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Kids' Calming Stimulants Not Abused

ADHD drugs are mainly used correctly in schools, says government report

FRIDAY, Sept. 28 (HealthDayNews) - The increased use of stimulants to treat attention-deficit hyperactivity disorder (ADHD) in growing numbers of children has not resulted in abuse of the drugs in schools, a government investigation has concluded.

Fewer than 10 percent of middle and high school principals interviewed could recall any case of such ADHD drugs as Ritalin being abused. The report also found that only 2 percent of school kids receive daily medication for ADHD in school.

"Schools are aware that these drugs could be a problem, and they have taken many measures to see that problems don't happen under their watch," says one of the report's authors, Monica Kelly, a senior analyst with the U.S. General Accounting Office (GAO) in Los Angeles, Calif.

A government report last year found that some kids in middle schools and high schools in large cities were abusing Ritalin, either by swallowing it or crushing it and snorting it. There have also been reports of users injecting it, or mixing it with both cocaine and heroin before taking it.

Ritalin (methylphenidate) stimulates the central nervous system; it's stronger than caffeine but weaker than amphetamines. It can only be bought with a prescription, and the Drug Enforcement Agency reports that it is among the top 10 controlled drugs that are stolen.

For this latest report, the GAO researchers gathered their information from 735 public schools across the United States. Most schools said that they only allow a nurse to give out drugs, and that they store the drugs in a locked cabinet or room. Most also observe the students as they take their medication.

Experts, however, were quick to point out a problem with this report: Many of these drugs are taken once-a-day, and parents give them to the kids at home, which means that school nurses and principals can't observe the procedure.

Depending on which study you believe, ADHD affects between 2 percent and 18 percent of all children, reports the GAO. The National Institutes of Mental Health (NIMH) puts the number around 4 percent for those between the ages of 9 and 17. But whatever the total, one thing has been acknowledged: Since 1990, the number of children taking stimulants for ADHD has, by some accounts, almost quadrupled.

Kids with ADHD have trouble concentrating or paying attention and are often impulsive and hyperactive. They also have a higher rate of injury than other children, according to the NIMH.

But trying to pin down the number of kids who are taking these drugs is as difficult as figuring out how many children actually have the disorder.

The GAO report says that just under 2 percent of youngsters are being medicated in middle school and high school every day. Other studies have put that number as high as 11 percent.

"The good news is that the anti-medication zealots are wrong. Now we have hard evidence that there is no overuse in school," says Ellen Kingsley, founder of ADDitude and mother of an ADHD son.

But, she adds, the GAO finding that only 2 percent of kids are getting medications in school means that many children who need them aren't getting the drugs.

"ADHD remains an underdiagnosed and undertreated disorder, as well as an extremely disabling disorder for children," she adds.

Dr. Jerry Rushton, a clinical lecturer at the University of Michigan, recently presented a study to the Pediatric Academic Societies and the American Academy of Pediatrics in which he found that 10.7 percent of children between 6 and 14 years old are taking ADHD medications.

Asked about the GAO's report, Rushton says, "One important item to consider relative to school dispensing is that many medications are once-a-day, sustained-release formulations that are not taken to school because they are given at home in the morning." So, the number of kids taking ADHD medication could be higher than reported by the school principals, he says.

Rushton agrees, however, with the GAO's conclusion that abuse of these drugs is a fairly small problem considering the large number of prescriptions for them.

What To Do

To learn more about ADHD, read this article from the National Institute of Mental Health, or this one from PBS' News Hour.

ADHD can persist into adulthood if untreated. To learn more about ADHD, visit the Children and Adults with Attention-Deficit/Hyperactivity Disorder.

For more on Ritalin, try this National Institute on Drug Abuse fact sheet.

SOURCES: Interviews with Monica Kelly, senior analyst, U.S. Government Accounting Office, Los Angeles, Calif.; Ellen Kingsley, founder, ADDitude Foundation, Houston, Texas; Jerry Rushton, M.D., clinical lecturer, University of Michigan Medical School, Ann Arbor; September 2001 GAO report
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