Sunday, April 16, 2000

Drugging our kids

Are 'brain pills' to control behavior a cure or a curse?

Local experts speak out
What we're talking about

BY Linda Cagnetti
The Cincinnati Enquirer

        It's been a year since Columbine High School jarred us into a national panic over our children. We're frantic to figure out why they're angry, violent and sad, and how to “fix” them, fast.

        Soon after the shootings, the Clinton White House convened a mental health summit dominated by biopsychiatrists who informed us our children suffer from biological brain disorders linked to mental distress, violence and worse, and that psychiatric pills for the brain are the newest (and inevitable) solution. The president then proposed a massive increase in psychiatric interventions in schools to identify and treat the potentially violent and troubled ones.

        We got another jolt in February. The Journal of the American Medical Association reported a huge increase in the number of preschoolers taking psychotropic drugs, particularly stimulants such as Ritalin and antidepressants such as Prozac. It underscored the alarming rise in the use of powerful psychiatric drugs to control behavior in kids of all ages — despite the fact the drugs are largely untested for the young.

        Public anxiety went up a notch. So did the White House damage control. The Clintons swiftly switched channels and announced “a major effort to study and curb this alarming trend,” including new policy, more research and another summit this summer.

        Meanwhile, an alarming number of kids are being diagnosed with brain or behavior disorders and given a variety of brain-altering drugs that are not sufficiently tested on young people and often have under-publicized, serious side effects. Almost nothing is known about how the drugs affect a child's developing brain. Much medication is haphazard.

        Incredibly, however, this psychiatric prescription for troubled children is poised to become the official norm. The problem is that only one side — the pro-medicators — have had the microphone. They're telling us our children's problems aren't cultural, emotional or spiritual — they're biological. Their dysfunction is brain chemistry. And we are backward, misinformed or cruel to deny them drugs to fix it.

        Well, we're desperate to stop the violence, control the disorder, save our kids. We will turn schools into fortresses or psychiatrically sort and label kids if necessary. If half of them need psychoactive drugs, we'll tolerate that, too — if the experts say they'll work.

        Already we have 4 million to 5 million children on stimulants such as Ritalin and 2.5 million on antidepressants such as Prozac. Medicating is quicker and cheaper than therapy and other approaches. Insurance companies prefer Prozac at $20 a week to therapy at $100 an hour. Teachers recommend medication for learning or behavior problems because schools don't have enough counselors or psychologists to deal with them otherwise. Desperate parents try everything.

        I know children who are helped dramatically with medication and others who are not. I know the frustration of children with legitimate problems and the pain they suffer from being different. I hate the cruel, self-righteous criticism heaped by some parents on other parents who are doing their best in difficult and confusing situations.

        Tragedies like Columbine exacerbate everybody's anxiety and the rush toward hasty, ill-informed public policy. But why, in light of all we know and don't know about these drugs, would we sanction them as the preferred and only “enlightened” prescription for so many children's problems? “If antidepressant and stimulant drugs sometimes cause excessively violent behavior (there are many published anecdotal cases), why, in the aftermath of these school shootings, are we promoting more of the drugs?” asks Dr. Peter Breggin, psychiatrist and author of Reclaiming our Children.

        Why aren't we asking what's wrong with the society our kids live in, or with adults' priorities? Why, in the world's richest country, won't we pay for proper diagnoses and treatment for children who need it? Why won't we create and support inspiring schools? Why do we abandon children literally and emotionally? Why are we hell-bent on labeling and cubbyholing them by how they act and perform or don't? Why is our discourse about them so desperate and strident?

        Maybe the adults are more berserk than the children.

        We're learning some awesome things about the brain. But many Cincinnati specialists point out that both nature and nurture matter with children. And there's still plenty we can do to improve our efforts on the nurture side.

        The next White House mental health summit should examine the flaws in adult priorities, in families, schools and communities — not just the flaws in the brains of our kids.

        Linda Cagnetti is deputy editor of the Enquirer's editorial pages: 312 Elm Street, Cincinnati, Ohio, 45202; 513-768-8527; e-mail to


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