Today, we have concluded a national
conference of experts from the fields of research, medicine,
public health and law enforcement brought together by the U.S.
Drug Enforcement Adminstration (DEA) to examine issues concerning
the prescribing of stimulants to school-age children for the
treatment of Attention Deficit Hypertensive Disorder (ADHD).
The principal drug used for this purpose is methylphenidate,
commonly known as "Ritalin".
Like many others, the DEA has become
alarmed by the tremendous increase in the prescribing of these
drugs in recent years. Since 1990, prescriptions for methylphenidate
have increased 500 percent, while prescriptions for amphetamine
for the same purpose have increased 400 percent. Now we see a
situation in which from 7-10% of the nation's boys are on these
drugs at some point as well as a rising percentage of the girls.
When so many children are involved in the daily use of such powerful
psychoactive drugs, it is important for all of us to understand
what is going on and why. The DEA has a responsibility to the
nation to control such abusable legal drugs and to insure that
their use is confined to legitimate medical need. Certain things
have become clear from our deliberation of the last several days,
and the public, parents and decision-makers need to hear them.
First, let me say that medical experts
agree that these drugs do help the small percentage of children
who need them. But there is also strong evidence that the drugs
have been greatly over prescribed in some parts of the country
as a panacea for behavior problems. These drugs have been over-promoted,
over-marketed and over-sold, resulting in profits of some $450
million annually. This constitutes a potential health threat
to many children and has also created a new source of drug abuse
and illicit traffic. The data shows that there has been a 1,000%
increase in drug abuse injury reports involving methylphenidate
for children in the 10-14 year age group. This now equals or
exceeds reports for the same age group involving cocaine. The
reported numbers are still small but experts feel that this is
only the "tip of the iceberg."
I do want to emphasize that medical
authorities do believe that ADHD is a distinct health problem
affection some children who can be helped by these drugs when
prescribed after careful diagnosis. In those cases, parents should
work closely with their children, the family physician and school
authorities to insure proper administration and control of the
drug. But on the other hand, when we see that in some localities
as many as 15-20% of the children have been put on Ritalin or
similar stimulant, there is good reason to conclude that this
is "quick-fix," bogus medical practice which is nevertheless
producing large profits. This far exceeds any professional estimates
of actual need.
Parents need to understand that we
are talking about very potent, addictive and abusable substances;
a potency that can help in the right situation but can destroy
in the wrong situation. Above all, parents need to educate themselves
and protect their children by adopting an attitude of proper
parental caution. Regrettably, much of the literature and promotion
of the drug in recent years has ignored or understated the potency
and abuse potential of methylphenidate and Ritalin. This appears
to have mislead many physicians into prescribing the drug as
a quick fix for problems of school and behavior.
I want to emphasize that matters of
this kind are vital but cannot be simplified. There is a legitimate
place for these drugs, but we have become the only country in
the world where children are prescribed such a vast quantity
of stimulants that share virtually the same properties as cocaine.
We must find a better balance. We must turn down the flow which
is rapidly becoming a flood.
In conclusion, I want to cal upon
the drug industry, the parent support groups, the researchers
and medical authorities to get a better, more accurate message
out to the public. I want to call upon law enforcement authorities
to root out this new illicit traffic before it spreads. And I
want to urge parents to educate themselves, protect their children
and teach them a healthy respect for both the good and evil which
drugs can do.