The pressure's not from peers, it's from parents, teachers and doctors

David Bragi, Special to SF Gate

"There are some kids at my school who are, like, completely emotionless," said Tara (not her real name), a studious and outgoing high school student who lives in a prosperous East Bay suburb. She describes those among her friends and classmates who have been prescribed behavior-modification drugs to treat emotional disorders.

"Some of my friends are on Prozac. It's weird," she said. "There's a girl in one of my classes who's on Ritalin and Valium -- hello in there, echo, echo, echo, echo! Teenagers may have messed-up hormone stuff, but I'd rather be messed up than a dead-for-all-intents-and-purposes zombie Vulcan."

In today's instant-gratification society, such childhood experiences are fast becoming the norm. More and more, behavior-altering medication has become the treatment of choice for children who suffer from a wide variety of conditions, such as bipolar disorder, posttraumatic stress disorder and attention deficit/hyperactivity disorder (ADHD).

Visit your community's campuses and you are likely to find emotionally troubled students who are -- quite legally -- under the influence of drugs that, if sold on the street corner instead of in the pharmacy, would land the seller in prison.

A soon-to-be-released study by William Frankenberger, director of the Human Development Center & School Psychology Program at the University of Wisconsin-Eau Claire, reports on the controversy surrounding the use of stimulant medication to treat children with ADHD. A summary of the study's findings stated that "the issue of pharmacological treatments for ADHD is of importance because of the increasing use of stimulant medication by school-age children."

While noting that such drugs can be useful in improving an ADHD student's behavior, the study found that many young users suffered from a range of side effects, wanted to discontinue taking the medication and in some cases sold or gave away their pills. It also reported figures from the US Drug Enforcement Administration that production of Ritalin increased by 650 percent between 1990 and 1997; legal amphetamine (Dexedrine and Adderall) production increased by over 4,500 percent between 1993 and 2000, and those drugs were prescribed mostly to treat ADHD.

Various side effects of behavior-altering drugs can adversely affect young, growing minds and bodies. According to the study, children on stimulant medication often complain of tics, difficulty sleeping and loss of appetite. It also warned that, since the effects of combining different medications is often unknown, children taking more than one drug simultaneously may be vulnerable to unexpected side effects.

Frankenberger also noted that although psychiatrists tend to be aware of side effects, that information is apparently not filtering down to the family level. "Generally, parents know very little about potential side effects of stimulant medication," he said.

Parents may also be unaware of how their kids are using their meds. Some of them may sell or give away their prescriptions to friends and classmates. Frankenbergers's study indicates that most middle and high school students were at least aware of the underground trade in prescription drugs.

"There's a bunch of kids who sell their meds -- all kinds, but especially mental ones," said Tara. "One of the med-dealer guys is in my study-hall class, and he told me about the ways that he siphons off his pills, and how much the bizarro druggies like them. They pay a lot of money for his anticonvulsant medicines and for his Prozac."

The Convenience Factor

Unfortunately, a docile child is also a convenient child for overwhelmed parents or overworked teachers. "Often, hyperactive and unruly kids are made worse by parents who themselves have a depressive or anxiety disorder or who just don't have the proper parenting skills to raise their children," said physician Ray Sahelian, a nutritional expert and author of the book Mind Boosters. "Hence, the easy way out is to place the kids on medicines."

"There's a girl I know who had family problems, alcoholic parents, and she was starting to act out, and they put her on Prozac," said Tara. "So much for that problem."

According to a July 17, 2001, Associated Press story by Matthew Daly, even schoolteachers and counselors, who are not supposed to practice medicine, have been known to encourage parents to medicate unruly children in order to keep them quiet in class. "There was a guy in one of my classes a couple years ago who was a troublemaker," said Tara. "Not horribly evil, but he'd mess around in class and get in trouble, and he was pretty loud sometimes -- though very funny -- and they put him on Ritalin and transferred him into special-ed classes. That was pretty much the last we saw of him."

In response to outcries from parents, in July the Connecticut state legislature unanimously passed a law prohibiting teachers, counselors and other school officials from recommending that a child be placed on psychiatric drugs.

"We have a tendency as a culture to take the easy and quick way out in terms of solving common medical problems," said Sahelian, "using drugs versus the healthier alternative of diet, exercise, improved communication between parents and children, promoting activities that the child enjoys and providing good mental and physical stimulation."

So, who is really being medicated here, the kids or the adults responsible for them? Are children with behavioral disorders such as ADHD being medicated largely for the convenience of school officials or parents, rather than the needs of the child? "This is an extremely important question," said Frankenberger. "Our studies have consistently demonstrated that students treated for ADHD with stimulants report the largest drug effect for them is that their teachers and parents like them better when [the children take] the medication."

Some Choose Alternatives

Fortunately, not all parents accept the easy way out via medication. Some have even successfully bucked the system and developed original, alternative treatment methods, such as herbal medicines and meditation. Gwenny (only her first name is used here) is the mother of a child who had experienced difficulties dealing with grief and anger since he was a toddler. After he started attending school, child-welfare authorities forced her to medicate him, threatening to remove him from her custody if she refused.

After several years she finally convinced officials to back down, ceased all medications and temporarily removed him from school. "I homeschooled him for six months, taught him how to meditate and gave him a mantra: 'If I do this, what is going to happen?' He had no more significant incidents after being reenrolled in regular school at the beginning of the eighth grade. He is now twenty-one, has held a job for over five years and seems to be doing well."

Tara recalls a young friend who suffers from bipolar disorder. "He and his parents looked into alternative medicine, and he's a fully functional, generally happy person," she said. "He took Veratrum album, St.-John's-wort and SAM-e, and he did meditations and holistic stuff. Now he does yoga. He says he was pretty bad when he was on the psycho drugs, but he's so much better now. It's really amazing."

Frankenberger notes another case in which school authorities urged that a child be medicated for what they claimed was a case of ADHD. "The parents resisted, and he ended up being the class valedictorian in a large high school."

It is true that sometimes meditation isn't enough and medication is necessary -- but only sometimes. Medicating an emotionally disturbed child, even under a doctor's supervision, is potentially dangerous and should not be undertaken lightly. Parents and teachers need to take a close look at their own emotional needs and motives before making any fateful decisions. If they feel overwhelmed, better alternatives exist to simply drugging the child into obedience.

"I don't know if medications would have made any difference for me," said Jewel St. Michel, an adult who has struggled with ADHD all of her life, as have many of her relatives. "I know that the only real help for me has been self-knowledge, research and a retinue of nutritional supplements that have brought me to near normalcy in many ways."

St. Michel did not receive medication for her disorder as a child. "Most people rely on schools and TV and day care to raise their kids," she said. "If kids had a lot more family activity, more social outlets, more emotionally supportive, understanding resources in their lives -- maybe some kind of spiritual touchstone or family traditions to lean on -- I think they might be better equipped for dealing with ADD and whatever else their 'different' brain has in store for them."