Tuesday, October 9, 2012

Can't teach kids? Just drug them instead

It doesn't take a research expert to detect America's obsession with drugs. Just start watching football and after the fifth Cialis commercial in the first quarter alone you may find yourself remarking, as one of my friends did, "How can people criticize athletes for taking performance enhancing drugs when every other commercial is for performance enhancing drugs?"
But in professional sports, athletes are drug-tested. And even when they manage to pass every single drug test they've taken, they can still be banned for life based on witness testimonies (which, by the way, I find highly problematic). In academia, there is neither drug testing nor a universal consensus around the need for one. In an article in The Harvard Crimson this May, Quinn D. Hatoff details how some Harvard students have become dependent on various study drugs, especially Adderall, in order to meet deadlines and examines the consequences they have faced. As one student acknowledges, “There is no way you can take a drug to make your brain work at twice the speed and intensity as normal without having some consequences.”
These instances of collegiate drug abuse are troubling enough, but as Jezebel writer Katie J. M. Baker says of her own experiences, "at least I was a 20-year-old adult at the time able to make my own decisions, not a little kid with a developing brain." (Baker decided against continuing to use study drugs, as she also notes.
There are arguments to make in favor of allowing legal adults to abuse drugs as they so choose (though the practice is currently illegal), and with caffeine abuse a socially accepted vice, it is fair to question why caffeine is acceptable but Adderall is not.
That being said, when doctors are prescribing study drugs to children, a trend described in The New York Times, who do not medically require them, something is very, very wrong.
1. Children are having their physical health and well-being put at risk just because their parents wanted them to have better grades. Doctors should not be complicit in this.
The stories of drug abuse speak for themselves. Here's one from the Crimson:

She found herself hospitalized in ninth grade. Two months of daily use had taken their toll: her weight had plummeted from 130 to 94 pounds, and she had not had a full night of sleep in weeks.
“By the time I was actually hospitalized, I was kind of f---ed up,” she admits with a slight laugh. “I wanted more weight loss—that was one reason for taking it—but I also had become psychologically dependent on it. I really loved it.” 
Even more disturbing is the Times' story of the Rocafort family, who put their 12-year-old daughter and 9-year-old son on Adderall even after observing that it made their son Quintn suicidal (and have hallucinations).
For doctors and teachers to knowingly put young children at risk where there is no medical need just so parents can take pride in their children's academic performance is unacceptable.
Both the Crimson and Times article neglected to include examples of people who actually had ADD or ADHD and did not abuse their prescriptions. I have decided not to argue for or against the use of these drugs by children and teens with medical needs, as I lack the medical knowledge to do so.
That being said, I will comment on the faulty nature of the diagnoses Dr. Anderson administers as they are "teacher reports [that] almost invariably come back as citing the behaviors that would warrant a diagnosis, a decision he called more economic than medical." Since teachers are not medical professionals, I take issue with Dr. Anderson using their descriptions of children's behavior as a substitute for more rigorous undertakings to understand the brains of these students. I also take fault with teachers looking to doctors to "teach" their students.
Moreover, I am disturbed by the way children and teens with real ADD and ADHD could be lumped into a group with students with other study issues, thereby hindering their ability to have their medical needs addressed properly.
2. Doctors and teachers have very different jobs, and they should not be confused.
In the opening paragraph of the Times article, Alan Schwarz links this trend to suffering 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.”
While I agree that there are major problems in the inequality of education in America, I would disagree with Schwarz's argument that he doesn't have a choice. As a doctor, his job is to treat his patients' health, not their report cards. All he needs to do is state his job description to these parents. They have no choice but to understand. Instead, Dr. Anderson is trying to stretch his influence too far and to control things that really aren't under his domain. And by refusing to prescribe drugs to students with As and Bs, he is medically manipulating the academic hierarchy of the schools his patients attend.
The role of teachers is not articulated as thoroughly in this article. No teachers are interviewed, and for that reason, I can't develop a strong opinion on what I think of them. If teachers really are looking towards doctors to solve their students's academic needs rather than devote their own attention to them, that is of course problematic. But it is also possible that teachers know that they don't have the medical knowledge to diagnose specific cases and in the interest of helping any students who might need it, they are reporting any symptoms to doctors assuming that these doctors will be thorough enough to distinguish between medical condition and academic issue. In the latter scenario, teachers would likely be highly disturbed to hear that their qualitative descriptions of kids (kids for whom they have genuine concern) are essentially drug prescriptions.
Now I don't think it's fair to vilify most of these parents: they want to see their children succeed and they trust their doctors to make informed decisions that will not endanger their kids.
That being said, I think the incentives to solving falling grades with drugs need to be examined.
A. Have these parents considered the possibility that by medicating their kids to succeed in one area, they may be missing an opportunity for their children to find a different and unique passion?
B. What other methods did you try before resorting to medicine to solve these studying needs?
C. What will happen if these kids switch doctors and the new doctor finds a lack of medical need? How will these kids adjust to no longer studying with the assistance of drugs?
D. What good are the opportunities good grades afford if children will be too busy reeling from drug side effects to embrace them?

I would like to note that I have utmost respect for doctors and teachers and don't mean to degrade these professions in any way. Rather, I am a firm believer in the good both can do and in the responsibility that both hold.

My heart goes out to all of these kids, and my hope is that there will be more rigor and integrity in understanding kids' academic, personal, and medical needs both so that people with genuine ADD and ADHD will not be trivialized and so that children's health will not be ignored, especially by the doctors who have sworn to protect it.

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