It’s long been known that medications designed to boost focus and impulse control in children with attention deficit hyperactivity disorder offer the same benefits to people without the disorder. Now, Alan Schwarz reports for The Times in “Attention Disorder or Not, Pills to Help in School,” some doctors have decided to offer the drugs to students struggling in school for reasons unrelated to A.D.H.D.  Last June, Mr. Schwarz reported on students in competitive high schools across the country snorting “good grade pills” purchased from dealers or obtained by faking A.D.H.D. symptoms. These doctors and parents are talking about something different: providing the drugs without pretense to students who are flailing for reasons related to their schools and their environment, not their brain chemistry.  “When Dr. Michael Anderson hears about his low-income patients struggling in elementary school,” Mr. Schwarz writes, “he usually gives them a taste of some powerful medicine: Adderall.”  Although A.D.H.D is the diagnosis Dr. Anderson makes, he calls the disorder “made up” and “an excuse” to prescribe the pills to treat what he considers the children’s true ill — poor academic performance in inadequate schools.  “I don’t have a whole lot of choice,” said Dr. Anderson, a pediatrician for many poor families in Cherokee County, north of Atlanta. “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.”  Using the medications as a panacea for what ails low-income students whose parents and communities can’t provide the tutoring or nonpharmaceutical therapies that might be equally or more effective raises multiple questions. The medications are addictive, and “reported side effects of the drugs have included growth suppression, increased blood pressure and, in rare cases, psychotic episodes.”  Beyond that lies the question of how we’ve culturally reached a point when parents can embrace drugging preteens in the hope of finding elusive school success. Mr. Schwarz profiles a family with one child who takes medication to treat A.D.H.D. and three who take it for what they term “cosmetic” reasons:  These children don’t have A.D.H.D., their parents said. The Adderall is merely to help their grades, and because Alexis was, in her father’s words, “a little blah.”  ”We’ve seen both sides of the spectrum: we’ve seen positive, we’ve seen negative,” the father, Rocky Rocafort, said. … “If they’re feeling positive, happy, socializing more, and it’s helping them, why wouldn’t you? Why not?”  The community depicted in Mr. Schwarz’s article offers the reported version of the overuse of A.D.H.D. medications condemned by L. Alan Sroufe in the Opinion pages in January of 2012. In Ritalin Gone Wrong, Dr. Sroufe wrote “the illusion that children’s behavior problems can be cured with drugs prevents us as a society from seeking the more complex solutions that will be necessary. Drugs get everyone — politicians, scientists, teachers and parents — off the hook. Everyone except the children, that is.” His was an angry screed of blame that led to a small tempest of talk shows and defensive parents arguing that A.D.H.D. drugs were both a last resort and a necessary one in most cases, while Dr. Sroufe disagreed. The large-scale medication of children, he wrote, “feeds into a societal view that all of life’s problems can be solved with a pill and gives millions of children the impression that there is something inherently defective in them.”  And yet here is a doctor, supported by several peers, and one (brave, and arguably foolhardy) family admitting that indeed, they’ve embraced medication as the only viable remedy to a range of ills within a specific community, and saying that they’re not the only ones to go this route. It’s as if they’re planting a startlingly bold flag in a dystopian future, with drugs taking the place of everything from engagement to discipline, and hollering, “So, world, what else have you got?”  The answer, for now at least, is nothing. The circumstances that underlie Dr. Anderson’s prescriptions (large classrooms and a lack of funding for tutoring, family counseling or other alternative therapies) are unlikely to change, although his ability to prescribe medication in the hope of improving student performance might. If nothing else, his is a novel way of calling additional attention to the problems facing his young patients.  “Attention Disorder or Not, Pills to Help in School” is yet another article and circumstance unlikely to make life any easier for those really in need of medication for A.D.H.D., but it’s one that brings an important fresh angle onto the ongoing conversation: the double standard regarding what’s available to and considered acceptable for low-income families and what’s expected of (and by) the middle and upper strata of society.
A New York Times article offers a picture of a community where all of our worst expectations regarding the overuse of A.D.H.D. medications are beginning to be fulfilled.