Social justice theories have invaded the medical profession and Dr. Michael Anderson has a unique take. The New York Times highlights today the work of a doctor who considers prescribing Adderall a mark of social justice on behalf of poor students, giving them a leg up in an unequal society. The Times then goes on to cite sources who blame limited school funding and large classrooms for increasing ADHD diagnoses.
“Dr. [Michael] Anderson’s instinct, he said, is that of a ‘social justice thinker’ who is ‘evening the scales a little bit,’” reports Alan Schwarz for the New York Times. “He said that the children he sees with academic problems are essentially ‘mismatched with their environment’ — square pegs chafing the round holes of public education. Because their families can rarely afford behavior-based therapies like tutoring and family counseling, he said, medication becomes the most reliable and pragmatic way to redirect the student toward success.”
“People who are getting A’s and B’s, I won’t give it to them,” Dr. Anderson told the New York Times.
“It is not yet clear whether Dr. Anderson is representative of a widening trend,” reports Schwartz. “But some experts note that as wealthy students abuse stimulants to raise already-good grades in colleges and high schools, the medications are being used on low-income elementary school children with faltering grades and parents eager to see them succeed.”
According to the FDA, adverse side effects of Adderall XR include “heart-related problems” such as “sudden death in patients who have heart problems or heart defects,” “stroke and heart attack in adults,” and “increased blood pressure and heart rate.” It may also cause mental problems. Teenagers should be monitored for “new psychotic symptoms (such as hearing voices, believing things that are not true, are suspicious) or new manic symptoms,” states the FDA. Schwartz also notes that these Schedule II substances are “particularly addictive.”
Yet, the reporter quotes several sources claiming the issue is monetary, and due to insufficient school funding. “Dr. Anderson said that every child he treats with A.D.H.D. medication has met qualifications,” reports Schwartz. “But he also railed against those criteria, saying they were codified only to ‘make something completely subjective look objective.’”
“[Dr. Anderson] added that teacher reports almost invariably come back as citing the behaviors that would warrant a diagnosis, a decision he called more economic than medical,” reports Schwartz. “The school said if they had other ideas they would,” Dr. Anderson said. “But the other ideas cost money and resources compared to meds.”
Schwartz cites an anonymous superintendent in California as saying “I don’t know, but it could be happening right here. Maybe not as knowingly, but it could be a consequence of a doctor who sees a kid failing in overcrowded classes with 42 other kids and the frustrated parents asking what they can do. The doctor says, ‘Maybe it’s A.D.H.D., let’s give this a try.’”
For more reading on this topic, you may want to check out my 2007 article, “Drugging our Poor.” As I noted then, “Foster children, minorities, and incarcerated prisoners are most likely to be prescribed psychotropic drugs. In 2004, Texas Comptroller Carole Keeton Strayhorn found that 60% of Texas foster-care participants were receiving antipsychotic drugs. […] According to the ICSPP, nearly 2/3 of Massachusetts foster children and 55% of Florida foster children take psychiatric drugs beginning as early as 3 years old.”