CONFERENCE OF STIMULANT USE IN THE TREATMENT OF ADHD

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ADD/ADHD

Statement of

Drug Enforcement Administration

The following is a statement reproduced verbatim in its entirety by:

Mr. Gene R. Haislip
Deputy Assistant Administrator
Office of Diversion Control
Drug Enforcement Administration
United States Department of Justice
Washington, DC

at the conclusion of the
CONFERENCE OF STIMULANT USE IN THE TREATMENT OF ADHD
in San Antonio, December 10-12, 1996

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.

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