URGENT! SUPPORT HR 2218 TO PROTECT CHILDREN FROM COMPULSORY DRUGGING and PROTECT PARENTAL RIGHTS AT THE SAME TIME
ACTION ITEM: http://salsa.democracyinaction.org/o/568/t/1128/campaign.jsp?campaign_KEY=27246
OPPOSE S 324 TO PROTECT PREGNANT MOTHERS AND THEIR BABIES FROM COMPULSORY SCREENING AND COERCIVE DRUGGING:
ACTION ITEM:http://salsa.democracyinaction.org/o/568/t/1128/campaign.jsp?campaign_KEY=23065

Children are the latest victims in the Drug Crimes Against Humanity. Let me share my bias with you and then tell you why I believe that babies and children are being assaulted in increasing numbers with a deadly weapon: psychotropic drugs. These drugs kill and maim at the physical, neurological, psychological and emotional levels. They have lethal and sub-lethal side effects but are, astonishingly, handed out like candy as if they were properly tested, safe or effective. They are none of the above. Click here, http://salsa.democracyinaction.org/o/568/t/1128/campaign.jsp?campaign_KEY=27246, to tell State and Federal Legislators to protect parents’ right to make medical decisions for their children and stop the use of government money for unscientific and skewed screening tests to herd kids into the drug pusher’s offices where unnecessary and dangerous prescriptions await them.

Pregnant mothers are up for “protection” from postpartum depression by being “screened” with phony screening tools and then “offered” drugs which the PDR advises doctors to avoid or use with extreme caution in women of child-bearing age. Infants exposed to these toxic compounds can suffer a horrifying range of damage, including being born with their internal organs outside of their bodies and life long brain damage. “Never mind”, says Big Pharma, “pregnant and new moms are an untapped market. Let’s go for it! And just think! Babies with brain damage, diabetes, etc., all require meds for the rest of their lives. Yes, indeed! We will surely go for it.” And go for it they did by getting the bill passed in the House of Representatives whose companion bill, S 324, is now before the Senate. Click here http://salsa.democracyinaction.org/o/568/t/1128/campaign.jsp?campaign_KEY=23065 to tell your Senators not to pass this dangerous and totally unnecessary bill.

I was graduated from the Albert Einstein College of Medicine in 1970 and took my Postgraduate training in Child, Adolescent and Adult Psychiatry, finishing my training in 1975. I am trained in psychoanalysis, group therapy and a host of other modalities. I have run drug and other treatment facilities, worked in inpatient and out patient facilities for children, adults and adolescents and have been in the private practice of psychiatry and medicine for decades.
All without drugs, electroshock or other dangerous, primitive and harmful techniques. I believe that psychoactive drugs, like virtually all other drugs, are dangerous and, unless you are in a surgery suite or an emergency room, unnecessary.

This is a conviction born out of a very long and successful drug free medical and psychiatric practice (during which, unlike most of my medical colleagues, I have never been sued for malpractice).

When I saw the article in the most recent journal of the Schafer Autism Report which is reproduced below, I wrote to congratulate the Report for publishing this outstanding piece decrying the medication of millions and millions of children for little more than mythic disorders.

Representative Ron Paul MD (TX-R) introduced the Parental Consent Act, HR 2218, on April 30, 2009. The bill prevents Federal monies from being used to support mental health screenings which are nothing short of pharma marketing tools for kids. They have no scientific validity, are supported by, and developed by, the greedy folks at Big Pharma. Kids answer trick questions in normal ways and they are “diagnosed” with phony terms and lables. Parents who resist the requirement for medication which almost always follows face enormous pressure, including jail time for “medical neglect” or “child abuse”. This sells pills, all right, but it sure does not protect rights or kids brains and bodies.

As a psychiatrist and physician I can tell you that psychoactive drugs are dangerous. They can cause permanent physical damage, obesity, suicide, homicide, diabetes, neurological damage which is life-long, rob children of their moods and their developmental opportunities and much, much more. Every single school shooting in the US has involved kids either on drugs or coming off them. There is, in my opinion, absolutely no excuse for psychoactive medicines.

Furthermore, parents have the right, and must continue to have the right, to make the life and death decisions for their children with which they have been entrusted. Those rights are fundamentally as the rights we claim for ourselves to make our own decisions about what happens to our own bodies. Absent that, our bodies are owned by others who make decisions about what happens to them and we are, by definition, slaves. I have no wish to be a slave to the government of any country or to its corporations, including Big Pharma. So it is my duty to oppose these pieces of legislation.

This is an invitation to join me in that opposition and bring all of your contacts along.

By the way, the Natural Solutions Foundation is a privately supported not for profit, tax exempt organization and we depend on your donations. Please visit http://drrimatruthreports.com/?page_id=189 to make your donation. Recurring donations are especially helpful. We appreciate your support, whether large of small.

Yours in health and freedom,
Dr. Rima
Rima E. Laibow, MD
Medical Director
Natural Solutions Foundation
www.HealthFreedomUSA.org
www.GlobalHealthFreedom.org
www.NaturalSolutionsFoundation.org
www.NaturalSolutionsMarketPlace.org
www.Organics4U.org
www.HealthFreedomRadio.com

Here is the letter I wrote to the Editor of the Schafer Autism Review:
To the Editor:

I am writing to congratulate you on your publication of “The Wholesale Sedation of America’s Youth” By Andrew M. Weiss. As a Child, Adolescent and Adult Psychiatrist who has practiced drug free medicine for my entire career, I found myself reading my own thoughts and writings in this excellent article. Physicians, Nurse Practitioners and others who endorse and enforce medicating children because they have been entrained or constrained to do so win the approval, praise and appreciation of the forces that use them and of their peers, but are, in fact, worthy of scorn and, at best, loss of licenses or, at worst, criminal prosecution for their mindless, damaging and cowardly refusal to think clearly about the needs of the children they are charged to heal, not poison.

Every doctor is trained to think logically and systematically about diagnosis and treatment. If they refuse to use that training because they have allowed themselves to be brainwashed and browbeaten into down and dirty, quick and quality-less medicine, then shame upon each and every one of them. Drug ads, phony science and cheer leader “continuing medical education” seminars are nothing short of cynical organized deceptions designed to accomplish one goal and one goal only: the generation of massive profits.

Who stands between a child and pharmaceutical damage? A doctor. Who steps aside for 8 million American children every year? A doctor. If parents object or refuse to medicate their children, they run the very real risk of being charged with medical abuse or neglect, loosing their children and/or facing criminal charges for trying to protect the vulnerable youngsters in their care. Commonly drug-company-sponsored “screening tools” used by teachers or other school personnel are what got the kids in front of the doctor or nurse practitioner staring at the dangerous end of a prescription pad.

On April 30, 2009 Representative Ron Paul (R-TX) introduced the Parental Consent Act, HR 2218, “To prohibit the use of Federal funds for any universal or mandatory mental health screening program.” The ominously Orwellian-named “New Freedoms Initiative, passed in 2004 during the drug-friendly reign of President George W. Bush, provides for mandatory screening of every child from 0 to 18. In uterine screening is accomplished by “mental health screening” of pregnant women and the compulsory drugging of those women to “protect” the unborn child despite the former cautions urged on doctors to avoid the use of psychotropic medication in women of child bearing age because of the known and unknown dangers inherent in exposing unborn or nursing babies to those drugs.

The New Freedoms Initiative also mandates the screening for “mental problems” of everyone involved in any way with children – parents, grandparents, teachers, policemen and women, merchants who sell children things, clergy, doctors, nurses, etc. In short, everyone.

The madness must stop. Doctors must think about children and childhood as a developmental process, not a disease. Parents must be free to be what the law says they are, “GUARDians” and bureaucrats and administrators, teachers and others involved with children must ask why a child is showing signs of stress or distress and look for ways to solve that problem, not dissolve the child’s mind in a chemical soup of long and short term toxicity.

The Natural Solutions Foundation, www.GlobalHealthFreedom.org and www.HealthFreedomUSA.org, of which I am proud to be the Medical Director, supports the right of every person to make their own health decisions and, of course, of parents to make those decisions for their children. And we strongly support the rights of parents and others to say “NO!” to drugs, “No” to compulsory screenings to get kids onto subjective, and profitable diagnostic conveyor belts.

Our Health Freedom Action eAlerts offer action options to concerned parents and other persons to preserve these essential rights.

Medical fascism is facing us all. Soviet Russia was condemned world-wide because it condoned the atrocious use of psychoactive drugs to control its population and prevent behaviors it found disagreeable or unwelcome in vast numbers of people. Are our children our dissidents? Do their discontents require chemical straight jackets and personality-ectomies? Have we become mindless mind-assassins, robbing our children of their emotions and their neurological developmental opportunities because we do not dare to ask the penetrating question, “WHY?” to this drug mania we have been marketed into?

Since graduation from Albert Einstein College of Medicine in 1970 and completion of my Child and Adolescent Psychiatry Fellowship in 1975 I have practiced medicine and psychiatry without resorting to drugs. The results have been nothing short of astonishing for someone trained in the “Medical Model” – my patients got well because the underlying cause of their discomforts, disabilities, distortions and difficulties were uncovered and addressed. Using intensive nutritional strategies, herbology, homeopathy, detoxification, NeuroBioFeedback, frequency medicine and a host of other techniques, each patient was treated individually and their treatment tailored to their realities, including emotional ones. This type of medicine takes time – lots of it – and therefore the cottage industry, piecework compensation which doctors have allowed insurance carriers to impose upon them (insurance carriers which are often co-owned by Big Pharma so that forcing doctors to see more patients in a shorter time is a successful marketing ploy for their shareholders’ interests) make the economics unpalatable to insurance companies. Doctors have, in the main, behaved like good serfs and allowed themselves to be made wage slaves to the interests of the insurance companies, seeing more patients in shorter slots – and writing prescriptions quickly so they can see the next patient and the next and the next.

The solution? If you are a parent, find a health care professional who does not take insurance and pay for treatment so you and the doctor can spend as much time as your child needs. If you are a doctor or nurse practitioner, rethink your slavish devotion to the medicine of convenience – yours – and start doing what you have been expensively trained to do: think about root causes, look for underlying factors and return to your roots as a healer. Yes, you will have to unlearn much and question more. But you were a bright student looking for ways to help people when you fought your way into medical school. You were, after all, the best and the brightest. You may still have the capacity to think and to discern real science from marketing. And, somewhere deep down inside you, perhaps you still have a deep commitment to service and truth.

You will quickly find, if you follow the intellectual path I am advocating, that many of your most cherished believes must be abandoned by the wayside. One of those believes is that you must continue to take insurance payment for your services or you will not make a living. In fact, those doctors who have dared to let go of the insurance teat report that they are making more money, spending less in overhead and serving patients better than they dreamed possible before they took the plunge into service, not serfdom.

Yours in health and freedom,
Rima E. Laibow, MD
Medical Director
Natural Solutions Foundation
www.HealthFreedomUSA.org
www.GlobalHealthFreedom.org

And here is the Special Edition article to which I was responding:

Special Edition

The Wholesale Sedation of America’s Youth

By Andrew M. Weiss, Skeptical Inquirer. is.gd/yXAW

In the winter of 2000, the Journal of the American Medical Association published the results of a study indicating that 200,000 two- to four-year-olds had been prescribed Ritalin for an “attention disorder” from 1991 to 1995. Judging by the response, the image of hundreds of thousands of mothers grinding up stimulants to put into the sippy cups of their preschoolers was apparently not a pretty one.
Most national magazines and newspapers covered the story; some even expressed dismay or outrage at this exacerbation of what already seemed like a juggernaut of hyper-medicalizing childhood. The public reaction, however, was tame; the medical community, after a moment’s pause, continued unfazed. Today, the total toddler count is well past one million, and influential psychiatrists have insisted that mental health prescriptions are appropriate for children as young as twelve months. For the pharmaceutical companies, this is progress.
In 1995, 2,357,833 children were diagnosed with ADHD (Woodwell 1997) — twice the number diagnosed in 1990. By 1999, 3.4 percent of all American children had received a stimulant prescription for an attention disorder. Today, that number is closer to ten percent. Stimulants aren’t the only drugs being given out like candy to our children. A variety of other psychotropics like antidepressants, antipsychotics, and sedatives are finding their way into babies’ medicine cabinets in large numbers. In fact, the worldwide market for these drugs is growing at a rate of ten percent a year, $20.7 billion in sales of antipsychotics alone (for 2007, IMSHealth 2008).
While the sheer volume of psychotropics being prescribed for children might, in and of itself, produce alarm, there has not been a substantial backlash against drug use in large part because of the widespread perception that “medically authorized” drugs must be safe. Yet, there is considerable evidence that psychoactive drugs do not take second place to other controlled pharmaceuticals in carrying grave and substantial risks. All classes of psychoactive drugs are associated with patient deaths, and each produces serious side effects, some of which are life-threatening.
In 2005, researchers analyzed data from 250,000 patients in the Netherlands and concluded that “we can be reasonably sure that antipsychotics are associated in something like a threefold increase in sudden cardiac death, and perhaps that older antipsychotics may be worse” (Straus et al. 2004). In 2007, the FDA chose to beef up its black box warning (reserved for substances that represent the most serious danger to the public) against antidepressants concluding, “the trend across age groups toward an association between antidepressants and suicidality . . . was convincing, particularly when superimposed on earlier analyses of data on adolescents from randomized, controlled trials” (Friedman and Leon 2007). Antidepressants have been banned for use with children in the UK since 2003. According to a confidential FDA report, prolonged administration of amphetamines (the standard treatment for ADD and ADHD) “may lead to drug dependence and must be avoided.” They further reported that “misuse of amphetamine may cause sudden death and serious cardiovascular adverse events” (Food and Drug Administration 2005). The risk of fatal toxicity from lithium carbonate, a not uncommon treatment for bipolar disorder, has been well documented since the 1950s. Incidents of fatal seizures from sedative-hypnotics, especially when mixed with alcohol, have been recorded since the 1920s.
Psychotropics carry nonfatal risks as well. Physical dependence and severe withdrawal symptoms are associated with virtually all psychoactive drugs. Psychological addiction is axiomatic. Concomitant side effects range from unpleasant to devastating, including: insulin resistance, narcolepsy, tardive dyskenisia (a movement disorder affecting 15–20 percent of antipsychotic patients where there are uncontrolled facial movements and sometimes jerking or twisting movements of other body parts), agranulocytosis (a reduction in white blood cells, which is life threatening), accelerated appetite, vomiting, allergic reactions, uncontrolled blinking, slurred speech, diabetes, balance irregularities, irregular heartbeat, chest pain, sleep disorders, fever, and severe headaches. The attempt to control these side effects has resulted in many children taking as many as eight additional drugs every day, but in many cases, this has only compounded the problem. Each “helper” drug produces unwanted side effects of its own.
The child drug market has also spawned a vigorous black market in high schools and colleges, particularly for stimulants. Students have learned to fake the symptoms of ADD in order to obtain amphetamine prescriptions that are subsequently sold to fellow students. Such “shopping” for prescription drugs has even spawned a new verb. The practice is commonly called “pharming.” A 2005 report from the Partnership for a Drug Free America, based on a survey of more than 7,300 teenagers, found one in ten teenagers, or 2.3 million young people, had tried prescription stimulants without a doctor’s order, and 29 percent of those surveyed said they had close friends who have abused prescription stimulants.
In a larger sense, the whole undertaking has had the disturbing effect of making drug use an accepted part of childhood. Few cultures anywhere on earth and anytime in the past have been so willing to provide stimulants and sedative-hypnotics to their offspring, especially at such tender ages. An entire generation of young people has been brought up to believe that drug-seeking behavior is both rational and respectable and that most psychological problems have a pharmacological solution. With the ubiquity of psychotropics, children now have the means, opportunity, example, and encouragement to develop a lifelong habit of self-medicating.
Common population estimates include at least eight million children, ages two to eighteen, receiving prescriptions for ADD, ADHD, bipolar disorder, autism, simple depression, schizophrenia, and the dozens of other disorders now included in psychiatric classification manuals. Yet sixty years ago, it was virtually impossible for a child to be considered mentally ill. The first diagnostic manual published by American psychiatrists in 1952, DSM-I, included among its 106 diagnoses only one for a child: Adjustment Reaction of Childhood/Adolescence. The other 105 diagnoses were specifically for adults. The number of children actually diagnosed with a mental disorder in the early 1950s would hardly move today’s needle. There were, at most, 7,500 children in various settings who were believed to be mentally ill at that time, and most of these had explicit neurological symptoms.
Of course, if there really are one thousand times as many kids with authentic mental disorders now as there were fifty years ago, then the explosion in drug prescriptions in the years since only indicates an appropriate medical response to a newly recognized pandemic, but there are other possible explanations for this meteoric rise. The last fifty years has seen significant social changes, many with a profound effect on children. Burgeoning birth rates, the decline of the extended family, widespread divorce, changing sexual and social mores, households with two working parents — it is fair to say that the whole fabric of life took on new dimensions in the last half century. The legal drug culture, too, became an omnipresent adjunct to daily existence. Stimulants, analgesics, sedatives, decongestants, penicillins, statins, diuretics, antibiotics, and a host of others soon found their way into every bathroom cabinet, while children became frequent visitors to the family physician for drugs and vaccines that we now believe are vital to our health and happiness. There is also the looming motive of money. The New York Times reported in 2005 that physicians who had received substantial payments from pharmaceutical companies were five times more likely to prescribe a drug regimen to a child than those who had refused such payments.
So other factors may well have contributed to the upsurge in psychiatric diagnoses over the past fifty years. But even if the increase reflects an authentic epidemic of mental health problems in our children, it is not certain that medication has ever been the right way to handle it. The medical “disease” model is one approach to understanding these behaviors, but there are others, including a hastily discarded psychodynamic model that had a good record of effective symptom relief. Alternative, less invasive treatments, too, like nutritional treatments, early intervention, and teacher and parent training programs were found to be at least as effective as medication in long-term reduction of a variety of symptoms (of ADHD, The MTA Cooperative Group 1999).
Nevertheless, the medical-pharmaceutical alliance has largely shrugged off other approaches and scoffed at the potential for conflicts of interest and continues to medicate children in ever-increasing numbers. With the proportion of diagnosed kids growing every month, it may be time to take another look at the practice and soberly reflect on whether we want to continue down this path. In that spirit, it is not unreasonable to ask whether this exponential expansion in medicating children has another explanation altogether. What if children are the same as they always were? After all, virtually every symptom now thought of as diagnostic was once an aspect of temperament or character. We may not have liked it when a child was sluggish, hyperactive, moody, fragile, or pestering, but we didn’t ask his parents to medicate him with powerful chemicals either. What if there is no such thing as mental illness in children (except the small, chronic, often neurological minority we once recognized)? What if it is only our perception of childhood that has changed? To answer this, we must look at our history and at our nature.
The human inclination to use psychoactive substances predates civilization. Alcohol has been found in late Stone Age jugs; beer may have been fermented before the invention of bread. Nicotine metabolites have been found in ancient human remains and in pipes in the Near East and Africa. Knowledge of Hul Gil, the “joy plant,” was passed from the Sumerians, in the fifth millennium b.c.e., to the Assyrians, then in serial order to the Babylonians, Egyptians, Greeks, Persians, Indians, then to the Portuguese who would introduce it to the Chinese, who grew it and traded it back to the Europeans. Hul Gil was the Sumerian name for the opium poppy. Before the Middle Ages, economies were established around opium, and wars were fought to protect avenues of supply.
With the modern science of chemistry in the nineteenth century, new synthetic substances were developed that shared many of the same desirable qualities as the more traditional sedatives and stimulants. The first modern drugs were barbiturates — a class of 2,500 sedative/hypnotics that were first synthesized in 1864. Barbiturates became very popular in the U.S. for depression and insomnia, especially after the temperance movement resulted in draconian anti-drug legislation (most notoriously Prohibition) just after World War I. But variety was limited and fears of death by convulsion and the Winthrop drug-scare kept barbiturates from more general distribution.
Stimulants, typically caffeine and nicotine, were already ubiquitous in the first half of the twentieth century, but more potent varieties would have to wait until amphetamines came into widespread use in the 1930s. Amphetamines were not widely known until the 1920s and 1930s when they were first used to treat asthma, hay fever, and the common cold. In 1932, the Benzedrine Inhaler was introduced to the market and was a huge over-the-counter success. With the introduction of Dexedrine in the form of small, cheap pills, amphetamines were prescribed for depression, Parkinson’s disease, epilepsy, motion sickness, night-blindness, obesity, narcolepsy, impotence, apathy, and, of course, hyperactivity in children.
Amphetamines came into still wider use during World War II, when they were given out freely to GIs for fatigue. When the GIs returned home, they brought their appetite for stimulants to their family physicians. By 1962, Americans were ingesting the equivalent of forty-three ten-milligram doses of amphetamine per person annually (according to FDA manufacturer surveys).
Still, in the 1950s, the family physician’s involvement in furnishing psychoactive medications for the treatment of primarily psychological complaints was largely sub rosa. It became far more widespread and notorious in the 1960s. There were two reasons for this. First, a new, safer class of sedative hypnotics, the benzodiazepines, including Librium and Valium, were an instant sensation, especially among housewives who called them “mothers’ helpers.” Second, amphetamines had finally been approved for use with children (their use up to that point had been “off-label,” meaning that they were prescribed despite the lack of FDA authorization).
Pharmaceutical companies, coincidentally, became more aggressive in marketing their products with the tremendous success of amphetamines. Valium was marketed directly to physicians and indirectly through a public relations campaign that implied that benzodiazepines offered sedative/hypnotic benefits without the risk of addiction or death from drug interactions or suicide. Within fifteen years of its introduction, 2.3 billion Valium pills were being sold annually in the U.S. (Sample 2005).
So, family physicians became society’s instruments: the suppliers of choice for legal mood-altering drugs. But medical practitioners required scientific authority to protect their reputations, and the public required a justification for its drug-seeking behavior. The pharmaceutical companies were quick to offer a pseudo scientific conjecture that satisfied both. They argued that neurochemical transmitters, only recently identified, were in fact the long sought after mediators of mood and activity. Psychological complaints, consequently, were a function of an imbalance of these neural chemicals that could be corrected with stimulants and sedatives (and later antidepressants and antipsychotics). While the assertion was pure fantasy without a shred of evidence, so little was known about the brain’s true actions that the artifice was tamely accepted. This would later prove devastating when children became the targets of pharmaceutical expansion.
With Ritalin’s FDA approval for the treatment of hyperactivity in children, the same marketing techniques that had been so successful with other drugs were applied to the new amphetamine. Pharmaceutical companies had a vested interest in the increase in sales; they spared no expense in convincing physicians to prescribe them. Cash payments, stock options, paid junkets, no-work consultancies, and other inducements encouraged physicians to relax their natural caution about medicating children. Parents also were targeted. For example, CIBA, the maker of Ritalin, made large direct payments to parents’ support groups like CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder) (The Merrow Report 1995). To increase the acceptance of stimulants, drug companies paid researchers to publish favorable articles on the effectiveness of stimulant treatments. They also endowed chairs and paid for the establishment of clinics in influential medical schools, particularly ones associated with universities of international reputation. By the mid 1970s, more than half a million children had already been medicated primarily for hyperactivity.
The brand of psychiatry that became increasingly popular in the 1980s and 1990s did not have its roots in notions of normal behavior or personality theory; it grew out of the concrete, atheoretical treatment style used in clinics and institutions for the profoundly disturbed. German psychiatrist Emil Kraepelin, not Freud, was the God of mental hospitals, and pharmaceuticals were the panacea. So the whole underlying notion of psychiatric treatment, diagnosis, and disease changed. Psychiatry, which had straddled psychology and medicine for a hundred years, abruptly abandoned psychology for a comfortable sinecure within its traditional parent discipline. The change was profound.
People seeking treatment were no longer clients, they were patients. Their complaints were no longer suggestive of a complex mental organization, they were symptoms of a disease. Patients were not active participants in a collaborative treatment, they were passive recipients of symptom-reducing substances. Mental disturbances were no longer caused by unique combinations of personality, character, disposition, and upbringing, they were attributed to pre-birth anomalies that caused vague chemical imbalances. Cures were no longer anticipated or sought; mental disorders were inherited illnesses, like birth defects, that could not be cured except by some future magic, genetic bullet. All that could be done was to treat symptoms chemically, and this was being done with astonishing ease and regularity.
In many ways, children are the ideal patients for drugs. By nature, they are often passive and compliant when told by a parent to take a pill. Children are also generally optimistic and less likely to balk at treatment than adults. Even if they are inclined to complain, the parent is a ready intermediary between the physician and the patient. Parents are willing to participate in the enforcement of treatments once they have justified them in their own minds and, unlike adults, many kids do not have the luxury of discontinuing an unpleasant medication. Children are additionally not aware of how they ought to feel. They adjust to the drugs’ effects as if they are natural and are more tolerant of side effects than adults. Pharmaceutical companies recognized these assets and soon were targeting new drugs specifically at children.
But third-party insurance providers balked at the surge in costs for treatment of previously unknown, psychological syndromes, especially since unwanted drug effects were making some cases complicated and expensive. Medicine’s growing prosperity as the purveyor of treatments for mental disorders was threatened, and the industry’s response was predictable. Psychiatry found that it could meet insurance company requirements by simplifying diagnoses, reducing identification to the mere appearance of certain symptoms. By 1980, they had published all new standards.
Lost in the process was the fact that the redefined diagnoses (and a host of new additions) failed to meet minimal standards of falsifiability and differentiability. This meant that the diagnoses could never be disproved and that they could not be indisputably distinguished from one another. The new disorders were also defined as lists of symptoms from which a physician could check off a certain number of hits like a Chinese menu, which led to reification, an egregious scientific impropriety. Insurers, however, with their exceptions undermined and under pressure from parents and physicians, eventually withdrew their objections. From that moment on, the treatment of children with powerful psychotropic medications grew unchecked.
As new psychotropics became available, their uses were quickly extended to children despite, in many cases, indications that the drugs were intended for use with adults only. New antipsychotics, the atypicals, were synthesized and marketed beginning in the 1970s. Subsequently, a new class of antidepressants like Prozac and Zoloft was introduced. These drugs were added to the catalogue of childhood drug treatments with an astonishing casualness even as stimulant treatment for hyperactivity continued to burgeon.
In 1980, hyperactivity, which had been imprudently named “minimal brain dysfunction” in the 1960s, was renamed Attention Deficit Disorder in order to be more politic, but there was an unintended consequence of the move. Parents and teachers, familiar with the name but not always with the symptoms, frequently misidentified children who were shy, slow, or sad (introverted rather than inattentive) as suffering from ADD. Rather than correct the mistake, though, some enterprising physicians responded by prescribing the same drug for the opposite symptoms. This was justified on the grounds that stimulants, which were being offered because they slowed down hyperactive children, might very well have the predicted effect of speeding up under-active kids. In this way, a whole new population of children became eligible for medication. Later, the authors of DSM-III memorialized this practice by renaming ADD again, this time as ADHD, and redefining ADD as inattention. Psychiatry had reached a new level: they were now willing to invent an illness to justify a treatment. It would not be the last time this was done.
In the last twenty years, a new, more disturbing trend has become popular: the re-branding of legacy forms of mental disturbance as broad categories of childhood illness. Manic depressive illness and infantile autism, two previously rare disorders, were redefined through this process as “spectrum” illnesses with loosened criteria and symptom lists that cover a wide range of previously normal behavior. With this slim justification in place, more than a million children have been treated with psychotropics for bipolar disorder and another 200,000 for autism. A recent article in this magazine “The Bipolar Bamboozle” (Flora and Bobby 2008) illuminates how and why an illness that once occurred twice in every 100,000 Americans, has been recast as an epidemic affecting millions.
To overwhelmed parents, drugs solve a whole host of ancillary problems. The relatively low cost (at least in out-of-pocket dollars) and the small commitment of time for drug treatments make them attractive to parents who are already stretched thin by work and home life. Those whose confidence is shaken by indications that their children are “out of control” or “unruly” or “disturbed” are soothed by the seeming inevitability of an inherited disease that is shared by so many others. Rather than blaming themselves for being poor home managers, guardians with insufficient skills, or neglectful caretakers, parents can find comfort in the thought that their child, through no fault of theirs, has succumbed to a modern and widely accepted scourge. A psychiatric diagnosis also works well as an authoritative response to demands made by teachers and school administrators to address their child’s “problems.”
Once a medical illness has been identified, all unwanted behavior becomes fruit of the same tree. Even the children themselves are often at first relieved that their asocial or antisocial impulses reflect an underlying disease and not some flaw in their characters or personalities.
Conclusions In the last analysis, childhood has been thoroughly and effectively redefined. Character and temperament have been largely removed from the vocabulary of human personality. Virtually every single undesirable impulse of children has taken on pathological proportions and diagnostic significance. Yet, if the psychiatric community is wrong in their theories and hypotheses, then a generation of parents has been deluded while millions of children have been sentenced to a lifetime of ingesting powerful and dangerous drugs.
Considering the enormous benefits reaped by the medical community, it is no surprise that critics have argued that the whole enterprise is a cynical, reckless artifice crafted to unfairly enrich them. Even though this is undoubtedly not true, physicians and pharmaceutical companies must answer for the rush to medicate our most vulnerable citizens based on little evidence, a weak theoretical model, and an antiquated and repudiated philosophy. For its part, the scientific community must answer for its timidity in challenging treatments made in the absence of clinical observation and justified by research of insufficient rigor performed by professionals and institutions whose objectivity is clearly in question, because their own interests are materially entwined in their findings.
It should hardly be necessary to remind physicians that even if their diagnoses are real, they are still admonished by Galen’s dictum Primum non nocere, or “first, do no harm.” If with no other population, this ought to be our standard when dealing with children. Yet we have chosen the most invasive, destructive, and potentially lethal treatment imaginable while rejecting other options that show great promise of being at least as effective and far safer. But these other methods are more expensive, more complicated, and more time-consuming, and thus far, we have not proved willing to bear the cost. Instead, we have jumped at a discounted treatment, a soft-drink-machine cure: easy, cheap, fast, and putatively scientific. Sadly, the difference in price is now being paid by eight million children.
Mental illness is a fact of life, and it is naïve to imagine that there are not seriously disturbed children in every neighborhood and school. What is more, in the straitened economy of child rearing and education, medication may be the most efficient and cost effective treatment for some of these children. Nevertheless, to medicate not just the neediest, most complicated cases but one child in every ten, despite the availability of less destructive treatments and regardless of doubtful science, is a tragedy of epic proportions.
What we all have to fear, at long last, is not having been wrong but having done wrong. That will be judged in a court of a different sort. Instead of humility, we continue to feed drugs to our children with blithe indifference. Even when a child’s mind is truly disturbed (and our standards need to be revised drastically on this score), a treatment model that intends to chemically palliate and manage ought to be our last resort, not our first option. How many more children need to be sacrificed for us to see the harm in expediency, greed, and plain ignorance?
Schafer Autism Review
http://www.sarnet.org/lib/todaySAR.htm