Abstract
A definition of ADHD and its symptoms are given. Adults are now being diagnosed with ADHD. Statistics of the rising number of children and adults diagnosed with ADHD are given. Assessment of the disorder, and the role of the doctors, teachers, and parents is discussed. Ritalin is the drug of choice for those diagnosed with ADHD. Harmful side effects of this drug are given and alternatives to medication are also discussed. Drug abuse of Ritalin is now being reported. Children are using Ritalin as a recreational drug by snorting it like cocaine.

ADHD And The Ritalin Crisis
Attention Deficit Hyperactivity Disorder (ADHD) is one of the fastest growing illnesses in America today. It effects children and adults alike. Methylphendiate Hydrochloride (Ritalin) is the drug prescribed most for this condition. A thorough assessment of the problem is critical in order to diagnose the problem and avoid an improper dosage which can lead to overdosing. There are many side effects to consider before taking this drug. Unfortunately, Ritalin is being used by children today as a recreational drug the same way that cocaine is used. There are alternatives besides Ritalin to treat ADHD.

What Is Attention Deficit Hyperactivity Disorder?
ADHD, also known as ADD, was first recognized in 1980 and is considered to be a mental disorder. This qualifies the child for special treatment under the Americans with Disabilities Act. Approximately three million children in America are said to have ADHD. In 1985, ten boys were diagnosed with ADHD to every one girl. Since then, the gap has gotten smaller. In 1995, five boys were diagnosed to every one girl.

The causes for ADHD are unknown. Some believe that it comes from a genetic dysfunction, more likely a short circuit in the brain. Others believe that it could be caused by the pregnant mother's use of cigarettes, alcohol, and illicit drugs. It could also be caused from factors in the environment like lead, mercury, cadmium, insecticides, and herbicides, overprocessing of food additives, sugar, and allergies to foods such as milk, wheat, and corn. Research has found that identical twins are both diagnosed with ADHD 51% of the time and fraternal twins 33% of the time therefore, the problem could be genetic. There is no strong evidence to support any of these claims.

Symptoms of ADHD are inattentiveness, impulsiveness, hyperactivity, and talkativeness. Students seldom complete homework, class assignments, exams, or projects in the time period required. They are usually disorganized, forgetful, and have a hard time following the rules. The symptoms are usually revealed by the age of seven; however, a growing number of adults are being diagnosed with the disorder as well.

What is Ritalin
Ritalin is used in 90% of all cases diagnosed with ADHD. Ritalin is an amphetamine. It comes in a tablet form, in regular and sustained released formulas. It is recommended that it be taken twice a day, usually at breakfast and lunch. Ritalin is the drug of choice for those diagnosed with ADHD. In 1993, children in America consumed three times as much Ritalin as the children in the rest of the world. Most of the children taking Ritalin are males. Ciba-Geigy Corporation is the company that manufactures Ritalin. Each year they produce 8.5 tons of Ritalin, of which 90% is consumed by the United States. The average cost of Ritalin is about $9.45 per week.
Assessment

Psychiatrists have found it very difficult to diagnose ADHD; the symptoms are close to mania and depression. Proper assessment is critical because the wrong diagnosis can cause additional problems and the wrong prescription can have little or no effect on the problem. Physicians are the ones responsible for diagnosing ADHD and deciding on the dosage level of Ritalin to give a child. They should spend quality time getting to know their client. The sad thing is that this amount of assessment time is rarely ever done. It has been shown that 50% of all physicians spend an hour or less diagnosing a child and prescribing medication for them. In addition to that, most physicians do not properly monitor the medication they prescribe.

The school psychologist, physician, teacher and parents should all be involved in the assessment of the disorder. Interviews should be done in detail with the parents, teacher and the child. Intelligence and achievement tests should also be given and evaluated. A thorough medical examination should be given to establish the medical history of the child and family. Ritalin should not be given to anyone who has a family history of tics or Tourette's Syndromes, hearing problems, glaucoma, or other visual problems. One of the most important parts of the assessment process is the interview with the child. It is important for the doctor to know the circumstances and their development that may have caused the symptoms. The doctor should look for whether the child is experiencing depression, anxiety, or hallucinations. The teacher and the parents should also fill out questionnaires about the child to help in a valid assessment.

Once it has been determined that the child has ADHD, it is important for the doctor to prescribe the proper dosage level he believes the child needs. After the drug has been administered, a close evaluation must be made as to the effect it is having on the child. There are teacher and parent rating scales that are used on a weekly basis to measure these effects. The evaluation is most effective when the child is doing individual work because that is when the problem is the most noticeable. Some of the things that the teacher observes are academic performance, classroom behavior, and organization. The results of these evaluations are to find out whether the medication is working properly and whether the child is experiencing any side effects. This is particularly important because doctors cannot seem to agree on dosage levels. If a child happens to be diagnosed with a dosage level that is too high, Ritalin can cause over-focusing and have an adverse effect in learning ability. If a child tends to get tense, anxious, agitated, or is under stress, Ritalin could aggravate these conditions.

Teachers have been given a tremendous responsibility with these children. They have had to become more educated in the study of ADHD. They are responsible to administer the drugs to the children before lunch every day. It is the teachers responsibility for the child to succeed in school. Classrooms have become more and more unmanageable for the teachers. Kids are under so much pressure to succeed. Instead of playing and being creative in school while learning, like the past generations did, creativity, music, and even recess are slowly being removed from schools. Kids are now into computers and so much more is expected from them. The diagnosis of ADHD and the administration of Ritalin seems to be a "quick-fix" for these problems and helps the teacher resume control of the classroom. Most of the symptoms of ADHD reveal normal child-like behavior. We are expecting children to behave as adults when they haven't had the opportunity to be children. Child development at a normal pace is important to the development of a mature adult.

Peter R. Breggin, M.D., Director of the International Center for the Study of Psychiatry and Psychology, and Associate Faculty Member at the John Hopkins University, Department of Counseling, recently wrote a book, titled Talking Back To Ritalin. In it he says, "ADHD does not reflect children's attention deficits, but our lack of attention to their needs. The true information about Ritalin is kept from parents and teachers in order to promote the sale of the drugs. Drug companies have targeted children as a big market likely to boost profits, and the children are suffering as a result. We need to educate - not medicate."
Side Effects Caused By Ritalin

There are many side effects caused by Ritalin, some of which are frightening. A parent should be aware of these possibilities and question whether this drug is something they should really be giving their children. Ritalin can cause a decrease of the blood flow to the brain; it can cause gross malfunctions in the development of the brain as well. Research has found that it can cause atrophy, which is shrinkage of the brain, and other physical abnormalities that are permanent. Ritalin can cause growth retardation, a loss of appetite and weight loss; it can cause increases of the heart rate, blood pressure, body temperature and respiration; it can cause skin rashes, irritability, nervousness, anxiousness, insomnia, headaches, stomachaches, nausea and dizziness. Ritalin has been known to cause emotional problems, depression, and a proneness to crying. It can cause a child to become robotic, withdrawn, lethargic, and even suppress creative ability. About one third of all children taking Ritalin experience what is called "behavioral rebound," which causes an increase in the very behaviors the drug is supposed to be treating. This generally occurs late in the afternoon or evening after the medication begins to wear off. An additional dose is recommended late in the afternoon if the behavior is a problem.

Ritalin can cause more serious side effects such as neurological tics that are permanent, including Tourette's Syndrome. Other serious side effects are confusion, extreme anxiety, difficulty breathing, and vomiting. Research has proven that Ritalin can cause cancer in some laboratory animals; the FDA has not taken this seriously. Ritalin has been found to cause addiction and dependency when taken over a long period of time and in excessive doses. It is recommended that children take a "drug holiday" on weekends and family vacations. Experiencing these serious side effects could show that the dosage being taken is too high.

What Ritalin Can And Cannot Do For You
Ritalin does have some benefits, if you want to risk the side effects. A chemical in the brain, called dopamine, is believed to be increased with the use of Ritalin. People with ADHD are thought to have a shortage of this chemical. Ritalin helps to improve attention, concentration, and performance. Children are better able to complete homework, follow directions easier, and their behavior in the classroom improves; they are less aggressive and more accepted by their peers.

Ritalin is a temporary fix; it does not improve or heal the problem long term; it does not help you deal with stress, anxiety, or anger; it does not teach you how to relax, deal with transition periods, or rebound effects. Once the drug wears off, the problem returns. In order to get the results, you must keep taking the drug.
Ritalin Abuse

Until 1980, ADHD wasn't even heard of. In 1996, the University of Wisconsin performed a survey with three hundred and ninety six teachers who had students diagnosed with ADHD. The results showed that 40% were elementary school students, 32% junior high, and 15 % high school. 66% of them were using Ritalin to treat the disorder. Recently, psychiatrists have discovered that ADHD can be carried over from childhood or discovered in adults. It is estimated that six to nine and a half million adults have ADHD. In 1992, the number of adults diagnosed with ADHD was 217,000. In 1998, it is expected that 729,000 adults will be diagnosed with ADHD and receive prescriptions for Ritalin. In the last few years, the number of children who are now taking Ritalin has multiplied several times. There have been many questions as to whether or not this illness is overdiagnosed.

What are we teaching our children by this rising distribution of Ritalin? We are giving double messages when we tell them to "just say no to drugs" and then turn around and give them Ritalin to help them cope with the problems they are having. Carl L. Kline, a child psychiatrist, believes that "Ritalin is nothing more than a street drug given to our children because we don't know what is going on with them." We are teaching our children to abuse drugs. Children are lining up at school and the teachers are giving them their daily doses of amphetamines. Most of these problems could possibly be taken care of if things were dealt with at home. When we deal with the emotional problems of children by giving them drugs, we teach them that in order to cope you need to take drugs.

We are teaching children to become dependent on drugs to succeed. Christi Rade, a 16 year old student, shared that Ritalin really made a difference in her grades and without it she is unable to pay attention. Some people have been known to stop taking Ritalin after experiencing a false sense of success and confidence. Tyler Buch, a college student, had a grade point average (GPA) of 1.8. After taking Ritalin for a year and a half, his GPA rose to 3.3. He decided to stop taking Ritalin; his GPA went way down and he dropped out of college.

The signs of abuse are beginning to reveal themselves. One of the most frightening things about the drug Ritalin is that it is becoming a recreational drug, much like cocaine. It is scary to note that Ritalin and cocaine are similar in their psychopharmocology, meaning that the effect these drugs have on the mind and behavior are the same. Many say that Ritalin is not addictive and it is difficult to overdose on Ritalin because it only stays in the blood stream for four hours. The reality is, too much of anything over a period of time can be addictive; and too much of anything at one time can cause major problems, including overdose.

Some overdose signs and symptoms to watch out for are vomiting, nausea, hallucinations, confusion, severe headache, high fever, extreme anxiety, delirium, sweating, enlarging of the eye's pupil, euphoria, redness of the face, hands and other extremities, uncontrollable muscle twitching, irregular or rapid heartbeat or breathing, convulsions (sometimes followed by a coma), and dryness of the mouth and nose.

Ritalin abuse is increasing. If you don't think we are giving kids the wrong message, here is a startling report. The DEA and the U.N. International Narcotics Control Board are concerned about the fact that there have been incidents of teenagers who are selling their Ritalin to other kids, crushing the pills into powder, and snorting it like cocaine. On April 24, 1995, in Virginia, a 19 year old boy, reportedly snorted Ritalin at a party and then died; a sad, but true story. Another sign of Ritalin abuse is that doctors recommend giving children the drug to prevent them from having sleeping problems. This conditions them to believe they need drugs to help them sleep.

It is a fact that children who have ADHD and are treated with Ritalin have been known to be kept out of the armed services. Because of the number of males taking this amphetamine, this is a frightening possibility if we were ever faced with war. Possible reasons for this could be that Ritalin has been known to increase the behavioral problems that it is supposed to decrease. Ritalin abuse has been known to lead to psychotic episodes, violent behavior, and severe psychological dependence. As a result, in March 1996, a campaign to reduce abuse was launched by the manufacturers of Ritalin. This campaign did a nationwide mailing to doctors and pharmacists. Unfortunately, it wasn't sent to teachers, parents, or children. We should be educating our children on the dangers of taking drugs of all kinds.

Alternatives to Medication
There are alternatives that can be taken besides Ritalin. Some doctors have chosen to treat ADHD by improving the child's diet. The best food solution is a well balanced diet in addition to taking good vitamin and mineral supplements, preferably food form supplements - not synthetic. Chiropractors believe that a misaligned spine and skull can cause some of these problems; therefore, chiropractic care can be a good alternative. Biofeedback, nuerofeedback, integrative sensory training, and music therapy have also been known to help. Since many of the child's behavior problems may be cause by their life at home, individual and family therapy may be very beneficial. Since ADHD is considered a mental disorder, a good solution might be to design a school specifically for children with this disorder.

Conclusion
While none of these suggestions have proven to be totally effective, they sound more reasonable than putting a child on a drug that can cause serious side effects and conditioning them to become dependent on drugs for survival. We need to look inward to see what is causing these problems and deal with the emotional issues. Parents need to start paying more attention to their children, spending quality family time with them, and developing healthy relationships. Teachers should not have to have the pressure of administering drugs to our children. Our society is producing "Stepford children" by using drugs to control their behavior. It is important for parents to look deeply into this disorder called ADHD, the drug Ritalin, and the possibility of other treatment alternatives before making a decision. One of the most important things to know is that there is life beyond Ritalin.

References
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