FDA'S ATTENTION DEFICIT ABOUT KIDS AND DRUGS

Medications can't supplant caring attention

The Food and Drug Administration (FDA) has issued new rules that
require drug companies to study a lot more thoroughly the safety and
effectiveness of drugs for children. Staggering though it is to
believe, many drugs regularly prescribed to children have been tested
only on adults. Even their labels admit as much: "Safety and
effectiveness in pediatric patients have not been established."
Nonetheless, these drugs continue to be peddled to children, while
unwitting parents and society as a whole turn a blind eye to the
unknown and potentially disastrous long-term effects.

On the surface the FDA ruling is good news indeed. But it opens an
avenue for abuse. Dr. Peter Breggin, author of "Talking Back to
Ritalin" and "Talking Back to Prozac," told me, "FDA pediatric
approval could provide an official imprimatur that would give even
more confidence to doctors to indiscriminately drug children. It could
become another marketing strategy."

One way to prevent this is to demand that all studies -- whether they
show adverse effects or benefits -- are made available to the public,
and to end the practice of ceding to the drug companies proprietary
rights to the information. "The public might be shocked to learn,"
Breggin told me, "that the vast majority of studies done for the FDA
approval of psychiatric drugs such as Prozac show them to be of no
value whatsoever. The companies are allowed to pick out two often
marginally or questionably successful studies as 'proof' that the
drugs work."

Making all studies available is all the more urgent given the growing
evidence that the drug companies, by sponsoring research and offering
grants, trips and other perks, are contaminating the conclusions of
the research. Examples prolifhe most recent involves three doctors
editorializing in the British Medical Journal that Prozac is not
addictive -- presumably the same way Big Tobacco-paid research assured
us that nicotine was not addictive. In this instance, the doctors had
just returned from an all-expenses-paid -- by Prozac manufacturer Eli
Lilly -- trip to a symposium in Phoenix.

The FDA decision coincides with a report issued by the National
Institutes of Health that conceded that for the most widely medicated
childhood "condition" -- attention deficit disorder -- "there is no
current, validated diagnostic test."

This hasn't stopped prescriptions of Ritalin to children diagnosed
with Attention Deficit Hyperactivity Disorder from jumping to 75
percent in 1996, up 20 percent since 1989. At the same time, the
percentage of those receiving psychotherapy dropped from 40 percent to
25 percent. Such statistics highlight the crass, bottom-line approach
of most health care providers, who prefer relatively cheap drugs to
costly therapy. But they also speak to our lazy culture's inclination
to medicate major social problems rather than act on them.

This problem was summed up by Dr. Lawrence Diller, author of "Running
On Ritalin": "Settling for Ritalin says we prefer to locate our
children's problems in their brains rather than in their lives."
Diller described three candidates for ADHD diagnosis: 4-year-old
Stevie and his two younger sisters, all of whom get dropped off for
preschool at 7 a.m. by their dad and are picked up at 5:30 p.m. by

their mom "if she isn't running late." Stevie is overly aggressive and
his parents, whose own marriage is troubled, are desperate, demanding
a fix: prescription drugs.

In most cases, parents get the short-term relief they're looking for
from prescription drugs, but as Breggin put it: "Behaviors are signals
that should be interpreted and understood, not suppressed."

The overprescribing of drugs has made possible the suppression of
signals a society needs to detect and address growing problems -- in
this case, the failures of our managed care system; the pressures
imposed on children by two working parents, longer work hours and
inadequate child care; and the connection between legal and illegal
drug abuse.

This last may be the least well known, but has the potential to become
the most dangerous. Dr. Nadine Lambert, a developmental psychologist
at UC Berkeley, published a paper in October with the chilling finding
that children on Ritalin are three times more likely to develop a
taste for cocaine. Meanwhile, the Drug Enforcement Administration
reports increasing Ritalin abuse among adolescents who sometimes
crush it into a powder and snort it, which can lead to heart failure.

When the government spends $16 billion a year on the drug war, and
when more than half those in jail are nonviolent drug offenders, isn't
it time we connected the dots between prescription drugs and street
drugs? How many more prisons do we have to build to jail offenders
whom, earlier in life, we had drugged with abandon?

Checked-by: Rich O'Grady