups
from class to class, dispensing pills into outstretched young palms." For
this nurse, as for her counterparts in middle- and upper-middle class schools
across the country, the dayís routine is now driven by what the Times
dubs "a ticklish question," to wit: "With the number of children across the
country taking Ritalin estimated at well over three million, more than double
the 1990 figure, who should be giving out the pills?"
"With nurses often serving more than one school at a time," the story
goes on to explain, "the whole middle of the day can be taken up in a
school-to-school scurry to dole out drugs." Massachusetts, for its part,
has taken to having the nurse deputize "anyone from a principal to a secretary"
to share the burden. In Florida, where the ratio of school nurses to students
is particularly low, "many schools have clerical workers hand out the pills."
So many pills, and so few professionals to go around. What else are the
authorities to do?
Behold the uniquely American psychotropic universe, pediatrics zone ó
a place where "psychiatric medications in general have become more common
in schools" and where, in particular, "Ritalin dominates." There are by now
millions of stories in orbit here, and the particular one chosen by the Times
ó of how the drug has induced a professional labor shortage ó
is no doubt an estimable entry. But for the reader struck by some of the
facts the Times mentions only in passing ó for example, that Ritalin
use more than doubled in the first half of the decade alone, that production
has increased 700 percent since 1990, or that the number of schoolchildren
taking the drug may now, by some estimates, be approaching the 4 million
mark ó mere anecdote will only explain so much.
Fortunately, at least for the curious reader, there is a great deal of
other material now on offer, for the explosion in Ritalin consumption has
been very nearly matched by a publishing boom dedicated to that same phenomenon.
Its harbingers include, for example, Barbara Ingersollís now-classic
1988 Your Hyperactive Child, among the first works to popularize a drug regimen
for what we now call Attention Deficit Disorder (add, called adhd when it
Five years later, with add diagnoses and Ritalin prescriptions already
rising steeply in the better-off neighborhoods and schools, Peter D. Kramer
helped fuel the boom with his best selling Listening to Prozac ó a
book that put the phrase "cosmetic pharmacology" into the vernacular and
thereby inadvertently broke new conceptual ground for the advocates of Ritalin.
In 1994, most important, psychiatrists Edward M. Hallowell and John J. Ratey
published their own best selling Driven to Distraction: Recognizing and Coping
with Attention Deficit Disorder from Childhood to Adulthood, a book that
was perhaps the single most powerful force in the subsequent proliferation
of add diagnoses; as its opening sentence accurately prophesied, "Once you
catch on to what this syndrome is all about, youíll see it
Not everyone received these soundings from the psychotropic beyond with
the same enthusiasm. One noteworthy dissent came in 1995 with Thomas
Armstrongís The Myth of the add Child, which attacked both the scientific
claims made on behalf of add and what Armstrong decried as the "pathologizing"
of normal children. Dissent also took the form of wary public pronouncements
by the National Education Association (nea), one of several groups to harbor
the fear that add would be used to stigmatize minority children.
Meanwhile, scare stories on the abuse and side effects of Ritalin popped
out here and there in the mass media, and a national controversy was born.
>From the middle to the late 1990s, other interested parties from all
over ó the Drug Enforcement Administration (dea), the Food and Drug
Administration (fda), the medical journals, the National Institutes of Health
(nih), and especially the extremely active advocacy group chadd (Children
and Adults with Attention Deficit Disorder) ó further stoked the debate
through countless reports, conferences, pamphlets, and exchanges on the
To this outpouring of information and opinion two new books, both on the
critical side of the ledger, have just been added: Richard DeGrandpreís
iconoclastic Ritalin Nation: Rapid-Fire Culture and the Transformation of
Human Consciousness (Simon and Schuster, 1999), and physician Lawrence H.
Dillerís superbly analytical Running on Ritalin: A Physician Reflects
on Children, Society and Performance in a Pill (Bantam Books, 1998). Their
appearance marks an unusually opportune moment in which to sift through some
ten yearsí worth of information on Ritalin and add and to ask what,
if anything, we have learned from the national experiment that has made both
terms into household words.
Letís put the question bluntly: How has it come to pass that in
fin-de-siËcle America, where every child from preschool onward can recite
the "anti-drug" catechism by heart, millions of middle- and upper-middle
class children are being legally drugged with a substance so similar to cocaine
that, as one journalist accurately summarized the science, "it takes a chemist
to tell the difference"?
What is methylphenidate? The first thing that has made the Ritalin explosion
possible is that methylphenidate, to use the generic term, is perhaps the
most widely misunderstood drug in America today. Despite the fact that it
is, as Lawrence Diller observes in Running on Ritalin, "the most intensively
studied drug in pediatrics," most laymen remain under a misimpression both
about the nature of the drug itself and about its pharmacological effects
What most people believe about this drug is the same erroneous
characterization that appeared elsewhere in the Times piece quoted earlier
ó that it is "a mild stimulant of the central nervous system that,
for reasons not fully understood, often helps children who are chronically
distractible, impulsive and hyperactive settle down and concentrate." The
word "stimulant" here is at least medically accurate.
"Mild," a more ambiguous judgment, depends partly on the dosage, and partly
on whether the reader can imagine describing as "mild" any dosage of the
drugs to which methylphenidate is closely related. These include
dextroamphetamine (street name: "dexies"), methamphetamine (street name:
"crystal meth"), and, of course, cocaine. But the chief substance of the
Timesí formulation here ó that the reasons why Ritalin does
what it does to children remain a medical mystery ó is, as informed
writers from all over the debate have long acknowledged, an enduring public
"Methylphenidate," in the words of a 1995 dea background paper on the
drug, "is a central nervous system (cns) stimulant and shares many of the
pharmacological effects of amphetamine, methamphetamine, and cocaine." Further,
it "produces behavioral, psychological, subjective, and reinforcing effects
similar to those of d-amphetamine including increases in rating of euphoria,
drug liking and activity, and decreases in sedation." For comparative purposes,
that same dea report includes a table listing the potential adverse physiological
effects of both methylphenidate and dextroamphetamine; they are, as the table
shows, nearly identical (see below). To put the point conversely, as Richard
DeGrandpre does in Ritalin Nation by quoting a 1995 report in the Archives
of General Psychiatry, "Cocaine, which is one of the most reinforcing and
addicting of the abused drugs, has pharmacological actions that are very
similar to those of methylphenidate, which is now the most commonly prescribed
psychotropic medicine for children in the U.S."
Such pharmacological similarities have been explored over the years in
numerous studies. DeGrandpre reports that "lab animals given the choice to
self-administer comparative doses of cocaine and Ritalin do not favor one
over another" and that "a similar study showed monkeys would work in the
same fashion for Ritalin as they would for cocaine."
The dea reports another finding ó that methylphenidate is actually
"chosen over cocaine in preference studies" of non-human primates (emphasis
added). In Driven to distraction, pro-Ritalin psychiatrists Hallowell and
Ratey underline the interchangeable nature of methylphenidate and cocaine
when they observe that "people with add feel focused when they take cocaine,
just as they do when they take Ritalin [emphasis added]." Moreover,
methylphenidate (like other stimulants) appears to increase tolerance for
related drugs. Recent evidence indicates, for example, that when people
accustomed to prescribed Ritalin turn to cocaine, they seek higher doses
of it than do others. To summarize, again from the dea report, "it is clear
that methylphenidate substitutes for cocaine and d-amphetamine in a number
of behavioral paradigms."
All of which is to say that Ritalin "works" on children in the same way
that related stimulants work on adults ó sharpening the short-term
attention span when the drug kicks in and producing equally predictable valleys
("coming down," in the old street parlance; "rebounding," in Ritalinese)
when the effect wears off. Just as predictably, children are subject to the
same adverse effects as adults imbibing such drugs, with the two most common
ó appetite suppression and insomnia ó being of particular
That is why, for example, handbooks on add will counsel parents to see
their doctor if they feel their child is losing too much weight, and why
some children who take methylphenidate are also prescribed sedatives to help
them sleep. It is also why one of the more Orwellian phrases in the psychotropic
universe, "drug holidays" ó meaning scheduled times, typically on
weekends or school vacations, when the dosage of methylphenidate is lowered
or the drug temporarily withdrawn in order to keep its adverse effects in
check ó is now so common in the literature that it no longer even
appears in quotations.
Just as, contrary to folklore, the adult and child physiologies respond
in the same way to such drugs, so too do the physiologies of all people,
regardless of whether they are diagnosed with add or hyperactivity. As Diller
puts it, in a point echoed by many other sources, methylphenidate "potentially
improves the performance of anyone ó child or not, add-diagnosed or
Writing in the Public Interest last year, psychologist Ken Livingston
provided a similar summary of the research, citing "studies conducted during
the mid seventies to early eighties by Judith Rapaport of the National Institute
of Mental Health" which "clearly showed that stimulant drugs improve the
performance of most people, regardless of whether they have a diagnosis of
add, on tasks requiring good attention." ("Indeed," he comments further in
an obvious comparison, "this probably explains the high levels of
ëself-medicatingí around the world" in the form of "stimulants
like caffeine and nicotine.")
A third myth about methylphenidate is that it, alone among drugs of its
kind, is immune to being abused. To the contrary: Abuse statistics have
flourished alongside the boom in Ritalin prescription-writing. Though it
is quite true that elementary schoolchildren are unlikely to ingest extra
doses of the drug, which is presumably kept away from little hands, a very
different pattern has emerged among teenagers and adults who have the manual
dexterity to open prescription bottles and the wherewithal to chop up and
snort their contents (a method that puts the drug into the bloodstream far
faster than oral ingestion). For this group, statistics on the proliferating
abuse of methylphenidate in schoolyards and on the street are dramatic.
According to the dea, for example, as early as 1994 Ritalin was the
fastest-growing amphetamine being used "non-medically" by high school seniors
in Texas. In 1991, reports DeGrandpre in Ritalin Nation, "children between
the ages of 10 and 14 years old were involved in only about 25 emergency
room visits connected with Ritalin abuse. In 1995, just four years later,
that number had climbed to more than 400 visits, which for this group was
about the same number of visits as for cocaine." Not surprisingly, given
these and other measures of methylphenidateís recreational appeal,
criminal entrepreneurs have responded with interest to the drugís
increased circulation. From 1990 to 1995, the dea reports, there were about
2,000 thefts of methylphenidate, most of them night break-ins at pharmacies
ó meaning that the drug "ranks in the top 10 most frequently reported
pharmaceutical drugs diverted from licensed handlers."
Because so many teenagers and college students have access to it,
methylphenidate is particularly likely to be abused on school grounds. "The
prescription drug Ritalin," reported Newsweek in 1995, "is now a popular
high on campus ó with some serious side effects." DeGrandpre notes
that at his own college in Vermont, Ritalin was cited as the third-favorite
drug to snort in a campus survey.
He also runs, without comment, scores of individual abuse stories from
newspapers across the country over several pages of his book. In Running
on Ritalin, Diller cites several undercover narcotics agents who confirm
that "Ritalin is cheaper and easier to purchase at playgrounds than on the
street." He further reports one particularly hazardous fact about Ritalin
abuse, namely that teenagers, especially, do not consider the drug to be
anywhere near as dangerous as heroin or cocaine. To the contrary: "they think
that since their younger brother takes it under a doctorís prescription,
it must be safe."
In short, methylphenidate looks like an amphetamine, acts like an amphetamine,
and is abused like an amphetamine. Perhaps not surprisingly, those who value
its medicinal effects tend to explain the drug differently. To some, Ritalin
is to children what Prozac and other psychotropic "mood brightening" drugs
are to adults ó a short-term fix for enhancing personality and
performance. But the analogy is misleading. Prozac and its sisters are not
stimulants with stimulant side effects; there is, ipso facto, no black market
for drugs like these.
Even more peculiar is the analogy favored by the advocates in chadd: that
"Just as a pair of glasses help the nearsighted person focus," as Hallowell
and Ratey explain, "so can medication help the person with add see the world
more clearly." But there is no black market for eyeglasses, either ó
nor loss of appetite, insomnia, "dysphoria" (an unexplained feeling of sadness
that sometimes accompanies pediatric Ritalin-taking), nor even the faintest
risk of toxic psychosis, to cite one of Ritalinís rare but dramatically
chilling possible effects.
What is methylphenidate "really" like? Thomas Armstrong, writing in The
Myth of the ADD Child four years ago, probably summarized the drugís
appeal best. "Many middle and upper-middle class parents," he observed then,
"see Ritalin and related drugs almost as ëcognitive steroidsí
that can be used to help their kids focus on their schoolwork better than
the next kid." Put this way, the attraction to Ritalin makes considerable
In some ways, one can argue, that after-lunch hit of low-dose methylphenidate
is much like the big cup from Starbucks that millions of adults swig to get
them through the day ó but only in some ways. There is no dramatic
upswing in hospital emergency room visits and pharmacy break-ins due to caffeine
abuse; the brain being jolted awake in one case is that of an adult, and
in the other that of a developing child; and, of course, the substance doing
the jolting on all those children is not legally available and ubiquitous
caffeine, but a substance that the dea insists on calling a Schedule II drug,
meaning that it is subject to the same controls, and for the same reasons
of abuse potential, as related stimulants and other powerful drugs like
What is CHADD? This mention of Schedule II drugs brings us to a second
reason for the Ritalin explosion in this decade. That is the extraordinary
political and medical clout of chadd, by far the largest of the add support
groups and a lobbying organization of demonstrated prowess. Founded in 1987,
chadd had, according to Diller, grown by 1993 to include 35,000 families
and 600 chapters nationally. Its professional advisory board, he notes, "includes
most of the most prominent academicians in the add world, a veritable whoís
who in research."
Like most support groups in self-help America, chadd functions partly
as clearing-house and information center for its burgeoning membership ó
organizing speaking events, issuing a monthly newsletter (Chadderbox), putting
out a glossy magazine (named, naturally enough, Attention!), and operating
an exceedingly active website stocked with on-line fact sheets and items
for sale. Particular scrutiny is given to every legal and political development
offering new benefits for those diagnosed with add. On these and other fronts
of interest, chadd leads the add world. "No matter how many sources of
information are out there," as a slogan on its website promises, "chadd is
the one you can trust."
One of chaddís particular strengths is that it is exquisitely
media-sensitive, and has a track record of delivering speedy responses to
any reports on Ritalin or add that the group deems inaccurate. Diller quotes
as representative one fundraising letter from 1997, where the organization
listed its chief goals and objectives as "conduct[ing] a proactive media
campaign" and "challeng[ing] negative, inaccurate reports that demean or
undermine people with add." Citing "savage attacks" in the Wall Street Journal
and Forbes, the letter also went on to exhort readers into "fighting these
battles of misinformation, innuendo, ignorance and outright hostility toward
chadd and adults who have a neurobiological disorder." The circle-the-wagons
rhetoric here appears to be typical of the group, as is the zeal.
Certainly it was with missionary fervor that chadd, in 1995, mounted an
extraordinary campaign to make Ritalin easier to obtain. Methylphenidate,
as mentioned, is a Schedule II drug. That means, among other things, that
the dea must approve an annual production quota for the substance ó
a fact that irritates those who rely on it, since it raises the specter,
if only in theory, of a Ritalin "shortage." It also means that some states
require that prescriptions for Ritalin be written in triplicate for the purpose
of monitoring its use, and that refills cannot simply be called into the
pharmacy as they can for Schedule III drugs (for example, low-dosage opiates
like Tylenol with codeine, and various compounds used to treat migraine).
Doctors, particularly those who prescribe Ritalin in quantity, are
inconvenienced by this requirement. So too are many parents, who dislike
having to stop by the doctorís office every time the Ritalin runs
out. Moreover, many parents and doctors alike object to methylphenidateís
Schedule II classification in principle, on the grounds that it makes children
feel stigmatized; the authors of Driven to Distraction, for example, claim
that one of the most common problems in treating add is that "some pharmacists,
in their attempt to comply with federal regulations, make consumers [of Ritalin]
feel as though they are obtaining illicit drugs."
For all of these reasons, chadd petitioned the dea to reclassify Ritalin
as a Schedule III drug. This petition was co-signed by the American Academy
of Neurology, and it was also supported by other distinguished medical bodies,
including the American Academy of Pediatrics, the American Psychological
Association, and the American Academy of Child and Adolescent Psychiatry.
Dillerís account of this episode in Running on Ritalin is particularly
credible, for he is a doctor who has himself written many prescriptions for
Ritalin in cases where he has judged it to be indicated. Nevertheless, he
found himself dissenting strongly from the effort to decontrol it ó
an effort that, as he writes, was "unprecedented in the history of Schedule
II substances" and "could have had a profound impact on the availability
of the drug."
What happened next, while chadd awaited the deaís verdict, was
in Dillerís words "a bombshell." For before the dea had officially
responded, a television documentary revealed that Ciba-Geigy (now called
Novartis), the pharmaceuticals giant that manufactures Ritalin, had contributed
nearly $900,000 to chadd over five years, and that chadd had failed to disclose
the contributions to all but a few selected members.
The response from the dea, which appeared in the background report cited
earlier, was harsh and uncompromising. Backed by scores of footnotes and
well over a 100 sources in the medical literature, this report amounted to
a public excoriation of chaddís efforts and a meticulous description,
alarming for those who have read it, of the realities of Ritalin use and
abuse. "Most of the add literature prepared for public consumption and available
to parents," the dea charged, "does not address the abuse liability or actual
abuse of methylphenidate. Instead, methylphenidate is routinely portrayed
as a benign, mild stimulant that is not associated with abuse or serious
effects. In reality, however, there is an abundance of scientific literature
which indicates that methylphenidate shares the same abuse potential as other
Schedule II stimulants."
The dea went on to note its "concerns" over "the depth of the financial
relationship between chadd and Ciba-Geigy." Ciba-Geigy, the dea observed,
"stands to benefit from a change in scheduling of methylphenidate." It further
observed that the United Nations International Narcotics Control Board (incb)
had "expressed concern about non-governmental organizations and parental
associations in the United States that are actively lobbying for the medical
use of methylphenidate for children with add." (The rest of the world, it
should be noted, has yet to acquire the American taste for Ritalin.
Sweden, for example, had methylphenidate withdrawn from the market in
1968 following a spate of abuse cases. Today, 90 percent of Ritalin production
is consumed in the United States.) The report concluded with the documented
observations that "abuse data indicate a growing problem among school-age
children," that "adhd adults have a high incidence of substance disorders,"
and that "with three to five percent of todayís youth being administered
methylphenidate on a chronic basis, these issues are of great concern."
Yet whatever public embarrassment chadd and its supporters may have suffered
on account of this setback turned out to be short-lived. Though it failed
in the attempt to decontrol Ritalin (in the end, the group withdrew its
petition), on other legislative fronts chadd was garnering one victory after
another. By the end of the 1990s, thanks largely to chadd and its allies,
an add diagnosis could lead to an impressive array of educational, financial,
and social service benefits.
In elementary and high school classrooms, a turning point came in 1991
with a letter from the U.S. Department of Education to state school
superintendents outlining "three ways in which children labeled add could
qualify for special education services in public school under existing laws,"
as Diller puts it.
This directive was based on the landmark 1990 Individuals with Disabilities
Education Act (idea), which "mandates that eligible children receive access
to special education and/or related services, and that this education be
designed to meet each childís unique educational needs" through an
individualized program. As a result, add-diagnosed children are now entitled
by law to a long list of services, including separate special-education
classrooms, learning specialists, special equipment, tailored homework
assignments, and more. The idea also means that public school districts unable
to accommodate such children may be forced to pick up the tab for private
In the field of higher education, where the first wave of Ritalin-taking
students has recently landed, an add diagnosis can be parlayed into other
sorts of special treatment. Diller reports that add-based requests for extra
time on sats, lsats, and mcats have risen sharply in the course of the 1990s.
Yet the example of such high-profile tests is only one particularly measurable
way of assessing addís impact on education; in many classrooms, including
college classrooms, similar "accommodations" are made informally at a
A professor in the Ivy League tells me that students with an add diagnosis
now come to him "waving doctorís letters and pills" and requesting
extra time for routine assignments. To refuse "accommodation" is to risk
a hornetís nest of liabilities, as a growing caseload shows. A 1996
article in Forbes cites the example of Whittier Law School, which was sued
by an add-diagnosed student for giving only 20 extra minutes per hour long
exam instead of a full hour. The school, fearing an expensive legal battle,
settled the suit. It further undertook a preventive measure: banning pop
quizzes "because add students need separate rooms and extra time."
Concessions have also been won by advocates in the area of college athletics.
The National College Athletic Association (ncaa) once prohibited Ritalin
usage (as do the U.S. and International Olympic Committees today) because
of what Diller calls its "possible acute performance-enhancing benefits."
In 1993, citing legal jeopardy as a reason for changing course, the ncaa
capitulated. Today a letter from the team physician will suffice to allow
an athlete to ingest Ritalin, even though that same athlete would be disqualified
from participating in the Olympics if he were to test positive for
Nor are children and college students the only ones to claim benefits
in the name of add. With adults now accounting for the fastest-growing subset
of add diagnoses, services and accommodations are also proliferating in the
workplace. The enabling regulations here are 1997 guidelines from the Equal
Employment Opportunity Commission (eeoc) which linked traits like chronic
lateness, poor judgment, and hostility to coworkers ó in other words,
the sorts of traits people get fired for ó to "psychiatric impairments,"
meaning traits that are protected under the law.
As one management analyst for the Wall Street Journal recently observed
(and as chadd regularly reminds its readers), these eeoc guidelines have
already generated a list of accommodations for add-diagnosed employees, including
special office furniture, special equipment such as tape recorders and laptops,
and byzantine organizational schemes (color coding, buddy systems, alarm
clocks, and other "reminders") designed to keep such employees on track.
"Employers," this writer warned, "could find themselves facing civil suits
and forced to restore the discharged people to their old positions, or even
give them promotions as well as back pay or reasonable accommodation."
An add diagnosis can also be helpful in acquiring Supplemental Security
Income (ssi) benefits. ssi takes income into account in providing benefits
to the add diagnosed; in that, it is an exception to the trend. Most of the
benefits now available, as even this brief review indicates, have come to
be provided in principle, on account of the diagnosis per se. Seen this way,
and taking the class composition of the add-diagnosed into account, it is
no wonder that more and more people, as Diller and many other doctors report,
are now marching into medical offices demanding a letter, a diagnosis, and
a prescription. The pharmacological charms of Ritalin quite apart, add can
operate, in effect, as affirmative action for affluent white people.
What is Attention Deficit Disorder? Another factor that has put Ritalin
into millions of medicine cabinets has to do with the protean nature of the
disorder for which it is prescribed ó a disorder that was officially
so designated by the American Psychiatric Association in 1980, and one that,
to cite Thomas Armstrong, "has gone through at least 25 different name changes
in the past century."
Despite the successful efforts to have add construed as a disability like
blindness, the question of what add is remains passionately disputed. To
chadd, of course, it is a "neurobiological disorder," and not only to chadd;
"the belief that add is a neurological disease," as Diller writes, also "prevails
today among medical researchers and university teaching faculty" and "is
reflected in the leading journals of psychiatry." What the critics observe
is something else ó that "despite highly successful efforts to define
add as a well-established disorder of the brain," as DeGrandpre puts it in
a formulation echoed by many, "three decades of medical science have yet
to produce any substantive evidence to support such a claim."
Nonetheless, the effort to produce such evidence has been prodigious.
Research on the neurological side of add has come to resemble a Holy Grail-like
quest for something, anything, that can be said to set the add brain apart
ó genes, imbalances of brain chemicals like dopamine and serotonin,
neurological damage, lead poisoning, thyroid problems, and more. The most
famous of these studies, and the chief grounds on which add has come to be
categorized as a neurobiological disability, was reported in The New England
Journal of Medicine in 1990 by Alan Zametkin and colleagues at the National
Institute of Mental Health (nimh). These researchers used then-new positron
emission tomography (pet) scanning to measure differences in glucose metabolizing
between hyperactive adults and a control group. According to the studyís
results, what emerged was a statistically significant difference in the rates
of glucose metabolism ó a difference hailed by many observers as the
first medical "proof" of a biological basis for add.
Diller and DeGrandpre are only the latest to argue, at length, that the
Zametkin study established no such thing. For starters ó and from
the scientific point of view, most important ó a series of follow-up
studies, as Diller documents, "failed to confirm" the original result.
DeGrandpre, for his part, details the methodological problems with the study
itself ó that the participants were adults rather than children, meaning
that the implications for the majority of the Ritalin-taking population were
unclear at best; that there was "no evidence" that the reported difference
in metabolism bore any relationship to behavioral activity; that the study
was further plagued by "a confounding variable that had nothing to do with
add," namely that the control group included far fewer male subjects than
the add group; and that, even if there had been a valid difference in metabolism
between the two groups, "this study tells us nothing about the cause of these
Numerous other attempts to locate the missing link between add and brain
activity are likewise dissected by Diller and DeGrandpre in their books.
So too is the causal fallacy prevalent in add literature ó that if
a child responds positively to Ritalin, that response "proves" that he has
an underlying biological disorder. This piece of illogic is easily dismissed.
As these and other authors emphasize, drugs like Ritalin have the same effect
on just about everybody. Give it to almost any child, and the child will
become more focused and less aggressive ó one might say, easier to
manage ó whether or not there were "symptoms" of add in the first
In sum, and as Thomas Armstrong noted four years ago in The Myth of the
ADD Child, add remains an elusive disorder that "cannot be authoritatively
identified in the same way as polio, heart disease, or other legitimate
illnesses." Instead, doctors depend on a series of tests designed to measure
the panoply of add symptoms. To cite Armstrong again: "there is no prime
mover in this chain of tests; no First Test for add that has been declared
self-referential and infallible."
Some researchers, for example, use "continuous performance tasks" (cpts)
that require the person being tested to pay attention throughout a series
of repetitive actions. A popular cpt is the Gordon Diagnostic System, a box
that flashes numbers, whose lever is supposed to be pressed every time a
particular combination appears. Yet as numerous critics have suggested, although
the score that results is supposed to tell us about a given childís
ability to attend, its actual significance is rather ambiguous; perhaps,
as Armstrong analyzes, "it only tells how a child will perform when attending
to a repetitive series of meaningless numbers on a soulless task."
In the absence of any positive medical or scientific test, the diagnosis
of add in both children and adults depends, today as a decade ago, almost
exclusively on behavioral criteria. The diagnostic criteria for children,
according to the latest Diagnostic and Statistics Manual (dsm-iv), include
six or more monthsí worth of some 14 activities such as fidgeting,
squirming, distraction by extraneous stimuli, difficulty waiting turns, blurting
out answers, losing things, interrupting, ignoring adults, and so on. (To
read the list is to understand why boys are diagnosed with add three to five
times as often as girls.) The diagnostic latitude offered by this list is
obvious; as Diller understates the point, "what often strikes those encountering
dsm criteria for the first time is how common these symptoms are among children"
The dsm criteria for adults are if anything even more expansive, and include
such ambiguous phenomena as a sense of underachievement, difficulty getting
organized, chronic procrastination, a search for high stimulation, impatience,
impulsivity, and mood swings. Hallowell and Rateyís 100-question test
for add in Driven to Distraction, an elaborately extrapolated version of
the dsm checklist, illustrates this profound elasticity.
Their questions range from the straightforward ("Are you impulsive?" "Are
you easily distracted?" "Do you fidget a lot?") to more elusive ways of eliciting
the disorder ("Do you change the radio station in your car frequently?" "Are
you always on the go, even when you donít really want to be?" "Do
you have a hard time reading a book all the way through?"). Throughout, the
distinction between what is pathological and what is not remains unclear
ó because, in the authorsí words, "There is no clear line of
demarcation between add and normal behavior."
Thus the business of diagnosing add remains, as Diller puts it, "very
much in the eye of the beholder." In 1998, partly for that reason, the National
Institutes of Health convened a conference on add with hundreds of participants
and a panel of 13 doctors and educators. This conference, as newspapers reported
at the time, broke no new ground, and indeed could not reach agreement on
several important points ó for instance, how long children should
take drugs for add, or whether and when drug treatment might become risky.
Even more interesting, conference members could not agree on what is arguably
the rather fundamental question of how to diagnose the disorder in the first
place. As one panelist, a pediatrician, put it succinctly, "The diagnosis
is a mess."
Who has ADD? To test this hypothesis, I gave copies of Hallowell and
Rateyís questionnaire to 20 people (letís call them subjects)
and asked them to complete it and total up the number of times they checked
"yes." The full questionnaire appears at the conclusion of this piece so
that interested readers can take it themselves. "These questions," as Hallowell
and Ratey note, "reflect those an experienced diagnostician would ask." Although,
as they observe, "this quiz cannot confirm the diagnosis" (as we have seen
already, nothing can), it does "offer a rough assessment as to whether
professional help should be sought." In short, "the more questions that are
answered ëyes,í the more likely it is that add may be present."
In a stab at methodological soundness, I had equal numbers of males and
females take the test. All would be dubbed middle- or upper-middle class,
all but one are or have been professionals of one sort or another, all are
white, and the group was politically diverse ó which is to say, the
sample accurately reflects the socioeconomic pool from which most of the
current Ritalin-taking population is drawn. As to the matter of observer
interference, although some subjects may have guessed what the questionnaire
was looking for, all of them (myself excepted, of course) took the test "blind,"
that is, without any accompanying material to prejudice their responses.
We begin with results at the lower end of the scale. Of the 18 subjects
who completed the test, two delivered "yes" scores of 8 and 10 (a professor
of English and his wife, an at-home mother active in philanthropy). These
"yes" results, as it turned out, were at least threefold lower than anyone
elseís. In "real" social science, according to some expert sources,
we would simply call these low scores "outliers" and throw them out for the
same reason. We, however, shall include them, if only on the amateur grounds
The next lowest "yes" tallies ó 29 in each case ó were achieved
by an editorial assistant and a school nurse. That is to say, even these
"low scorers" managed to answer yes almost a third of the time (remember,
"the more questions that are answered ëyes,í the more likely
it is that add may be present"). After them, we find a single "yes" score
of 33 (an assistant editor). Following that, fully six subjects, or a third
of the test-finishers, produced scores in the 40s. These include this
magazineís editor, two at-home mothers (one a graphic designer, the
other a poet), a writer for Time and other distinguished publications, Policy
Reviewís business manager, and ó scoring an estimable 49 ó
the headmaster of a private school in Washington.
Proceeding into the upper echelons, a novelist who is also an at-home
mother reported her score as 55, and a renowned demographic expert with ties
to Harvard and Washington think tanks scored a 57. A male British journalist
and at-home father achieved a 60, and a female American journalist and at-home
mother (me) got a 62. Still another at-home mother, this one with a former
career in public relations, garnered a 65.
In the lead, at least of the test-finishers, was a best selling satirist
whom we shall call, for purposes of anonymity, Patrick OíRourke; he
produced an estimable score of 75. "Mr. OíRourke" further advanced
the cause of science by answering the questions on behalf of his 16-month-old
daughter; according to his proud report, 65 was the result. Then there were
the two subjects who, for whatever reason, were unable to complete the test
in the first place.
One of these subjects called to say that heíd failed to finish
the test because heíd "gotten bored checking off so many yes answers."
When I pressed him for some, any, final tally for me to include, he got irritated
and refused, saying he was "too lazy" to count them up. Finally he said "50
would be about right," take it or leave it. He is a Wall Street investment
banker specializing in the creation of derivative securities. Our last subject,
perhaps the most pathological of all, failed to deliver any score despite
repeated reminding phone calls from the research team. He is the professor
mentioned earlier, the one who reported that add is now being used as a blanket
for procrastination and shirking on campus.
Now on to interpreting the results. Apart from the exceedingly anomalous
two scores of ten and under, all the rest of the subjects reported answering
"yes" to at least a quarter of the questions ó surely enough to trigger
the possibility of an add diagnosis, at least in those medical offices Diller
dubs "Ritalin mills." (As for the one subject who reported no result whatsoever,
he is obviously entitled to untold add bonus points for that reason alone.)
Fully 15 of the finishers, or 80-plus percent, answered yes to one-third
of the questions or more. Eight of the finishers, or 40-plus percent of the
sample, answered yes more than half of the time, with a number of scores
in the high 40s right behind them. In other words, roughly half of the sample
answered yes roughly half of the time.
My favorite comment on the exercise came from the school nurse (who scored,
one recalls, a relatively low 29). She has a background in psychiatry, and
therefore realized what kind of diagnosis the questionnaire was designed
to elicit. When she called to report her result, she said that taking the
test had made her think hard about the whole add issue. "My goodness," she
concluded, "it looks like the kind of thing almost anybody could have." This
brings us to the fourth reason for the explosion of add and its prescribed
corollary, Ritalin: The nurse is right.
What is childhood? The fourth and most obvious reason millions of Americans,
most of them children, are now taking Ritalin can be summarized in a single
word that crops up everywhere in the dry-bones literature on add and its
drug of choice: compliance. One day at a time, the drug continues to make
children do what their parents and teachers either will not or cannot get
them to do without it: Sit down, shut up, keep still, pay attention. That
some children are born with or develop behavioral problems so severe that
drugs like Ritalin are a godsend is true and sad (I totally disagree; most
of the problems mentioned here are caused, and are not ìborn withî
or developed, and this goes back to a lack of nutrition and the eating of
poor, additive ìfoods.î ñ David). It is also irrelevant
to the explosion in psychostimulant prescriptions. For most, the drug is
serving a more nuanced purpose ó that of "help[ing] your child to
be more agreeable and less argumentative," as Barbara Ingersoll put it over
a decade ago in Your Hyperactive Child.
There are, as was mentioned, millions of stories in the Ritalin universe,
and the literature of advocates and critics alike all illustrates this point.
There is no denying that millions of people benefit from having children
take Ritalin ó the many, many parents who will attest that the drug
has improved their childís school performance, their home lives, often
even their own marriages; the teachers who have been relieved by its effects
in their classrooms, and have gone on to proselytize other parents of other
unruly children (frequently, it is teachers who first suggest that a child
be checked for the disorder); and the doctors who, when faced with all these
grateful parents and teachers, find, as Diller finds, that "at times the
pressure for me to medicate a child is intense."
Some other stories seep through the literature too, but only if one goes
looking for them. These are the stories standing behind the clinical accounts
of teenagers who lie and say theyíve taken the dayís dose when
they havenít, or of the children who cry in doctorís offices
and "cheek" the pill (hide it rather than swallow, another linguistic innovation
of Ritalinese) at home. These are the stories standing behind such statements
as the following, culled from case studies throughout the literature: "It
takes over of me [sic]; it takes control." "It numbed me." "Taking it meant
I was dumb." "I feel rotten about taking pills; why me?" "It makes me feel
like a baby." And, perhaps most evocative of all, "I donít know how
to explain. I just donít want to take it any more."
But these quotes, as any reader will recognize, appeal only to sentiment;
science, for its part, has long since declared its loyalties. In the end,
what has made the Ritalin outbreak not only possible but inevitable is the
ongoing blessing of the American medical establishment ó and not only
that establishment. In a particularly enthusiastic account of the drug in
a recent issue of the New Yorker, writer Malcolm Gladwell exults in the idea
that "we are now extending to the young cognitive aids of a kind that used
to be reserved exclusively for the old."
He further suggests that, given expert estimates of the prevalence of
add (up to 10 percent of the population, depending on the expert), if anything
"too few" children are taking the drug. Surely all these experts have a point.
Surely this country can do more, much more, to reduce fidgeting, squirming,
talking excessively, interrupting, losing things, ignoring adults, and all
those other pathologies of what used to be called childhood. END
As more and more people begin to starve to death around the world, because
of actions directly related to Washington, DC, perhaps more Americans will
begin to understand why judgement will come against them. This is another
example of abuse of people, and the United States is exporting it to other
countries, for which America will be blamed.
I urge you to pass this post on to others, as they may need to understand
what is going on. We all have a moral obligation to help understanding and
knowledge spread across America. "But if the watchman sees the sword coming
and does not blow the trumpet to warn the people and the sword comes and
takes the life of one of them, that man will be taken away because of his
sin, but I will hold the watchman accountable for his blood." Ezekiel 33:6
The cost of liberty is eternal vigilance
I am now selling copies of the book ìStrategic Withdrawal; the
Peaceful Solutions Manual.î If you would like a copy of the paper
ìStrategic Withdrawal in a Nutshell,î please E-mail me and request
it at - firstname.lastname@example.org - In addition, various people around the country
are arranging Seminars for the author of this book. If you are interested
in seeing a schedule of upcoming events, please let me know and I will supply
the information. We will be holding a large Symposium on Sovereignty and
tax issues in June in Mexico. Please ask for more details if you are
Is information in this post for real? I assure you it is. If you do not
understand, I suggest you begin reading the papers that I have prepared for
people just like you (no cost; no obligation). There are currently 18 papers
in all and they cover health, cancer, nutrition, the Constitution, citizenship,
law, case law, nature, and many other subjects. Currently, there are at least
5 doctors, 2 lawyers, 1 judge (that I know of), 3 college/university professors
and many others reading the information. They read because they are learning;
maybe you should as well. Your first paper will be about United States
citizenship, and what case law says about it. Case law from the Supreme Court,
for instance. The second paper is on the Constitution.
To understand the world around you it is necessary to understand Scripture,
and one piece of information from Scripture is particularly telling; ìthe
LOVE of money is the root of ALL evil.î Not some evil; not most evil;
ALL evil. Private courts the IRS uses are simply another way to prey on the
uninformed; please, do not stay uninformed. Learn what is really going on
in America. Learn why the United States government (a corporation [in
bankruptcy]) allows abuse of people like the fraudulent IRS. I will be sending
other Posts I consider important; please pass them on to those you consider
in need of information. Please pass them on unedited. Please watch for them.
If you are interested, please E-mail - email@example.com - and
letís get started! And for those of you who have been reading and
stopped for some reason, any reason, please continue. Believe me, the real
information begins after Part X! There will be a total of 20 parts, and those
who are finishing are learning much more, and this learning is changing how
they look at the world around them, in some ways, drastically. God Bless,
"Most people, sometime in their lives, stumble across truth. Most jump
up, brush themselves off, and hurry on about their business as if nothing
had happened." - Sir Winston Churchill
When a man who is honestly mistaken hears the truth, he will either quit
being mistaken or cease to be honest.
Lawyers: 99.9 percent of them give the rest of the profession a bad
I don't think you can make a lawyer honest by an act of legislation. You've
got to work on his conscience. And his lack of conscience is what makes him
a lawyer -- Will Rogers (1879-1935)
It can be said better: When do you know a lawyer is lying? When his mouth
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