WASHINGTON (Reuters Health) - Adversaries in the debate
over widespread prescribing of Ritalin and other
stimulants to children squared off on Capitol Hill
Thursday, only to arouse the ire of lawmakers who
accused them of serving as fronts for the drug industry
and religious groups.
A parade of witnesses came
before the House Government Reform Committee to tell
lawmakers why an estimated 3 million to 6 million US
children are currently on Ritalin and other drugs used
to treat attention deficit hyperactivity disorder
(ADHD). Committee members voiced concern that doctors
are too quick to diagnose the disorder and prescribe
strong drugs in children who may not actually have a
mental disorder.
Chief among the drug's detractors were three
witnesses from the Citizen's Commission on Human Rights,
an anti-psychiatry watchdog group. The organization
points out that scientists have no reliable way of
confirming a child's ADHD diagnosis and that teachers
have too much sway in convincing doctors to medicate
unruly children.
In addition, parents are rarely informed about the
possible side effects of Ritalin and similar drugs like
Adderall before agreeing to give the drug, said Bruce
Wiseman, the group's US president.
ADHD is now diagnosed in 3% to 5% of all US children,
most of them boys, according to the National Institute
of Mental Health.
Lawmakers said that federal agencies like the Food
and Drug Administration should do more to inform doctors
and the public about potential side effects, including
heart irregularities, eating disruption, and psychosis.
But Rep. Constance Morella (R-MD) pointed out that
the Citizen's Commission for Human Rights (CCHR) was
founded in 1969 by the Church of Scientology, a
religious group known both for attracting celebrity
members and for vehement opposition to all of
psychiatry.
Morella read a statement from Jan Eastgate, the
organization's international president, which calls
psychiatry a "malignant disease" that "threatens society
and ultimately mankind."
Wiseman said he agreed with that view, and said that
his group maintains an independent tax status from the
Church of Scientology.
Morella also challenged Dr. Mary Ann Block, a board
member who treats ADHD children with nutritional and
anti-allergy interventions instead of drugs. Block
accused psychiatrists and other doctors of prescribing
ADHD drugs for financial gain.
"You'd probably gain a little bit too if people were
scared away from psychiatric drugs," Morella said.
The committee also heard from Children and Adults
with Attention Deficit/Hyperactivity Disorder (CHADD), a
group that defends the widespread treatment of children
and adults diagnosed with the disorder.
The CEO of CHADD, E. Clarke Ross, told the committee
that ADHD may be underdiagnosed in US kids and that more
doctors should be aware of professional guidelines
governing the identification and treatment of the
disease.
Ross, whose 11-year-old son Andrew has a severe
attention disorder and anxiety, told the committee that
drugs have helped his child.
"My son's problems are neither 'lies' nor 'frauds'
nor the 'failures of his parents,'" he said in a
statement. A few minutes before, committee member
Benjamin Gilman (R-NY) told witnesses that federal
researchers must do more to uncover possible causes of
attention disorders, including poisoning with lead or
mercury from vaccines.
Gilman also attacked Ross's group for promoting
stimulant drugs on behalf of their makers.
Gilman quoted a Drug Enforcement Administration study
concluding that Ritalin maker Ciba-Geigy, now known as
Novartis, had given CHAAD over $700,000 in grants over
five years in the 1990's. The agency expressed concern
in the report that CHAAD and similar groups serve as
front organizations for drug makers.
"Here we have a drug company that is influencing a
parental group, and that drug company has a strong
financial interest," Gilman said.
Psychiatrist David Fassler told lawmakers that drug
treatment "can be extremely helpful" in treating ADHD
but that "medication alone is rarely the appropriate
treatment."
"Medication should only be used as part of a
comprehensive treatment plan that will usually include
individual therapy, family support and counseling and
work with the schools," said Fassler, who heads the
American Academy of Child and Adolescent Psychiatry.