Sunday, 22 May 2011 02:30
By Dr. Jerry Simon
This article is not about aspirin. However, fundamental to its understanding is the concept or myth of the Aspirin Deficiency Syndrome. Now it is known that aspirin can help to relieve a headache.
But the Aspirin Deficiency Syndrome takes it a step further to say a headache is caused by a lack of aspirin..
To be honest with you, no one will tell you that (because they know it is pure foolishness), not even Bayer the big aspirin seller. However, that concept is used by physicians, under the influence of pharmaceutical industry, to over-prescribe medication for behavioural disorders in children. This may especially be true as it pertains to the use of Ritalin (methyphenidate) to treat Attention Deficit Hyperactivity Disorder (ADHD).
In his research work, “Ritalin and the Growing Influence of Big Pharma,” Dr Lawrence Diller, pediatrician and family therapist, contends that Ritalin is overused to treat ADHD, as its diagnosis is quite imprecise. And further, he argues that the proliferation in the use of Ritalin stems from its promotion by the pharmaceutical industry.
ADHD is the number one childhood psychiatric “disorder” in the United States, affecting approximately six million American school children. It is characterised by inattentiveness, hyperactivity, and impulsiveness. Basically, it is your child who pays you little attention, cannot sit still, and will touch and interfere with just about any- and everything. I am sure you do not know a child like that...?
Herein lies the first set of concerns in the problem of ADHD and its treatment with Ritalin. Is the condition over-diagnosed, and is Ritalin over-prescribed to treat the condition? Are the symptoms that were outlined pathologic, or are they found in many normal little boys as well?
American children consume 90 percent of the world's production of Ritalin, as only a very small percentage of children anywhere else in the world are diagnosed with ADHD. Further, in other parts of the world, social factors (such as the child's family and environment) are taken more into account when assessing a possible ADHD diagnosis. Therefore, the treatment is not mainly based on giving the child a medication to make some modification to his brain chemistry.
Herein lies the next set of concerns. Are American physicians (who diagnose this condition the most) overplaying the neurobiological aspect of ADHD, and what role does the pharmaceutical industry play in this process? In other words, is your child showing the symptoms of ADHD because his brain is just wired incorrectly? If that is the case, then there would be a justifiable high use of medication.
Dr Diller believes that this view has much to do with the politics of American psychiatry, and the influence of the multibillion-dollar psychopharmacology industry on scientific debates within the field. Hence, the big players in the field downplay the social causes of a child's behaviour and overplay the concept of the malfunctioning brain. Hence, the Aspirin Deficiency Syndrome is applied to Ritalin, since your child's brain "lacks a certain chemical balance that can be supplied by Ritalin.”
To take things a step further, any voice with a dissenting view is subject to being actively silenced by the so-called scientific community.That is, the section of it that has as its main focus the support of big pharmaceutical business.
This was brought out in an editorial, “Is Academic Medicine for Sale” by Marcia Angell, in the New England Journal of Medicine. She showed evidence that pointed clearly to researchers overplaying the benefits of products of companies they are linked to. By the same token, the ills are underplayed.
Now these concerns are fundamental to Ritalin's continued use, as its long-term effects may be detrimental to the patients using it. The drug is a stimulant similar in molecular structure to speed (amphetamine), crank (methamphetamine), and crack (cocaine). All these drugs are known to be very addictive and have serious side effects such as causing heart problems.
A study done by Nadine Lambert, a research psychologist at the University of California Berkeley, showed that by the time they reached their mid-twenties, children with ADHD who were treated with Ritalin had double the rate of cocaine abuse and cigarette smoking, compared to those who were not treated with Ritalin. This study lasted from the mid 1970s to 1990.
When she reported her findings on Ritalin at National Institute of Health conference in 1998, Lambert created a firestorm. Parents started to ask questions of their doctors, demanding that they take their children off Ritalin. This is when and where the scientific community and the pharmaceutical industry colluded in an effort to discredit this previously highly respected researcher.
Even though there might have been flaws in the study, objective observers still recognise it as one of the best and most complete studies regarding the use of Ritalin. The studies that her opponents used to try to discredit her were riddled with flaws, and unlike hers, were made with a clear conflict of interest. They had to protect their market. Currently, 10 percent of 11-year-old boys in the US take Ritalin or another similar stimulant, such as Dexedrine, Adderall, or Concerta.
What does this mean for us here Antigua & Barbuda? Like much of what we do here, there is a strong American influence in medical practice. I know of more and more parents who are seeking medical assistance regarding their children's behaviour.
Now I am not going to tell anyone that the diagnosis of ADHD is totally without merit. Neither am I going to tell anyone that stimulants in the treatment of ADHD do not have any merit. However, I would urge anyone with children with behavioural problems to look at them holistically.
Do not be a stooge for any physician or therapist or company with an agenda. But be prepared to do the hard work it takes to safeguard the health and well-being of your children.
Explore and discuss with your physician or therapist the non-pharmaceutical interventions for children with behavioural disorders. These include family therapy, behavioural interventions, and school and community-based programmes. Studies show they have a proven record of being effective in treating behavioural disorders and reducing drug abuse.
As Dr Diller suggests, it is not just the big-money drug companies, but we as physicians, patients, and families who are also enthralled by the quick medication fix. There now has to be a whole societal re-education.
Dr Jerry Simon (NSA Medical Surgical Rehab Centre, 268 462 0631,