Anyone who worked in education in the 1990’s watched students diagnosed with attention deficit hyperactivity disorder treated with psychoactive drugs like Ritalin from very young ages. For many of us, it was a bizarre, unsettling spectacle, but the drugs were promoted and prescribed with such confidence and consistency that it seemed there must be no alternative.
It turns out that it seemed that way because a small group of child psychiatrists, with the support of the National Institute of Mental Health (NIMH), wanted it to. According to a recent New York Times article, these psychiatrists may have used the platform granted them by the NIMH to exaggerate the benefits of drugs and to “distort…the debate over the most effective (and cost-effective) treatments [of A.D.H.D.]”
In essence, these authors of the NIMH report apparently dismissed or downplayed any evidence that behavioral therapy might be a viable adjunct (or alternative) to prescription drugs and preached their gospel that medication alone was the most effective way to treat A.D.H.D.
Not surprisingly, psychiatrists involved in the NIMH study have received financial support from the pharmaceutical companies who benefited most from the study’s aggressive promotion of medication over therapy. Co-author Dr. Lily Hechtman, for example, has Eli Lilly, GlaxoSmithKline, Janssen-Ortho, Purdue Pharma, and Shire; has received research funding from Shire (which manufactures Adderall) and Eli Lilly; she has also been on the speakers’ bureaus and advisory boards of both companies.
Hechtman told the Times that she hoped her aggressive advocacy of drug treatments over social and academic skill building “didn’t do irreparable damage.”
Dr. Gene Arnold, another of the study’s co-authors, told the Times he now views the NIMH study as a “lost opportunity to give kids the advantage of both and develop more resources in schools to support the child.” Like Hechtman, Arnold has received research funding and other fees from Shire. And Dr. Peter Jensen, who oversaw the NIMH study, has received training and/or research funds from Novartis (makers of Ritalin) and served as a consultant to both Novartis and Shire.
Today, these psychiatrists claim to regret pushing drugs over therapy so aggressively, particularly since more and more research is showing that behavioral therapy in combination with medication is the most effective treatment. As a special education teacher, I’ve certainly seen that drugs can be a necessary and effective component of treating A.D.H.D. As one psychologist told the Times, “Medication helps a person be receptive to learning new skills and behaviors, but those skills and behaviors don’t magically appear. They have to be taught.” In other words, drugs can help students calm down and focus, but they won’t teach a student how to function effectively in and out of the classroom.
This point is so patently obvious that it’s hard to believe the NIMH psychiatrists simply missed it. And it’s even harder not to gag when the same psychiatrists say, as Dr. Hechtman said to the Times, presumably with a straight face, “The people who pay the price in the end is the kids. That’s the biggest tragedy in all of this.”