Sunday, February 3, 2013

Chemicalization

The New York Times today leads with a story about a young man who became addicted to Adderall, a drug intended to treat attention deficit/hyperactivity disorder (ADHD). He had a long and complicated history with various prescription drugs, Adderall the last one; he committed suicide two weeks after his last Adderall prescription ran out. He was an adult, not a child. Neither his mother nor his father believed that he’d ever suffered from ADHD, not as a child, not later. But Adderall is evidently an addictive sort of medication, and enterprising young people can easily discover what ADHD symptoms are before approaching a doctor to treat it.

I am still without an Internet connection, hence left wondering when Adderall appeared—and what happened to Ritalin. Ritalin was a run-away best-seller a ways back when we (in the context of our publishing enterprise, Editorial Code and Data) became aware of ADHD while publishing Social Trends and Indicators USA (Vol 3). Data reported in that volume (p. 483) showed the growth in children diagnosed with ADHD and the number of children on Ritalin over the 1975-2000 period.

Back when that volume was published (2003) we noted that the ADHD syndrome explicitly excludes children who have actual physical and brain dysfunction. The syndrome is behavioral. And the academics consulted by the Centers for Disease Control assign its cause to transformations in families, marital instability, inadequate day care (that day care necessitated by economic conditions affecting the family), and poverty. The syndrome first came to be discovered in the early 1970s. We also noted, back then, that Ritalin was a highly controversial drug and often prescribed for children who did not meet the ADHD diagnosis.

Evidently some things have changed, others not, since the early 2000s. Now adults are “treating” a behavioral disorder—without any somatic causes—with prescription drugs. And the drug of choice seems to be a more powerful pharmaceutical. To be sure, looking a growth curves like I’m showing above for Ritalin, Pharma is obviously hell-bent on “discovering” even better cures for what is not really a disease, strictly speaking.

In this context, is it any wonder that performance-enhancing steroids are ripping apart the world of sports? Our culture is addicted to a kind of chemicalization† at every level with drastic consequences. It seems to be good for business—and it seems to make life easier for doctors who reflexively reach for the subscription pad (and more and more, to their frustration, for keyboard) than undertaking the thankless job of fixing at the medical level what has gone awry in the family.
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†I use that word here with apologies to Unity Church where the word has a much more complex and arcane meaning.

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