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Academic Bias, Accuracy in Academia, Recent News

Amphetamines for All

In a cutting new article for the Wall Street Journal, two professors criticize the American Psychiatric Association for loosening the standards by which Attention Deficit Hyperactivity Disorder (ADHD) is diagnosed. This, they argue, will make such diagnoses more likely and increase the amphetamine usage of the general public.

“Symptoms of ADHD remain the same in the new edition” of the Diagnostic and Statistical Manual of Mental Disorders, but with some changes: “The difference is that in the previous version of the manual, the first symptoms of ADHD needed to be evident by age 7 for a diagnosis to be made. In DSM-5, if the symptoms turn up anytime before age 12, the ADHD diagnosis can be made.”

“Before, adults needed to exhibit six symptoms” to be diagnosed, they write. “Now, five will do.”

As Amanda Busse wrote for Accuracy in Academia back in 2008, according to a “study, published in the Proceedings of the National Academy of Sciences, ADHD in children is caused when portions of the brain mature at a slower pace than normal.”

“For many, the condition eventually normalizes and nearly 80 percent of children grow out of the disorder, the researchers found” (emphasis added).

If your child is more than likely to grow out of a developmental disorder such as ADHD, then why give them a label and dependence on a pill during the formative years of their life? The authors, Pieter Cohen and Nicolas Rasmussen, share a similar perspective. “By medicating children for wiggling in their chairs, losing their homework and shouting out answers, we are not teaching them vital coping skills to manage their behavior,” they write. “Instead, we are teaching them to take a pill.”

Dr. Cohen is an assistant professor of medicine at Harvard Medicine School. His colleague, Dr. Rasmussen, authored On Speed: The Many Lives of Amphetamine, and is a professor of history at the University of New South Wales, Australia.

In their article, these professors outline the abuse of amphetamines in society since the 1930s. “Since their introduction by the pharmaceutical company Smith, Kline & French in 1937, amphetamines have been prescribed for maladies that had more to do with societal expectations than genuine mental illness,” they write. “American soldiers received stimulants during World War II to boost morale and improve performance in combat.” Amphetamines were prescribed for weight loss and depression, as well.

“By 1969, doctors were prescribing the equivalent of 120 mg of amphetamine for each American—a high-water mark of per-capita consumption we are only now about to surpass” (emphasis added). There were 202.67 million people in the U.S. in 1969. To date, there are approximately 316.07 million people in the U.S., according to the U.S. Census Bureau. Clearly, more amphetamines are being produced and taken in the U.S. than in 1969.

According to Cohen and Rasmussen, in the 1990s experts began arguing that ADHD stimulants would decrease the incidence of future drug abuse by those with the disorder. “Three months ago, the only randomized trial to study future substance abuse by ADHD kids refuted the notion that stimulants, when taken in childhood, have a protective effect,” they write. “Investigators found strong evidence that ADHD itself in fact predisposes children to later substance abuse—but no evidence that stimulant medication reduces this rate any better than treating ADHD with behavioral approaches.”

“Further evidence that stimulants do not protect children from addiction was provided in a comprehensive review published last month in JAMA Psychiatry.”

For the writers, the jury is in: taking amphetamines is not going to help with substance abuse problems.

But perhaps amphetamines should be billed as a necessary cognitive enhancement sought by many healthy young students and other persons looking to get ahead, not just those with ADHD? That’s what a series of professors argued in a 2008 Nature article entitled “Toward responsible use of cognitive-enhancing drugs by the healthy.” This article is purchase only, so I’ll give you a preview of what they said.

As I wrote in my 2008 article for Accuracy in Academia, “The authors’ commentary […] likens the ‘cognitive-enhancing’ effects of these drugs to healthy behavior and the ‘neural changes engendered by exercise, nutrition, and sleep, as well as instruction and reading.’” Ah yes, amphetamines are a healthy way to boost your natural talent, according to these authors.

“The drugs just reviewed, along with newer technologies such as brain stimulation and prosthetic brain chips, should be viewed in the same general category as education, good health habits, and information technology—ways that our uniquely innovative species tries to improve itself,” argue the authors. They continue: “Drugs may seem distinctive among enhancements in that they bring about their effects by altering brain function, but in reality so does any intervention that enhances cognition.” The authors included Philip Campbell, still editor-in-chief of Nature Magazine.

“In short, cognitive-enhancing drugs seem morally equivalent to other, more familiar, enhancements,” the authors conclude.

Another champion of these drugs, as I wrote earlier, considers ADHD medications a matter of social justice. ““People who are getting A’s and B’s, I won’t give it to them,” Dr. Michael Anderson told the New York Times last October.

“It is not yet clear whether Dr. Anderson is representative of a widening trend,” reports reports Alan Schwartz for the New York Times. “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.”

Clearly, we have an epidemic on our hand. Is more medication really the answer? Surely, success can be bought at a different price.

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