As parents we have very little protection from companies who want to sell you “stuff” to make your child better, or to “fix” your child’s behaviour. You are vulnerable, worried, and anxious about your child's future - an easy sell for greedy companies.
ADHD - and non-ADHD children are being increasingly battered by powerful forces doing battle for profits. This is not new, but the intensity has increased in the recent past.
For reasons that have got lost in the murky detritus of commerce, ADHD has received far more attention - pardon the pun - than other conditions. Unfortunately it’s the wrong kind of attention.
Two articles that have been published in the last week bring this issue into sharp focus.
The first article uses as it’s base a report compiled by a Dr Visser of The Centre for Disease Control (CDC) in at Atlanta in the USA. The article trumpets that more than 10 000 American toddlers, aged 2 and 3 years old, are being medicated for ADHD.
The second article shrieks that some cereals that children eat are more than half sugar by weight.
Both these articles affect children with ADHD in different ways. I want to use parts of both articles to illustrate why parents should be very worried, and what you can do about it to protect your children, whether they have ADHD or not.
Lets address the medication issue first.
Statement of Truth 1
To medicate any child for any condition or disease is a difficult decision for any parent, and so it should be. These are choices that must be made carefully and only after proper research and consultation.
So how do we as parents decide whether to medicate or not? There are two main sources we (should) go to. The first is our medical practitioner and the second is the pharmacist. Family and the Internet are normally not good options! In a recent GfK VEREIN survey it was found that Doctors are rated as the most trustworthy professionals in South Africa, they score an impressive 95%, and they rate in the top 5 in the rest of the world as well.
In fact medical-type professionals generally score in the very top section of the survey. So what’s the problem? There are two main issues we need to be aware of.
The first is that doctors are reliant on the studies and trials that all medication manufacturers are required to complete in order to get the certification to sell the medication. This is a time consuming process, it can be as long as a decade or more, and it used to be very rigorous. Certifications were not handed out easily. The way it should be.
Recently, over the last decade, more and more of these studies have proven to be seriously flawed. You can read more about this on Dr Ben Goldacre's blog and get his book, Bad Pharma if you want to really get outraged.
Just about all the large pharmaceutical companies have paid fines for misdemeanours, and outright lies, some may even say criminal acts. In short, these large conglomerates pay for the trials to be done. If data comes out that proves that the efficacy of the product is diminshed in relation to expectations, or that there are unexpected side effects, that data is simply not included in the data presented to the Food and Drug Administration (FDA) in the US, or in the Medicines Control Council (MCC) in South Africa.
Peer reviewed studies are the gold standard that all prescribing doctors must use when writing a prescription for a patient. The FDA also writes guidelines and exclusions for doctors to follow when prescribing.
Doctors are not compelled to follow those guidelines though - they are after all only guidelines. Many prescriptions are written for what is called “off-label” use. This is where the doctor goes outside of the guidelines. This is what is highlighted in the CDC report by Dr Visser.
Medicating these toddlers with Ritalin is outside of the guidelines, but it is not illegal. In fact the report states that the “off-label use of methylphenidate has produced encouraging results.” The American Academy of Pediatrics subsequently authorised it’s use in 4 and 5 year olds. This authorisation carries the caveat that this must “only occur after formal training for parents and teachers to improve the child’s environment were unsuccessful.”
Doctors who prescribe off-label run the risk of being sued for malpractice and could lose their licence. By the way, medical malpractice insurance premiums can cost more than R20 000 per month!
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