RITALIN STUDY GROUP ASKING FOR MORE DATA

A legislative study group looking at Ritalin use left off where it began:
asking for more information.

Lacking what it thinks is good data, the committee has decided to recommend
that several state agencies collaborate on a comprehensive study of the use
of Ritalin and similar drugs used to treat attention deficit disorders in
children.

Such an effort would use time-tested research methods and could take a year
or longer to complete, educators said.

"There are a lot of people who think we have just barely scratched the
surface," state Sen. Yvonne B. Miller, D-Norfolk, said as the study group
completed its work this week.

Prescription state Virginia, she said, is a high volume prescription state
when it comes to using Ritalin and similar drugs to treat attention deficit
disorder (ADD) and attention deficit hyperactivity disorder (ADHD).

Children are diagnosed with the disorders when they have trouble focusing
on school work and sitting still during class, so much that the behaviors
interfere with their ability to learn.

"We really need to look at alternative ways of dealing with children rather
than medicating them out of their minds," Miller said.

Miller's statements are backed by data that rank Virginia among the top 10
states in terms of Ritalin and similar drugs prescribed. The numbers are
based on Drug Enforcement Agency data.

On the other hand, a state education department survey in September did not
show an excessive number of children taking drugs for attention deficit
disorders - but that study was limited in scope.

In the survey of the state's 129 public school divisions, the results
showed 16,521 children - about 1.52 percent of the student population -
were receiving Ritalin or similar drugs.

Some say the numbers clearly underestimate the real picture.

"They have only [16,000] children across the state, we have about that many
in one or two school districts in the Hampton Roads region," said Dr.
Gretchen B. LeFever, an associate professor of pediatrics and psychiatry at
Eastern Virginia Medical School and Children's Hospital of the King's
Daughters in Norfolk.

LeFever said the state survey was done early in the school year before
student records were updated. Secondly, she noted, one-half to
three-quarters of children on drugs for attention deficit problems are
taking the new, longer-acting versions which they can take before they
leave for school.

Opinions on whether ADHD is a real disorder span the spectrum. Some
maintain it's a bogus diagnosis and that teachers and parents are too quick
to turn to drugs when they simply need to use different behavior management
strategies.

Others say there is evidence of neurobiological problems.

"I believe ADHD is a very real disorder with serious implications," LeFever
said.

Overdiagnosis expected In general, however, "We are diagnosing more
children than would be expected," she said. "I would agree with experts
from the National Institutes of Health that any community that has around
10 [percent] to 12 percent of their children being diagnosed has a problem
with overdiagnosis. I think many of our communities have problems."

The study committee, which also looked at OxyContin abuse, will endorse an
attorney general's task force proposal to create a centralized prescription
monitoring program.

The system would cost between $1 million and $2 million. It would allow law
enforcement officials to search for unusual use or prescribing patterns of
controlled substances.

Passing legislation for the system "is going to be a fight," said Del. John
M. O'Bannon, R-Henrico, who brought up privacy concerns.

That task force, which meets later this month, is also expected to
recommend stiffer penalties for dealing drugs like OxyContin.