Drugs are on the rise. They are in the news, the media, and have even found their way into affecting other platforms. Of the many types of drugs to be worried about, psychostimulants should definitely make the list. They are chemicals or substances that are used to stimulate the central nervous system. It sounds like something that would not be of interest to many people. For the most part, we would not advocate the chronic use of cocaine. However, what about caffeine—the most widely consumed drug in the world? (U.S. Nat. Library 1998). What about amphetamine use in children? ADHD, a disorder commonly treated with amphetamines, is impacting approximately eleven percent of children in the United States (Calabria & Etnier 2015).
I am going to be discussing why this is concerning by exploring the treatment options for one common disorder in children, ADHD, and how treatment with psychostimulants can create dependence by chronic use, why mediciaton may be preferred over therapy, and how therapy has shown that it is a worthy, and can even be a better competitor in treating this disorder in children.
What is ADHD?
The most common reason why children under the age of thirteen are prescribed psychostimulants is because of attention-deficit hyperactive disorder, ADHD. This neurodevelopmental disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition as: “a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by inattention and/or hyperactivity and impulsivity” (DSM-V 2013). The child’s teachers often first identify if the child may potentially have ADHD. There are no tests to confirm this diagnosis, it is only observed through behavior mainly by seeing that the child’s inability to focus is impacting schoolwork and the child’s day to day lifestyle.
Treatment Options
Treatment of ADHD is usually done through medication, psychotherapy, or both. The medication that is prescribed is usually amphetamines. There is concern about the potential long-term effects of this type of treatment, especially since millions of children are using it (Mental 2005). Commonly prescribed psychostimulants include: Ritalin, Dexedrine, Adderall, Concerta, and Vyvance (Haggerty 2013). Dependence is a major problem associated with the intake of psychostimulants (U.S. National Library of Medicine). Even if the doctor prescribes a very low dose of this drug, there is no guarantee that the child will not develop dependence. As the child grows up, the dependence can be negative to their lifestyle. The result of this dependence could be that the child may rely on psychostimulants to study or to do well in school and it is possible that it could affect their future negatively, for example: when they enter into the workforce. Thus, there are other ways to combat ADHD. There are many different tactics that can be applicable to several children, since not all children are the same. Generally, the approach focuses on academic, behavioral, and emotional problems. It focuses on the beliefs that the child has, or how the child thinks, and attempts to retrain the brain so that the child can cope and focus on these things by themselves.
One alternative to psychostimulants is cognitive behavioral therapy. Generally, these forms of treatments seek to help the parent employ behavioral modification techniques at home as well as empower the child to control their impulses without the use of medication (Barkly, 1997; Haggerty 2013). This approach is a more emotional and involved one where the parents must be very supportive of their child. They must develop a good bond in order to help the child through attending sessions for behavior training. At these training sessions the parents will learn how to deal with their child’s inattentiveness and bad behavior, making them more confident and transmitting that good feeling to their child (U.S. Dept. of Health). The downside is that the programs are not free but in many cases can be covered by insurance.
Many schools do understand that ADHD is a problem and offer their services to the child in many cases for free. If a child has ADHD and they continue to be in the public school system, then they can take advantage of a few of the programs that many schools offer. Luckily for them, there are programs in place that often include children with ADHD under the (IDEA) Individuals with Disabilities Education Act (U.S. Dept. of Health). Instead of having the parent, who might be busy at work, sit through all the different sessions, there are usually trained professionals at the schools who will help the students succeed. These education specialists will create (IEP) Individual Education Plan, with the help of parents and teachers, in order to help the child reach their maximum potential. These services are usually most widely used since they are free if you are in the public school system and they are offered at the child’s school (U.S. Dept. of Health).
Through some research regarding non-medication treatments on ADHD in children, it was found that a good moral support and dedication from the parents with therapy and attending sessions really helped to lower ADHD symptoms in the future (U.S. Dept. of Health). It was also studied that the frequency of parents attending therapy sessions is correlated with their children’s behavior and whether they improve or not. The more sessions the parents attend, then usually the more improvement the child with ADHD makes.
Medication is often seen as easier and quicker than behavioral therapy. There is an increased pressure on parents to control the disorder in their child as quickly as they can so that it does not impact their child’s schoolwork or allow them to fall behind. It is also much less expensive. With insurance, many psychostimulants are low cost or even free. Therapy is expensive and time consuming, which can be a turn off to some parents who are very busy and do not want to deal with the insurance companies.
What Next?
There are many disorders other than ADHD that children suffer from that are treated with psychostimulants. Currently, the focus is just trying to find some sort of treatment that will last long term so that the child can be treated without the fear of becoming addicted, dependent, or any other potentially negative long-term effects. The goal with an improved treatment of ADHD would be to find the root cause of it and to be able to fix the issues through studying it, so that psychostimulants would no longer be necessary. At the point we are at right now, it would be ridiculous to remove medication as a potential treatment option, however it should be much more heavily evaluated when it comes to prescribing it to the younger generation, and it would be ideal if other options were explored first before committing the child to psychostimulants.
References
Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychological bulletin, 121(1), 65.
Calabria, C., Etnier, J. (2015). The effect of acute exercise on cognitive performance in children with and without ADHD. Journal of Sport and Health Science. Retrieved from http://libres.uncg.edu/ir/uncw/listing.aspx?id=17787
Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.
Haggerty, J. (2013). Treatment of ADHD in Children. Psych Central. Retrieved on July 30, 2015, from http://psychcentral.com/lib/treatment-of-adhd-in-children/
Mental Health in the United States: Prevalence of Diagnosis and Medication Treatment for Attention-Deficit/Hyperactivity Disorder —United States, 2003. (2005, September 2). Retrieved July 30, 2015.
Thomas J. Spencer, Michael Greenbaum, Lawrence D. Ginsberg, and William Rory Murphy. (2009, October) Journal of Child and Adolescent Psychopharmacology. Retrieved from 19(5): 501-510
U.S. Department of Health and Human Services (2012, June 26). Treatment Options for ADHD in Children and Teens: A Review of Research for Parents and Caregivers . Retrieved from http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?productid=1148&pageaction=displayproduct.
U.S. National Library of Medicine (2013, August 1). Efficacy of psychostimulant drugs for amphetamine abuse or dependence . Retrieved from: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0058557/.
U.S. National Library of Medicine (1998, December 16) Is caffeine addictive? The most widely used psychoactive substance in the world affects same part of the brain as cocaine. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9889511