ADHD Controversy Paper
Brittney Katz
HDFS 432
Pennsylvania State University
November 29th, 2018
ADHD Controversy Paper
In today’s day and age, one of the most largely argued controversies is over the usage of certain pharmacological drugs to treat ADHD in children. ADHD, also known as Attention Deficit Hyperactivity Disorder, is among one of the most prevalent childhood neurobehavioral disorders. In the United States, 6.4 million children are diagnosed with ADHD (Hamed, Kauer, Stevens, 2015). If not competently treated, the disorder can lead several aspects of one’s life to become significantly impaired. According to the article Pharmacological Treatment of Attention Deficit Hyperactivity Disorder in Children and Adolescents: Clinical Strategies”, the symptoms associated with ADHD are “…developmentally inappropriate levels of inattention, hyperactivity, and impulsivity resulting in functional impairment and negative outcomes in academic, family, occupational, and social settings, and increased risk for substance abuse disorders”. Reasons for ADHD being untreated in a child vary from that it could be undiagnosed, parents could be unwilling to administer pharmacological drugs, and parents could lack the financial resources to provide behavioral treatment. On one side of the controversy, the adverse side effects of pharmacological drugs are what lead parents and/or doctors to feel precarious about the usage of them. On the other side of the controversy, many doctors and parents feel that the use of pharmacological drugs are beneficial to their child’s overall quality of life.
On the pro-pharmacological agent side of the controversy, drugs such as Adderall have been found to have a positive correlation to enhanced academic success in children ages eight to twelve. Other effects of these drugs include improvement of the dysfunction of certain brain activities and improvements in quality of overall health. Pharmacological drugs to treat ADHD in childhood were also found to be correlated with a decreased chance of the child developing a substance use disorder as well as a decreased possibility that the child will partake in cigarette smoking (Shier, Reichenbacher, Ghuman, 2012). If your child has ADHD, studies show that there is an 80% chance that they are going to respond to the medication and that there will be significant improvements in their deficits (Boorady, 2017). Many experts nationwide are in agreement that parents and/or guardians should highly contemplate allowing their children to take ADHD medication. When manifestations of ADHD are hindering a child’s social, academic, and emotional life, many experts feel that medication is necessary. While interventions such as behavioral therapy do exist and help in some children, experts say that these tactics are infrequently influential enough to have the same effect that medications do on children. According to William W. Dodson, M.D., a psychologist who specializes in ADHD, “The risks of using these medications are very low and the risks involved in not treating ADHD are very high. These include academic failure, social problems, car accidents, and drug abuse”. Parents who are aware of their child’s cardiac history and current cardiac complications have the knowledge that their child is already at the risk for sudden death. Therefore, there is no indication that ADHD medications increase that risk any more than playing a sport might. Furthermore, before taking any type of ADHD stimulant, a child should be examined by their doctor in order to determine whether the stimulant they may take will increase risks associated with their health (McCarthy, 2018).
On the anti-pharmacological agent side of the controversy, many parents and doctors believe that the adverse side effects of medications used to treat ADHD outweigh any possible benefits that may be present. Aside from the adverse effects from certain medications, another reason people are against treating ADHD in children with medication is because these medications have not proven long term changes in the prognosis and life improvement of children with ADHD. In other words, the beneficial effects that are present due to medications are only present when the medication is traveling throughout the bloodstream. The effects of the medication wear off between 3 and 10 hours of consumption (Pelham, 2000). The main reasons that many are against the usage of drugs such as Adderall to treat ADHD in children is due to their adverse medical effects. Some of the common adverse effects resulting from usage of stimulant medications include suppression of appetite, stomach pains, lack of sleep, and headaches. Some of the less common adverse effects include tics, emotional instability, and a rise in heart rate and/or blood pressure. Evidence in the MTA study showed that the children whose ADHD was treated with medication showed a decline in the rate in which they were growing. This decline did not show evidence that there would be a growth pick up in their future. There has also been reports of sudden deaths due to usage of certain stimulants (Shier, Reichenbacher, Ghuman, 2012).
While there are several adverse risks and effects of taking stimulants such as Adderall, Atomoxetine, and Methylphenidate, there are strategies to manage the stimulants adverse effects. Since ADHD medications are an appetite suppressant, to minimize the risk of weight loss, parents/guardians are strictly directed to ensure that the child is taking his/her medication on a full stomach or during a meal. Parents/guardians are also encouraged to allow the child to consume generous amounts of food, both in the morning and after dinner. Another adverse of ADHD medication is insomnia. To diminish sleep difficulties that the child may endure, the medications should never be taken at late hours of the afternoon or night (Shier, Reichenbacher, Ghuman).
Something known as clinical behavioral therapy is an alternative to medication. Though, many children fail to show improvement with this type of therapy. It is unknown whether children with ADHD simply cannot be treated with this form of therapy or whether this is due to the noncompliance on the behalf of parents and professors. Behavioral modification therapy is difficult because it requires a lot of time, dedication, money, and patience (Pelham, 2000). Considering there are constraints to both pharmacological interventions and behavioral interventions, there is now a new clinical practice which combines the two interventions. While current evidence does state that the combined treatment approach is the most adequate way to treat ADHD in children, this method has not been studied nearly enough. The Multimodal Treatment Study of Children with ADHD (MTA) was conducted in order to learn more about the effects of the combined approach of pharmacological drugs and behavioral interventions in children with ADHD. Children in the combined treatment grouped received both pharmacological and behavioral interventions. Children in the behavioral treatment group were not administered any medication and only received behavioral forms treatment. According to the results of the study, children in the combined treatment group exhibited undoubtedly superior results to that of the behavioral treatment group. Those in the combined treatment group showed better results in terms of rule following, good sportsmanship, and negative peer events (Pelham, 2000).
Different people are in fact motivated to have contrasting opinions on the issue of whether medication should be administered to children with ADHD. There are differing things that motivate both a parent and a doctor to have such differing issues on the topic. For instance, parents are motivated to have strong opinions on this issue because they are naturally protective of their children. Because it is ultimately up to the parent/guardian if the child gets the stimulant, adverse outcomes experienced by the child may. Cause the parent to feel responsible. In a situation like this, it would be easy for the parent to blame drug companies and doctors if their child had an adverse reaction. On the other hand, many doctors nationwide are in support of administering stimulants to treat ADHD. For instance, the strong desire for doctors to diagnose and treat ADHD early on is accredited to the intentions of pharmaceutical companies to seek financial benefits (Hamed, Kauer, Stevens, 2015). With this knowledge, I am led to believe that both parties are biased and that there is no way in truly knowing the intentions of a doctor or the reasonings of a parent. Though, overall the evidence that is presented from parental opinions stems from emotion rather than opinion. In choosing whether they want to treat their child’s disorder with medication, it is inevitable that a parent’s emotions will take the wheel in making this decision. On the other hand, evidence presented by doctors, psychiatrists, empirical studies, etc. are all scientific in nature. When information is scientific in nature, there is automatic sense of credibility that comes along with it. For example, in The Multimodal Treatment Study of Children with ADHD (MTA), the researchers designed a large, controlled, randomized clinical trial. In this trial they studied the children’s ability through sports skills training, classroom monitoring, peer interventions and daily report cards. The evidence presented from this study was extremely credible because the study elaborated on how every aspect of the results were measured (Pelham, 2000).
While there are many positive and negative aspects to the usage of pharmacological drugs to treat ADHD in children, I feel that the benefits of the usage of medications to treat ADHD in children outweigh the risks.
References
Hamed, A. M., Kauer, A. J., & Stevens, H. E. (2015, November 12). Why the Diagnosis of Attention Deficit Hyperactivity Disorder Matters. Retrieved from https://www.frontiersin.org/articles/10.3389/fpsyt.2015.00168/full
Shier, A. C., Reichenbacher, T., Ghuman, H. S., & Ghuman, J. K. (2012). Pharmacological Treatment of Attention Deficit Hyperactivity Disorder in Children and Adolescents: Clinical Strategies. Journal of Central Nervous System Disease,5. doi:10.4137/jcnsd.s6691
Boorady, R. (n.d.). The Facts on ADHD Medications. Retrieved from https://childmind.org/article/the-facts-on-adhd-medications/
McCarthy, L. F. (2018, May 03). Top 10 Questions About ADHD Medications for Children… Answered! Retrieved from https://www.additudemag.com/top-10-questions-about-meds-answered/
Pelham, W. E., Gnagy, E. M., Greiner, A. R., Hoza, B., Hinshaw, S. P., Swanson, J. M., . . . McBurnett, K. (n.d.). Behavioral versus Behavioral and Pharmacological Treatment in ADHD Children Attending a Summer Treatment Program. Retrieved from https://link.springer.com/article/10.1023/A:1005127030251