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Thursday, April 04, 2013

Thoughts on ADHD

Today's topic is, umm, err, what was I going to write about again?  Oh. right. I need to focus and pay attention. :-)

The attention deficit diagnoses didn't even exist prior to 1980, yet somehow, when I went to school back before 1980, it didn't seem to be needed.  Now, according to a NY Times article (via Brothers Judd) 11% of all children are diagnosed with A.D.H.D.  Judd feels that (and has repetitively stated over the years) it's "just a way to control boys", but he ignores the key statement in the Times article:

"... the pills can vastly improve focus and drive among those with perhaps only traces of the disorder, an A.D.H.D. diagnosis has become a popular shortcut to better grades..."
In this very competitive world in which today's students exist, managing to cop an A.D.H.D diagnosis gives you a huge advantage.

And I do mean huge. During college, a friend's girlfriend's father was a pharmacist and via this connection I had the opportunity to try Ritalin a couple of times.  It made the most mundane trivial facts and bits of knowledge seem fascinating; the most monotone and dull lecturer seem like a visionary putting forth pearls of enlightenment with me hanging (and remembering!!!) every word; and the most boring mental tasks like memorization and editing papers seem like The. Most. Interesting. Activities. Ever!

So it's not that this class of drugs increases attention via somehow controlling you.  Instead, you focus because everything is so, so interesting!  I'd be willing to bet that the vast majority of users, even those without a supposed attention deficit, do a lot better in school than they would've if they hadn't regularly taken the drugs.


The drugs aren't particularly euphoric, but they're not unpleasant either.  For example, they seemed less jittery than caffeine.   I'm told they're addictive, but addiction in and of itself isn't a problem.  For example, the vast majority of those in western civilization are addicted to caffeine, and it's simply not a problem.  Addiction is only a problem when the cost of obtaining the drug is excessively high.

There are probably other downsides to chronic use of the drugs used to treat A.D.H.D., but they seem fairly mild, and even if more significant, excelling in school and career might well be worth it anyway.

To me, the question becomes: if grades are important to the student and the parent, why shouldn't all students be allowed to get A.D.H.D. drugs if anybody's allowed to get one.  Why should only some people be allowed this huge advantage?  Do we really have to teach our children to fake A.D.H.D. symptoms to get ahead?  Why does a doctor have the final say about what's best for us and our children?

Everybody's focus varies - that's part of being human.  Perhaps being human in this day and age is a disorder for which we need to be treated.

17 comments:

Harry Eagar said...

I was talking to the psychologist who treated my daughter about this and that, and I asked him if he believed in the existence of ADHD.

He doesn't and I don't either.

I cannot agree that, in general, addiction is only a problem of money cost. My wife is addicted (or dependent, in practice the same thing) on steroids.

Without them she'd be dead. But after 40 years she's suffering from serious side effects.

Bret said...

Harry,

The point I'm trying to make is that it's the drug use that causes the side effects, not the addiction. For example, if you were addicted to something completely inert, the only downside is the cost. The steroids are what have serious side effects, the addiction (or dependence) has no side effect except what will happen if she stops.

erp said...

Let people know the pros and cons and let them make their own decisions unless what they will affect others negatively, e.g., driving drunk or drugged or falling asleep with a lit cigarette in your hand.

I've said it before and firmly believe that it's rambunctious dare devil boys who are the biggest threat to lefties who want girly boys and men who will be easily led around.

Annoying Old Guy said...

Bret;

It's certainly the case that other disability labels are sought by overly competitive parents because of the advantages they bring (e.g., extra time on tests). Your theory here is simply a different application of something already documented which makes it quite plausible.

erp said...

http://spectator.org/archives/2013/04/05/the-drug-war-on-boys

Interesting line in the article was that sports formerly used up a lot of male teenagers' energy, but it failed to say that running around, climbing trees, etc. formerly used up a lot of younger boys energy as well.

Now much of that is considered too dangerous and males of all ages are resorting to computer/mind games many of which are so violent as to boggle the mind instead of doing physical feats that nature intended to prepare the male mind and body for adulthood.

We may soon answer the question about new short term evolution. Will changing behavior change male biology producing the kind of men feminists want and will that actually produce a new species entitled girly men?

Thank God I won't be around to find out.

Peter said...

Addiction is only a problem when the cost of obtaining the drug is excessively high.

Say what? Did somebody forget to take his Ritalin before writing that?

It made the most mundane trivial facts and bits of knowledge seem fascinating; the most monotone and dull lecturer seem like a visionary putting forth pearls of enlightenment with me hanging (and remembering!!!) every word; and the most boring mental tasks like memorization and editing papers seem like The. Most. Interesting. Activities. Ever!

Bret, is it possible somebody slipped a little LSD in your Ritalin bottle?

Bret said...

Peter,

Most of us are addicted to caffeine. Caffeine isn't particular bad for you and may even be good for at least some people. Does it matter that we're all addicted to caffeine? No, it doesn't. Taking a given drug might hurt you, but it's the drug itself that does the damage. And it does equal damage whether or not it's addicting to you.

Also, I haven't heard of anyone being helped by psychedelics in their learning and/or studying, so I rather doubt there was LSD added to the pills. Of course I couldn't claim to know for sure.

Hey Skipper said...

Addiction is only a problem when the cost of obtaining the drug is excessively high.

Say what? Did somebody forget to take his Ritalin before writing that?


Ummm, no. Addiction is a problem to the extent detrimental consequences of uncontrolled are a problem.

For me, the consequences of alcohol addiction would be a problem looooong before cost became an issue. And I'm sure there are plenty of other examples of compulsive consumption causes problems completely independent of cost.

Bret said...

Hey Skipper,

You are likely addicted to caffeine. Please explain to me why that's a problem.

Peter said...

For one thing, Bret, if the price of coffee suddenly increased twentyfold, I wouldn't worry much that Skipper and millions of others would succumb to ruinous personally and financially destructive behaviour to get their fixes. I think it's a big fallacy to throw out this abstract, generic concept of "addiction" and analyse it without distinguishing the widely ranging concrete effects of individual objects. Does it make sense to speak of crack cocaine and chocolate as if the differences were mere details of One Big Problem?

I also have difficulty with the sweeping conclusions your youthful experiences led you to make. I was socially nervous in college to the point of frequently being tongue-tied. Then a friend introduced me to alcohol and I found it relaxed me greatly and loosened my tongue, especially around pretty women. The. Most. Interesting. Evenings. Ever! What general conclusions do you think we should draw from this about socialization and alcohol use in America? No, I didn't think so.

Leaving aside ongoing controversies about physical and physiological effects in kids, the drug is prescribed for general behavioural issues that go far beyond the immediate focussing on a classroom lecture. As any teacher will tell you, many parents shop for diagnoses and medications for their unruly children and can become pretty upset if they don't get them. There is no way a child can give informed consent and I'm afraid this is one area where the notion that parents know best breaks down pretty quickly.

Bret said...

Peter, Hey Skipper,

Let's start with the definition:

===

addiction

noun

the state of being enslaved to a habit or practice or to something that is psychologically or physically habit-forming, as narcotics, to such an extent that its cessation causes severe trauma.

====

The point is that most of all of problem with addiction occurs at the "cessation". You can perhaps extend that to the concept that cessation may inherently have to occur one day, but that's not inherent.

Is a non-addicted heavy drinker any better off than an alcoholic with identical drinking patterns?

Is a non-addicted cigar smoker better off than an addicted one who smokes the same number of cigars?

Is a non-addicted meth user better off than addicted one, again with similar usage patterns?

Consider these questions assuming that the addict can obtain supply at minimal cost.

You apparently answer yes to the above questions, but I'm still baffled as to why.

erp said...

Bret, define "better off."

I'm told heroin and other hard drug addicts suffer great physical pain when the drug isn't available and it's almost impossible to overcome the craving.

Alcohol apparently affects some people physically too, so they have a hard time getting and staying on the wagon.

Not so for nicotine and caffeine.

A cigar or cigarette smoker may get antsy and cranky for a week or two -- ditto caffeine. Stopped smoking cold after 30 years of 2+ packs/day. Coffee likewise. Nobody even noticed until one day my husband asked for a light in the car and I told him, I didn't have one on me.

He stopped then and there as well over 25 years ago. We must have saved a gazillion dollars not buying 3 cartons a week all these years, not to mention health benefits.

Bret said...

erp,

I define "better off" in terms of any objective measure of health, fitness, or standard of living.

erp said...

Of course.

I meant in the context of this string.

Peter said...

Bret:

I'm not sure I undertstand your categorical distinction between a heavy non-addicted meth user and a meth addict. But even if there is such a distinction, is this one where you believe the individual in the one best-placed to make that call?

The spouses and children of drug and alcohol addicts might have a few things to say about the notion that most addiction "problems" are related to cessation.

Hey Skipper said...

[Bret:] You are likely addicted to caffeine. Please explain to me why that's a problem.

Well, as it happens, despite being a regular coffee drinker I am not. But that's beside your point.

If all addictions were as benign as a caffeine addictions, no one would care. The only reason the term exists is to capture the consequences of excessive and consequently harmful consumption.

For each of those questions, this presents the problem of trying to determine a distinction in the absence of difference.

It doesn't matter, in terms of harm, whether the drinking is voluntary, or do to some compulsion. Indeed, the only people who would know the difference are the drinkers themselves, and one of the truisms about addiction is that when their lips are moving, addicts are lying. So how would you even know heavy drinkers who insist they aren't alcoholics aren't lying?

Hey Skipper said...

[Bret:] You are likely addicted to caffeine. Please explain to me why that's a problem.

Well, as it happens, despite being a regular coffee drinker I am not. But that's beside your point.

If all addictions were as benign as a caffeine addictions, no one would care. The only reason the term exists is to capture the consequences of excessive and consequently harmful consumption.

For each of those questions, this presents the problem of trying to determine a distinction in the absence of difference.

It doesn't matter, in terms of harm, whether the drinking is voluntary, or do to some compulsion. Indeed, the only people who would know the difference are the drinkers themselves, and one of the truisms about addiction is that when their lips are moving, addicts are lying. So how would you even know heavy drinkers who insist they aren't alcoholics aren't lying?