Adderall and Propaganda

[editor’s note: this came out of a comment I made at Morgan’s place that I thought warranted expansion.  I’m recapping a lot of his post here; RTWT]

I must admit, I’m not much of a consumer of news (no, not even “Faux News”).  So on the rare occasions I do see a story from a “mainstream media” outlet, I’m shocked by the crudity of the propagandizing.

Consider this New York Times piece, excerpted by Morgan.  It starts with the heartbreaking story of Richard Fee, a college student (mis?)diagnosed with ADHD who became addicted to Adderall, underwent a psychotic break, and ultimately committed suicide.

As tragic as this story is, it’s the only part of the NYT article that passes the smell test.  Powerful stimulants have equally powerful crashes.  The rest, though, is pure advocacy.

Morgan has done the heavy lifting for us.  Buried in the verbiage is this link, which, as he points out, contains all the good stuff.  Specifically this:

When Dr. Michael Anderson hears about his low-income patients struggling in elementary school, he usually gives them a taste of some powerful medicine: Adderall.

The pills boost focus and impulse control in children with attention deficit hyperactivity disorder. 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.”

Dr. Anderson is one of the more outspoken proponents of an idea that is gaining interest among some physicians. They are prescribing stimulants to struggling students in schools starved of extra money — not to treat A.D.H.D., necessarily, but to boost their academic performance.

It is not yet clear whether Dr. Anderson is representative of a widening trend. But some experts note that as wealthy students abuse stimulants to raise already-good grades in colleges and high schools, the medications are being used on low-income elementary school children with faltering grades and parents eager to see them succeed.

This stinks.  It stinks to high heaven.

Notice the implied cause and effect here:

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.

Catch that?  I can think of about two dozen reasons off the top of my head for why Dr. Anderson’s patients might be struggling academically, and “inadequate schools” doesn’t even crack the top ten.  Ever heard of redshirting?  This might not be a tactic to which Dr. Anderson’s low-income parents avail themselves too often, but it highlights the dramatically different rates at which children develop.   A kid who is having trouble in elementary school might be…. just having trouble with elementary school.  Remember that urban legend about Einstein flunking grade-school math?

And then there’s the fact, unremarked upon by the NYT, that this is elementary school.  It’s a tenet of the liberal faith that drastic interventions in early childhood education lead to all kinds of good stuff later on — see that article on redshirting — but that doesn’t pass the smell test either.  Here, for instance, are Georgia’s K-5 curriculum standards for math:

The grade-by-grade K-5 standards provide students with a solid foundation in whole numbers, addition, subtraction, multiplication, division, fractions and decimals—which taken together provide students with a strong foundation for learning and applying more demanding math concepts and procedures, and for moving into robust applications.

The only way you could fail second grade in a Georgia elementary school is to sit around picking your boogers instead of doing your homework.  Not because Georgia schools are bad (though they’re not great), but because it’s fucking elementary school.  If you can get through six years of it without being able to do that stuff, you probably can’t breathe without cue cards.  How much academic performance enhancement could you possibly need?

What we’re seeing here, in other words, is a not-so-stealthy stealth push for yet more school funding, despite the fact that we spend more per pupil than every other nation already.  This, according to Dr. Anderson, is the choice we face:

“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.”

Drugs or infrastructure.  Head Start or greenies.  Notice what’s not in there:  School vouchers.  Community action.  Parental supervision.  It’s either the teachers’ unions or Pfizer.

“It’s scary to think that this is what we’ve come to; how not funding public education to meet the needs of all kids has led to this,” said the superintendent [of "a large California school district"], referring to the use of stimulants in children without classic A.D.H.D.

The only thing a mere parent can do is to drive the kid to Dr. Anderson’s clinic.

Which also doesn’t pass the sniff test.  I know a lot of parents, including my own, who were faced with the prospect of enrolling their kids in substandard schools.  They moved to a different district.  Even if that’s not an option available to Dr. Anderson’s patients (though my folks did it on considerably less than Cherokee County’s $66,419 median family income), there are lots of other options besides Adderall.  Did anybody try giving these kids a time-out?  I find it hard to believe that turning their kids into drug-zorched zombies is the first option these parents turn to.

Which is to say, I don’t find it hard to believe at all, because there’s something very big and obvious missing from both these articles:  Just what is ADHD?

You can read through all twelve pages of these articles without ever seeing a definition, much less a set of diagnostic criteria.  There’s a mention of an 18-item questionnaire, as used in the case of poor Richard Fee, but hardly a clue what’s on it.  The closest things I can find are this:

None of [Fee's] dozen high school and college acquaintances interviewed for this article said he had ever shown or mentioned behaviors related to A.D.H.D. — certainly not the “losing things” and “difficulty awaiting turn” he reported on the Triad questionnaire

and this:

Jacqueline Williams said she can’t thank Dr. Anderson enough for diagnosing A.D.H.D. in her children — Eric, 15; Chekiara, 14; and Shamya, 11 — and prescribing Concerta, a long-acting stimulant, for them all. She said each was having trouble listening to instructions and concentrating on schoolwork.

and this:

The disorder, which is characterized by severe inattention and impulsivity, is an increasingly common psychiatric diagnosis among American youth: about 9.5 percent of Americans ages 4 to 17 were judged to have it in 2007, or about 5.4 million children, according to the Centers for Disease Control and Prevention.

and this:

While telling this story, the Rocaforts called Quintn [sic] into the kitchen and asked him to describe why he had been given Adderall.

“To help me focus on my school work, my homework, listening to Mom and Dad, and not doing what I used to do to my teachers, to make them mad,” he said. He described the week in the hospital and the effects of Risperdal: “If I don’t take my medicine I’d be having attitudes. I’d be disrespecting my parents. I wouldn’t be like this.”

Anybody noticing a trend here?  Powerful stimulants are being prescribed for a condition we used to call “being a brat” or, more generally, “being a kid.”  What child naturally does homework or waits patiently in line?  That kind of instruction is what elementary school, to say nothing of parenting, is for.

And yet, relentlessly, the Times juxtaposes their exaggerated concern for drugged-out kids like Quintn [sic], Chekiara [sic], and Shamya [sic] with stuff like this:

Dr. Anderson’s instinct, he said, is that of a “social justice thinker” who is “evening the scales a little bit.” He said that the children he sees with academic problems are essentially “mismatched with their environment” — square pegs chafing the round holes of public education. Because their families can rarely afford behavior-based therapies like tutoring and family counseling, he said, medication becomes the most reliable and pragmatic way to redirect the student toward success.

Here again, it’s the State or Big Pharma.  Believe it or not, I too once had problems concentrating in school.  I got some behavior-based therapy, all right — it was known as “my father’s boot so far up my ass I had tread marks on my esophagus.”  It was remarkably effective.  But he also helped me with my homework when I asked, and kept on my to make sure I did it.  As did my mom, because that’s what parents do.

Or at least did, way back when.  No doubt the New York Times would consider that child abuse, considering that neither of my folks had psychiatry degrees or paid dues to a teachers’ union….

3 thoughts on “Adderall and Propaganda

  1. “It’s scary to think that this is what we’ve come to; how not funding public education to meet the needs of all kids has led to this,”

    Yeah. Because we’re not funding public education. Right.

  2. I’ve gone around with Morgan a few times on this subject – I disagreed with his analysis that behavioral drugs are over-prescribed, and it seemed like his entire analysis of the problem was entirely subjective. It is perhaps the only area in which he and I disagree. Do we trust people with medical degrees and decades of experience studying behavioral problems, to prescribe mind altering drugs…or don’t we?

    I simply don’t understand from whence the credibility comes in order to make that assertion, and instead of simply answering my question, Morgan fingered every boogeyman he could think of – teachers, schools, doctors, parents, Big Pharma. When I called him on that, he switched gears and said that the point of disagreement was over extreme cases vs borderlines ones.

    Not to sound like the Zachariel, but I do not understand the impetus to second guess people who psychoanalyze children and prescribe this stuff for a living…especially when I can offer personal experience that some of these drugs do actually work as advertised. I simply do not buy into the idea that all of the issues with inattentiveness and the like are “boys being boys.”

    Some of the sorts of “little boy” problems the drugs were intended to correct, are still with me as an adult…and no amount of corporal punishment would have corrected the problem. I can’t tell you how maddening it was to be back in college, be trying my darndest to pay attention to the lecturer, only to have it dawn on me that my mind wandered off and I missed the last three minutes of the discussion. It’s so subtle that I don’t even notice it, and eventually it would get to the point where paying attention to the effort to pay attention was so consuming that I was right back where I started. The behavioral drugs aren’t miracle cures and didn’t completely eliminate my problems, but I can tell you that without them I was completely useless as a student, and later, as an employee.

  3. I suppose I should back up. I’m not claiming that ADD isn’t a real thing. Or that the drugs don’t work — evidently they work all too well. But this Dr. Anderson cat is explicitly saying that he himself doesn’t believe these kids have ADD; they’re not doing well in school, he says, and since we as a society aren’t “properly funding” our schools, he’ll continue to string kids who by his own admission don’t have a diagnosable disorder out on powerful stimulants so that they can focus better.

    The only reason the NYT is reporting on this is because they’re fearmongering for more money for schools (i.e. the teachers’ unions) — “up school budgets or every lower-class kid in America is going to be a meth head.” Which is dangerous, infuriating, pathetic, and blatant propaganda….. all par for the media course.

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