Rates of ADHD, autism, bipolar and schizophrenia have all dramatically increased due to misdiagnosis.

2016

An Epidemic of ADHD
and other
misdiagnosed
childhood mental
illnesses.

How increasing academic requirements,

careless medical practices and
pharmaceutical industry influence have
fueled the rise of misdiagnosed
childhood mental illness.

The connection between over-

prescribed psychotropic drugs and
addiction, brain atrophy, violence and
death.

BJ Brown
MS in the Department of Kinesiology and Health Science Management
10/29/2016
 CONTENTS
Evolution of ADHD 4
Introduction 5
Diagnostic and Statistical Manual 9
Definition 13
Children and Adults with Attention-Deficit/Hyperactivity Disorder 15
Schedules 18
Pre K - Kindergarten 18
Elementary 19
Middle School 21
High School 23
Guidelines 29
Homework 29
Colleges 31
Results and Remedies 32
Side Effects 34
Psychotropic Drugs and Violence 48
Pharmaceutical Companies 57
Funding 68
Concerns 74
Doctors' Opinions 76
Foster Care, Doctors and Corruption 80
Consequences 85
Conclusion 97
Answers 101

2
ADHD EVOLUTION TO EPIDEMIC

In 2011, the Centers for Disease Control (CDC) reported that the incidence of attention-

deficit/hyperactivity disorder (ADHD) in children ages 4 to 17 years was 11%, with 6.4 million children

diagnosed with the condition and 4.2 million taking psycho stimulants. These findings represent an alarming

increase from 30 years ago, when the rate of ADHD was estimated at between 3% and 5%.1 However, only

about 1%-2% qualifies as actual ADHD. More than 20% of boys and 10% of girls have been diagnosed with

the mental illness ADHD.2 One-third of boys in certain areas of Virginia have received this diagnosis.3 This

label and medication use disqualifies them from military service.4 The cause of this epidemic is threefold: 1)

over-diagnosis driven by corruption, careless evaluation and societal pressure for treatment; 2) a significant

increase in the demands placed upon our children, schools, and families through No Child Left Behind (NCLB);

and 3) one of the most successful pharmaceutical marketing campaigns in US history which has been aided by

tainted research, kickbacks and false advertising/claims. These factors have combined to change society’s

perception of the normal child.

Government funding incentivizes public and private schools to apply the ADHD label to their students.

ADHD is the second most prevalent childhood disease after obesity. Unskilled pediatricians render a diagnosis

and prescribe a psycho stimulant. Teachers are demanding it of parents; stressed parents are yielding to the

demand. However, many medical providers do not have the time, skill or resources to conduct a thorough

evaluation. In areas across the nation, one-third or more of children are reported to be taking psycho

stimulants because of academic pressure to succeed. ADHD in foster care children and Medicaid patients is

60% higher than the normal population due to corruption by drug makers, doctors and pharmacists. This

resulted in two of the largest healthcare fraud settlement recoveries in the history of the US Department of

Justice. Physicians must now seek pre-authorization through the states’ behavioral health agencies before

prescribing ADHD medications to children under the age of six. This requirement resulted from nearly 30,000

infants/toddlers being wrongly medicated.

3
Evolution of ADHD

Treating childhood behavioral problems such as ADHD with medications was unheard of prior to the

1960’s. In the 1970’s, pharmaceutical companies began marketing drugs to unsuspecting parents, schools,

doctors and agencies who were misinformed of the side effects. Parents were trying desperately to help their

ADHD-diagnosed children. These parents were persuaded to place them on psychostimulant drugs, not

realizing the long-term effects of these medications.5 Currently, millions of children are misdiagnosed and

forced into using these drugs in hopes of maneuvering through difficult school schedules and satisfying

demanding school expectations. In the meantime, the very organizations charged with helping families were

taking millions of dollars from drug companies while pushing their drugs. Drug companies’ reach goes well

beyond these seemingly benign organizations. Information in the Physician’s Desk Reference comes directly

from drug companies. Furthermore, 19 of the 27 psychiatrist-editors of the fourth and fifth editions of the

Diagnostic and Statistical Manual of Mental Disorders (DSM) had financial ties with pharmaceutical companies.

DSM classifications including ADHD contribute $25 billion in psychotropic drug sales every year in the US.6

Well-intended policies have exacerbated this problem. Public awareness is essential in combating this

epidemic. No Child Left Behind (NCLB) was designed to help all children succeed academically. However, its

focus on test grades resulted in many unintended consequences – PE, break and recess times were drastically

reduced or eliminated. Obesity is now the number one disease in American children, affecting 1 out of 3.

Academic standards were raised and children were sent home with more homework than ever before. When

children are saddled with 3 hours of homework as early as the third grade, the temptation to obtain an

Individualized Education Program (IEP) in order to reduce the workload can prove too great. The ADHD label

follows with its potentially life altering consequences.

While the Every Student Succeeds Act (ESSA) is being implemented to provide more flexibility and less

testing, it still does not address the long hours, lack of exercise and inadequate breaks. Children are left with

no breaks, no rights and working harder than adults. They are now given black label drugs, which are banned

in many countries due to serious life-altering side effects, as the fuel to complete their ten-to-twelve-hour days.

4
Introduction

What is causing the mislabeling of ADHD in children in Virginia and across the country? Due to drastic

changes in children’s academic and break schedules, they are being pushed beyond their ability. Children are

now pushed through excessive testing, class work and homework with a lack of breaks. Long hours and

excessive stress, without any adequate unstructured time, are promoting an unhealthy atmosphere. The

average child gets 20-minute lunch periods, which actually amount to 10 or 11 minutes in practice after waiting

in long lines and traveling to and from cafeterias. Restroom breaks are now discouraged with schedules so

tight. Punishments are given for spending too much time in the bathroom, causing a rise in encopresis and

urinary tract infections. When children become sick due to their overscheduled lives, they are pushed even

further behind. They must catch up with their current heavy workloads and make-up work. Children are

drowning in a sea of work as young as Kindergarten. This promotes depression, anxiety and hopelessness.

Suicide is the second leading cause of death for 10 - 24 year olds, according to the CDC, and the rise

started in 2002, coincidentally when NCLB was instituted.7 In the first three years after NCLB was

implemented, treatment visits for teens who self-injure doubled. Those numbers are expected to grow as life

becomes more complex for teenagers. Directors at self-injury treatment programs refer to this growth trend as

an epidemic that reaches even into middle schools.8

Immature children, who are usually the youngest in the class, are expected to keep up with these

increased expectations. When children cannot keep up or remain quiet, still and productive, ADHD is

diagnosed. A 2015 CDC report states, “About 2 million of the more than 6 million children with ADHD were

diagnosed as young children aged 2-5 years.”9

Children are expected to attend a full day of school, engage in after-school activities and complete

hours of homework. After-school sports, which provide their only source of exercise, have become

increasingly difficult for children to engage in due to excessive homework. This adult-like pace, coupled with

before- and after-school activities or daycare, leaves children with little or no opportunity to experience

unstructured down time. An employer would be in violation of child labor laws for imposing such a schedule on

5
young ones. Boys are far more likely to be diagnosed with ADHD. Children are now expected to sit quietly for

hours and refrain from any impulsive behavior involving expressions of opinion or child-like questioning. In

short, they are expected not to be what they are--children.

Turning around in one’s seat or even looking bored or inattentive is now grounds for ADHD labeling.

Children are labeled by teachers with a learning disability for leaving a book at home or just being

disorganized. For most children this level of robotic attention is unattainable. Adults now expect children to

maintain a level of attention and energy beyond human ability. Numerous international studies prove the

youngest students in their class grade are more likely to be misdiagnosed with ADHD.10 11 Furthermore,

children are now expected to excel in all subjects, to meet the demands of NCLB.

Adults could not possibly meet these standards, but they force children to do so. As children are

handed off to the next adult during their busy day, a whole new set of unreasonable expectations is imposed

upon them as they are expected to maintain energy and attentiveness levels beyond their natural ability. Many

children cannot maintain this schedule. Since NCLB was implemented far less children are graduating due to

these expectations. Fewer boys are attending college. To shift the blame onto children for the results of

unreasonable schedules and expectations is tantamount to blaming the victim.

The US accounts for 70% of ADHD drug use worldwide.12 According to the CDC, in 2009 alone nine

million children received ambulatory care due to adverse reactions to ADHD medications. The annual overall

cost of care for ADHD in the US is $52.4 billion dollars. Additionally, parents are not informed that the ADHD

label classifies their child with a mental illness. The label/medication disqualifies them for military service. Nor,

are they informed of the drugs’ black label, which indicates serious and permanent side effects, including

death, grey matter loss causing incompetence, movement disorders and violent/suicidal behavior.13 14

It was discovered at one elementary school, 60% of the kids were on or had been on psychotropic

drugs, two-thirds of the teachers took them regularly and 40% or more of the parents used psychiatric

prescriptions. Patients get specific prescriptions after seeing a commercial more than 70% of the time.15 The

U.S. and New Zealand are the only countries that allow Direct to consumer marketing.16

6
Controversy Surrounding the Disorder

The US National Library of Medicine published the following abstract from the National Institutes of

Health (NIH) discussing the findings of a series of five workshops concerning the controversies surrounding

ADHD.

Facts, values and ADHD: an update on the controversies

The Hastings Center, a bioethics research institute, is holding a series of five workshops to
examine the controversies surrounding the use of medication to treat emotional and
behavioral disturbances in children. These workshops bring together clinicians, researchers,
scholars and advocates with diverse perspectives and from diverse fields.

The duration of treatment and complexity of the treatment regimen is also growing. Before
2000, most children treated for ADHD received short-acting drugs, during school, for 1 or 2
years. Today, many receive long-acting drugs while in – and out – of school and the
prevailing recommendation from ADHD experts is to start medication early and to continue
as long as medication is needed. In addition, children are more likely than in the past to
have more than one diagnosis and, therefore, to be taking multiple medications
simultaneously.

In the majority of cases, teachers are the first to suggest that a child might have ADHD.
Initial assessments are often carried out by school psychologists or clinical psychologists
before a referral is made to a physician. Only 5% to 10% of cases result in a specialized
referral to a psychiatrist.’

ADHD does not have a single, simply identifiable form, diagnosing it requires a reobserver's
interpretation. Physicians, teachers, and parents may well disagree about whether children
in the zone of ambiguity exhibit the symptoms and suffer severe-enough impairment from
those symptoms to warrant the ADHD diagnosis. Increases in the rates of ADHD diagnoses
and the use of stimulant treatment have fueled the concern that too many children in the
zone of ambiguity are today given an ADHD diagnosis rather than considered simply
‘different’ or ‘spirited,’ and that drugs are too often the treatment of choice for these children.

These categories are abstractions we have created, not entities we have discovered in
nature. We – doctors, parents, teachers, and others – set the threshold between behaviors
and moods in need of pharmacological or behavioral treatment and differences that should
be left alone or dealt with in other ways.

One explanation for increased rates of diagnosis and stimulant use, therefore, is that we are
setting ever lower diagnostic thresholds. Data documenting an increase in diagnostic and
treatment rates and troubling decrease in societal tolerance of the behaviors and impairment
associated with the ADHD diagnosis.

Stimulant medications are used at higher rates in the US than in culturally similar places like
Germany, the Netherlands, and the United Kingdom.

7
Changes in expectations about the conduct of classroom education and the pace of
educational achievement make it more likely that the active, distractible child will be
considered a problem.

The Great Smoky Mountain study examined the prevalence of serious emotional and
behavioral disturbances, including ADHD, in children in the western region of North
Carolina. In the study, trained interviewers applied DSM criteria, including the requirement
for impaired functioning, to a representative sample of 1,422 children … [O]ver 57% of those
who received medication did not meet the criteria.

Sharing the medicalization concern, workshop participants like pediatrician William Carey
emphasized that we need to get better at accepting that children come into the world with
different temperaments (or behavioral styles). According to Carey, if we better understand
that ‘normal’ includes a wide variety of temperaments, we will also understand that
temperamental differences do not necessarily entail either impairment or harmful
dysfunction.; he is urging caution about using any means to shape what he urges us to view
as normal temperamental differences. He is equally concerned about the overuse of
behavioral interventions, which he thinks should be reserved for responding to problematic
behaviors (e.g., ignoring teacher requests) rather than problematic behavioral styles (e.g., a
restless temperament).

The authors of this report, and many members of the workshop, share Carey's commitment
to tolerating and even affirming a diversity of temperaments. And we recognize that this
commitment is, to some extent, rooted in an intuition about our appropriate attitude toward
ourselves and the world. It is an intuition about the value of accepting and affirming children
‘as they are’ and allowing them to unfold in their own way, as opposed to seeking to
transform them into our vision of how they ought to be.

Advocates for ‘behavioral treatments’ are referring to a set of interventions that include
teaching parents how to better parent a child with an ADHD diagnosis, teaching teachers
how to better teach children with ADHD, and helping children take responsibility for
monitoring and managing their own behavior.

Parents and teachers post rules, adjust workloads, provide choices, reinforce good
behavior, and offer special tutoring. The Multimodal Treatment Study of Children With
ADHD (MTA) study described above showed that this kind of behavioral treatment
significantly reduced the symptoms of ADHD and improved some aspects of the child's
overall functioning. Nearly 2 years after MTA's behavioral treatment finished, there had been
no loss in its effectiveness and the majority of children who received it were still
unmedicated.

Finally, workshop participants returned to a basic issue that, like others discussed above, is
not unique to ADHD. Many workshop participants believe that there is a system-wide push
toward the diagnosis of mental disorders and the use of drugs in preference to behavioral
therapy because drugs are easier to administer and, perhaps wrongly, considered cheaper.
Much like other chronic illnesses in the US, ADHD is often addressed in primary care
settings where practitioners are under pressure to see many patients quickly and face
restrictions on what third-party payers will reimburse.17

8
Diagnostic and Statistical Manual

The classifications for mental disorders are categorized in the Diagnostic and Statistical Manual (DSM)

written by the American Psychiatric Association. It is the manual to which physicians refer when diagnosing

mental illnesses, including ADHD. The DSM lists hundreds of “mental disorders.” Unfortunately, it is not

uncommon to misdiagnose an array of other mental disorders once the first mental disorder has been

diagnosed. This is especially true if prescription medications are consumed to treat the initial diagnosis. If a

child is diagnosed with ADHD, it is likely that other labels will be placed on him as well, including mathematics

disorder, disorder of written expression, conduct disorder and other similar ailments. Furthermore, the side

effects of ADHD drugs are such that multiple mental illnesses are then commonly misdiagnosed in addition to

ADHD. These include depression, bipolar and schizophrenia. Other antipsychotic drugs may then be added to

the mix, leading to more dangerous side effects. In the US alone, 8.4 million children are currently being

prescribed psychiatric drugs according to the Incident Management System (IMS) health source.

Diagnostic and Statistical Manual of Mental Disorders (DSM) reviews from the experts
according to author Kelly O'Meara:

Jeffrey A. Schaler, Ph.D., explains the legitimacy of the DSM this way: The Diagnostic and
Statistical Manual published by the American Psychiatric Association and used by licensed
psychotherapists throughout the country is notorious for low scientific validity. Yet it is
instrumental in securing insurance reimbursement for psychotherapy services…
O'Meara (978)

Examples of Disorders in the DSM

‘Mathematics Disorder’ is ‘mathematical ability that falls substantially below that expected for
the individual’s chronological age.’ ‘Disorder of Written Expression’- A child can be labeled
with this mental illness, as in the case of Mathematics Disorder, ‘if writing skills fall
substantially below those expected given the individual’s chronological age’. Is it possible
that some kids ‘get’ math and some don’t? That some kids are just better writers than
others? That tutoring may be the answer? No, there is not even a shred of scientific
evidence to support a neurologic or biologic abnormality of the brain for either of these
alleged mental disorders. ‘Conduct Disorder’ is ‘a pattern of behavior in which basic rights of
others or major age-appropriate social norms or rules are violated.’ ‘Oppositional Defiant
Disorder’ is a ‘recurrent pattern of negativistic, defiant, disobedient and hostile behavior
toward authority figures that persists for at least six months.’ This category is so subjectively

9
broad that anyone who dared to question the psychiatric label – anyone who verbalized the
nonsense of it, could be diagnosed with the alleged mental illness.
‘Caffeine Intoxication’ ‘occurs with the ingestion of as little as 100 mg of caffeine per day
include restlessness, nervousness, excitement, insomnia, flushed face, diuresis and
gastrointestinal complaints’. ‘Caffeine Withdrawal.’ is a characteristic withdrawal syndrome
due to the abrupt cessation of, or reduction in, the use of caffeine-containing products after
prolonged daily use.’ It’s a logical assumption that anyone who daily drinks large quantities
of coffee and then abruptly ceases might experience withdrawal, but is it a psychiatric
mental disorder in need of psychiatric treatment or drugs? Moreover, one has to wonder just
how many Americans stopped drinking coffee and then ran in a panic to their psychiatrists
seeking help from suffering caffeine intoxication or withdrawal, which apparently led to the
alleged mental disorders being included in the manual. The truth is, like all of the above
alleged psychiatric mental disorders, ‘caffeine intoxication’ and ‘caffeine withdrawal’ are not
based in science - objective, confirmable abnormalities of the brain. One of the problems
with taking the DSM-IV seriously (apart from the fact that it isn’t based in science) is that the
manual covers the psychiatric bases so completely that depending on one’s alleged mental
affliction, you’re damned if you do and damned if you don’t. O'Meara (875-897)

Dr. Thomas Dorman, a member of the Royal College of Physicians of the United Kingdom
and Fellow of the Royal College of Physicians in Canada, says, ‘In short, the whole
business of creating psychiatric categories of ‘disease,’ formalizing them with consensus
and subsequently ascribing diagnostic codes to them, which in turn leads to their use for
insurance billing, is nothing but an extended racket furnishing psychiatry a pseudo-scientific
aura. The perpetrators are, of course, feeding at the public trough.’
O'Meara (1008)

Paula Caplan, Ph.D., Professor of Applied Psychology at the Ontario Institute for Studies in
Education and author of several books explains: ‘I served on two of the committees that
were charged with writing the current edition [of the DSM-IV] and I resigned from both of
those committees because, as a clinical and research psychologist who among other things
specializes in research methodology and psychiatric assessment, I was horrified when I saw
what is done with the science by the members of the DSM groups. At various times I
firsthand saw them ignore the scientific research, distort good scientific research and can
even say I saw them lie about good scientific research. I also saw them produce or use
research that was poorly done when the results were said to come from that poor research
suited their purposes. So when they say that it is scientifically based it couldn’t be further
from the truth.’
O'Meara (1021)

And finally, Dr. Robert Spitzer, the well-known architect of the DSM admitted in the Jan. 3,
2005, edition of the New Yorker magazine, ‘To say that we’ve solved the reliability problems
is just not true. It’s [DSM] been improved. But if you’re in a situation with a general clinician
it’s certainly not very good.’ Given that the majority of prescriptions for mind-altering
antidepressants now are written by general practitioners – the family physician – Spitzer’s
admission is a frightening commentary on the accuracy of psychiatric diagnosing.
O'Meara (1024-1034)

Loren Mosher, M.D., resigned his membership from the APA in a letter addressed to Rodrigo
Munzo, (former) president of the APA, saying in part: After nearly three decades as a
member it is with a mixture of pleasure and disappointment that I submit this letter of
10
 resignation from the American Psychiatric Association. The major reason for this action is
my belief that I am actually resigning from the American Psychopharmacological
Association. Unfortunately, APA reflects and reinforces, in word and deed, our drug-
dependent society. APA likes only those drugs from which it can derive a profit – directly or
indirectly. This is not a group for me. In my view, psychiatry has been almost completely
bought out by the drug companies. The APA could not continue without the pharmaceutical
company support of meetings, symposia, workshops, journal advertising, grand rounds
luncheons, unrestricted educational grants, etc. Finally, why must the APA pretend to know
more than it does?’
O'Meara (1034-1047)

Alex Braiman, M.D After receiving a 50-year distinguished fellow award at APA’s 2004
annual meeting in May, commented the APA has become a polarized organization, perhaps
a reflection of the larger society, but it has tilted too far toward the advocacy of unsupported
‘biologic’ diagnostic and treatment practices. It is ironic that we are witnessing serious
challenges to the scientific integrity of studies supporting the FDA approval of the SSRI
class of antidepressants at a time when an unsilent majority of us go along with the pretense
that this is evidence-based psychiatry. It is too easy to fault drug companies. There are too
many of us whose integrity has been compromised by grant support or honoraria for the rest
of us to be able to trust their advice. I received my award before the name APA changes,
perhaps to the American Bipolar Association.’
O'Meara (1058-1081)18

The "Father of ADHD" laments its over-diagnosis.

Allen Frances, M.D., was the chair of the DSM-IV Task Force and of the department of psychiatry at

Duke University School of Medicine. He is currently professor emeritus at Duke. In an article posted on

Psychology Today's website, Dr. Frances wrote:

Keith Connors, Father of ADHD, Regrets Its Current Misuse.

Keith Conners can rightly be called the ‘Father of ADHD.’ Conners developed the standard
rating scales used for assessing children in research and clinical practice and for measuring
the impact of treatment. Once an obscure condition (then called Minimal Brain Dysfunction),
became the widely accepted and DSM official diagnosis, Attention Deficit Hyperactivity
Disorder.
I was already aware that in some circles America is a laughingstock for its love affair with the
idea of ADHD. Massive European birth registries show far lower rates than those being
reported in the US and my wife, who is a school psychologist, was telling me that any
misbehaving kid in school would be quickly labeled ADHD by teachers.
The reported rates are inaccurate and exaggerated, upper limits not true prevalence. There
was one exception in the literature, a massive study in the western counties of North
Carolina by two epidemiologists at Duke University.
The results of this amazing project were startling. Only about 1%-2% qualified as ADHD.
Moreover, many children not sick at all had been given a stimulant drug. It seems obvious to
me that the steady increase over time in the apparent high prevalence of ADHD is due to
11
 doctor practices fueled by the shoddy science and allure of the big numbers, without the
only meaningful ingredient of a comprehensive clinical history.
I felt and announced to stunned colleagues that the over-diagnosis of ADHD was ‘an
epidemic of tragic proportions.’ Tragic because many kids get the wrong diagnosis and really
have a different problem that needs a different treatment: or they are normal youngsters
given a treatment they don't need; or the drugs prescribed for them are given away or sold
to other students wanting a quick fix for studying or partying—a reason schools and colleges
now have huge numbers of students using stimulant drugs and why emergency rooms are
increasingly overwhelmed with overdosing youngsters.
Alan Schwartz of The New York Times exposed how disease-mongering and ruthless
advertising by big pharma had fed an eager medical system with false data, also capitalizing
on the cooperation of unscrupulous ‘thought leaders’ in child psychiatry. Doctors of course
bear a lot of the responsibility; prescriptions for stimulant drugs can only come from doctors.
Most hard-working primary care or general pediatric practitioners mean well but have too
little time to really get to know their patients and too little expertise to be skeptical of
misleading pharma propaganda.
I know how to tell the difference between studies relying on telephone interviews of parents
and those doing an actual meaningful clinical assessment. In today’s ADHD world the
detailed family and developmental history has been replaced by word of mouth from parents
and teachers and quickie interviews, largely by untrained primary care or general pediatric
practitioners.
It is disheartening to see diagnoses that are useful for the few become harmful when
misapplied for the many. ADHD is a good example, but there are many others—Autism,
Depression, Bipolar Disorder, PTSD, Generalized Anxiety Disorder, Binge Eating Disorder,
and on and on.
The history of psychiatry has always been a history of fads. What is new now is the massive
commercialization of psychiatric disorders in the service of pharmaceutical profit—selling the
ill through non-stop disease mongering in order to peddle the pill. Harried doctors and
worried patients have bought into the medicalization of everyday life, turning distress and
difference into mental disorder.
We are currently spending more than $10 billion dollars a year for ADHD drugs, a 50-fold
increase in just 20 years. Much of this is wasted, medicating children who have been
mislabeled. Studies in many countries show that the youngest kid in a class is twice as likely
as the oldest to get an ADHD diagnosis. We have turned normal immaturity into a mental
disorder. It would be much smarter to spend most of this money on smaller class sizes and
more gym periods.

Keith Conners has done us a great service. His alert to the over-diagnosis and over-
treatment of ADHD will hopefully mark an important turning point toward ending the fad.19

Many other mental disorders are now misdiagnosed at an alarming rate by pediatricians untrained in

the field of mental health. Lowered diagnostic criteria have compounded this problem. Far too often children

who are premature, too young or immature are misdiagnosed with a mental disorder because they meet the

criteria of the DSM. Currently, the American Academy of Pediatrics estimates less than a quarter of

pediatricians in the United States have specialized training in child mental health beyond what they learned in
12
residency. Sixty-two percent of pediatric doctors admit mental health issues were not adequately covered in

medical school. Rates of ADHD, autism, bipolar and schizophrenia have all dramatically increased due to

misdiagnosis. Better training and a complete revision of the DSM are needed according to Dr. Allen Frances,

considered to be the architect of DSM IV and V.20

A 2010 University of Hartford study found forty-five percent of graduate students in child psychology

had little coursework in child/adolescent lifespan development, which separates abnormalcy from normalcy.

This leaves them ill equipped to distinguish between normal and abnormal behaviors. Dr. Gary Freed, Chief of

the Division of General Pediatrics at the University of Michigan, surveyed physicians listed as pediatricians on

state-licensure files in eight states. He found that thirty-nine percent of state-identified pediatricians had not

completed a residency in pediatrics. The ones who had completed one admitted their training was minimal.21

All those living or working with children should familiarize themselves with the basic temperaments

children possess. Without this crucial information one cannot understand a child’s baseline predisposition.

How they react and what is normal can be better understood.

Diagnostic and Statistical Manual (DSM)

DSM-5 Criteria for ADHD

Inattention: Six or more symptoms:

● Often fails to give close attention to details or makes careless mistakes in
schoolwork, at work, or with other activities.
● Often has trouble holding attention on tasks or play activities.
● Often does not seem to listen when spoken to directly.
● Often does not follow through on instructions and fails to finish schoolwork,
chores, or duties in the workplace.
● Often has trouble organizing tasks and activities.
● Often avoids, dislikes, or is reluctant to do tasks that require mental effort over
a long period of time (such as schoolwork or homework).
● Often loses things necessary for tasks and activities (e.g. school materials,
pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile
telephones).
● Is often easily distracted
● Is often forgetful in daily activities.

13
Hyperactivity and Impulsivity: Six or more symptoms.
● Often leaves seat in situations when remaining seated is expected.
● Often fidgets with or taps hands or feet, or squirms in seat.
● Often runs about or climbs in situations where it is not appropriate.
● Often unable to play or take part in leisure activities quietly.
● Is often ‘on the go’ acting as if ‘driven by a motor’.
● Often talks excessively.
● Often blurts out an answer before a question has been completed.
● Often has trouble waiting his/her turn. Often interrupts or intrudes on others
(e.g., butts into conversations or games)

These “signs and symptoms” have defined the essence of childhood since the beginning of time. The

definition of childish is “having or showing the unpleasant qualities (such as silliness or lack of maturity) that

children often have.”22 Anyone who sees this as a mental disorder clearly does not have experience with

children. Now, instead of the expression "boys will be boys," it is "boys will be drugged." If the classroom is

boring and the child entertains himself, he is then labeled with ADHD. It is easier to give a pill than adapt the

school to the children. Today we have taken the burden off the schools and placed it upon the child. The

young, voiceless victim takes the blame for the changes in school demands forced by short-sighted policies.

The concept of temperaments dates back over two thousand years, when Hippocrates identified four

temperaments to explain personality differences.23 “Given the same circumstances or stimuli, different children

will react differently because of their temperament. Temperamental biases can be observed as young as four

months of age.”24 Due to the differences in infant and child temperament, children react to situations in very

different ways. These normal differences can now be diagnosed as a mental disorder due to weak DSM

criteria and poor evaluations.

Psychiatrists Stella Chess and Alexander Thomas identified certain behaviors as “normal extreme of

temperament” rather than a disorder. For example, the Sanguine is talkative, flighty, distractible, impulsive and

interruptive. A sanguine child’s distractibility may be misdiagnosed as ADHD. Or the choleric child who is

argumentative might be wrongly diagnosed as having oppositional defiant disorder (ODD). The melancholic’s

focus and attention to detail is incorrectly considered obsessive-compulsive disorder (OCD) or another anxiety

disorder. However, these traits are all normal temperaments of children.

14
 A 2007 study at the University of North Carolina in Chapel Hill discovered 30% of children diagnosed as

autistic at age two no longer fit the diagnosis at age four. Autism is believed to be a life-long neuropsychiatric

condition. This brings into question the improper diagnosis of childhood disorders.25

Journalist Robert Whitaker recently addressed the Society for Ethical Psychology and Psychiatry’s

conference in Los Angeles concerning the corruption in the American Psychiatric Association, writing:

The story told in the scientific literature was this: Research was failing to “validate” the DSM
disorders; the chemical imbalance hypothesis had not panned out; and the etiology of mental
disorders remained unknown. Prozac and the other SSRI antidepressants provided little
benefit over placebo for those with mild to moderate depression; the atypical antipsychotics
were no better than the first-generation antipsychotics. Meanwhile, long-term studies of drug
treatments for ADHD, depression, and schizophrenia were failing to find that the drugs
provided a benefit, with outcomes for the unmedicated patients in the depression and
schizophrenia studies better than outcomes for the medicated patients.

That is the “corruption” that has so harmed our society: Since 1980, the APA and academic
psychiatry have not fulfilled their public obligation to tell us what science has been revealing
about their disease model. As a result, our society has organized its treatment of psychiatric
disorders — and its policies and laws in this domain — around a false story, a story of a
disease model that had been validated and of drug treatments that are quite effective and
safe. While the pharmaceutical industry has surely played a role in telling that false story, it is
psychiatry as a medical profession that has given it public credibility.26

Children and Adults with Attention-Deficit/Hyperactivity Disorder

Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) was formed as a non-profit

organization to provide education, advocacy and support. Today, however, many feel it has become nothing

but a front group for the pharmaceutical industry.27 CHADD receives millions of dollars from drug makers,

enough to fund one-third of its budget.

A staff writer for Citizens Commission on Human Rights International, a mental health watchdog

group, provided the following summary of CHADDs history.

As early as 1995 the International Narcotics Control Board (INCB) raised the alarm
over the patient’s rights group CHADD actively lobbying for the use of
methylphenidate (Ritalin) for children labeled with ADHD while being funded by Ciba-
Geigy (now Novartis), the manufacturer of Ritalin. INCB said that this promotion of
sales of an internationally controlled substance could be identified as covert
advertising in contradiction of the provisions of the 1971 Psychotropic Drugs
Convention.

15
 The same year, the DEA added its concerns that the depth of the financial
relationship with the manufacturer was not well known to the public and that a
spokesperson for Ciba-Geigy had stated CHADD is essentially a conduit for
providing information to the patient population.
In 1987, members of the APA voted to include ADHD as a mental disorder in its
DSM. A year after, CHADD was formed and the financial relationship between
CHADD and Ciba-Geigy (then manufacturer of Ritalin) was formed.

CHADD came under scrutiny in 2002 at a hearing of the Government Reform

Committee, where Committee Chairman Dan Burton (R-IN) lambasted CHADD and
its CEO, E. Clarke Ross, for the group’s ties with drug companies, noting that it had
received $848,000 from one methylphenidate manufacturer [Ciba-Geigy] alone.
The appearance is that they’re feeding you to deal with this problem [of product
advocacy], Burton said, his voice rising. And I would just suggest, if there is a better
way to fund your organization … it would be helpful.

● Between 1991 and 1994 alone, the national CHADD office received almost $1 million from
pharmaceutical companies. This included support from Cephalon, Eli Lilly, McNeil, Ciba-
Geigy, Pfizer, Shire and UCB ••••Pharma.

● CHADD’s 2000–2001 annual report disclosed that the group received 19.6% of its budget
from drug makers. In 2005, that rose to 22% ($1,035,000) and within a year had jumped to
28% ($1,401,000)—a 35% increase in just five years.

● Despite INCB/DEA concerns and a clear conflict of interest with pharmaceutical companies,
in 2002, CDC gave $750,000 of taxpayer money to CHADD to act as a national resource
center on ADHD, including a web site that advocates biological (drug) approaches to
treatment. In 2004, this increased to $1 million.

● More than half of the drugs endorsed on the CHADD web site are manufactured by drug
companies that fund it.

● One of the largest growths in psychotropic drugs is stimulants prescribed for ADHD.
Approximately 94% of ADHD stimulant global sales were derived from the US in 2004. Also
in 2004, the value of the ADHD market was $2.4 billion and had become one of the fastest
growing (40% plus year-on-year). By 2008, it reached almost $4.4 billion, helped by
advocacy groups—the most prolific being CHADD—marketing for Pharma.

● As of June 30, 2008, in addition to $1.2 million in drug company donations and grants, 64%
of CHADD’s sales and advertising was derived from such companies ($466,104). Total
pharmaceutical support from companies such as Eli Lilly, McNeill, Novartis and Shire
Pharmaceuticals US represented $1,205,000 or 21.9% of CHADD’s total revenue.

● In 2009, the total pharmaceutical donation support of CHADD was 26.6% ($1,174,626). This
included donations received from Eli Lilly, McNeil, Novartis and Shire Pharmaceuticals US.
The drug companies paid another $412,500 to CHADD in sales and advertising. Thus, the
total financial support of CHADD by the drug manufacturers was $1.6 million, or 36% of total
revenues that year.

16
● CHADD used Ciba-Geigy money to build its membership and to promote awareness of the
disease ADD/ADHD. The number of CHADD chapters exploded from 29 to 500. In 1988, the
number of American children labeled with ADHD exploded with it, from zero to 500,000 and
has steadily increased since then.

Targeting Teachers and Schools

In 1991, CHADD lobbied for the Individuals and Disabilities Education Act (IDEA) to
amend eligibility rules for federal special education programs and federal education
grants, providing schools with $400 for each child diagnosed with ADHD. The same
year, the Department of Education formally recognized ADHD as a handicap and
directed all state education officers to establish procedures to screen for ADHD and
provide those identified with special educational and psychological services.

A decade later, with soaring special ed costs, a President-directed investigation into

special education found that more than 50%, or 3.2 million children, had been placed
in special education due to subjective categories such as Non-Specific Learning
Disorder, at an estimated cost of $28 billion per year. As was established, the real
problem was not that the kids had learning disabilities—including ADHD—but that
they had never been taught to read.

● In an article published in PLoS Medicine, Christine B. Phillips writes that CHADD tries to
make teachers sickness brokers for ADHD, marketing educational programs for them,
including acting as the lead editorial consultant of a special issue on ADHD in Health in
Action, a quarterly publication of the American School Health Association.

● Teachers are now expected to diagnose students using such instruments as the Conner’s
Teacher’s Rating Scale. Teachers—based on the APA’s diagnostic manual—and often
agree to administering psychostimulants to students during the school day.

● Phillips further stated: A subtle incentive for teachers to administer medication in the middle
of the day may be the assurance of a tractable {i.e., docile} child in the afternoon.

● Shire Pharmaceuticals, which makes stimulants Adderall and Vyvanse, funds CHADD. In
November 2009, the Food and Drug Administration (FDA) also approved a new non-
stimulant INTUNIV produced by Shire Pharmaceuticals, which CHADD already lists on its
web site.

● Shire Pharmaceuticals also funds ADHDSupport.com Teacher Discussion Guide,

copyrighted by Shire Pharmaceuticals (2009), which has parents fill out their child’s name on
a form and directs them to ask questions to elicit teacher collaboration to label the child,
such as: Could the school counselor/psychologist provide support in addition to what you’re
doing in the classroom? Would you be willing to fill out symptom checklists, to help monitor
progress, on a weekly basis? The Guide is promoted on what looks like a consumer
education web site called ADHD Support, described as an ADHD Resource Center.
However, it is just another marketing online site set up by Shire Pharmaceuticals. It includes
checklists for determining ADHD in children and adults and provides a Discussion Guide
and refers readers to the CHADD web site and its conferences.

Matthew Emmens, the CEO of Shire Pharmaceuticals displayed a graph of Adderall

sales, surging from just $10 million in 1996 to almost $520 million six years later..28

17
Schedules

Children are at risk at all educational levels

Pre-K and Kindergarten

A recent article posted on washingtonpost.com, How ‘twisted’ early childhood education has

become — from a child development expert, written by Valerie Strauss, reveals the change in

academic focus.

Valerie Strauss's interview of author Nancy Carlsson-Paige

My daughter’s first day of kindergarten — her very first introduction to elementary

school — consisted almost entirely of assessment. She was due at school at 9:30 and I
picked her up at 11:45. In between, she was assessed by five different teachers, each a
stranger, asking her to perform some task.

By the time I picked her up, she did not want to talk about what she had done in
school, but she did say that she did not want to go back. She did not know the teachers’
names. She did not make any friends. Later that afternoon, as she played with her animals
in her room, I overheard her drilling them on their numbers and letters.

There were 10 classrooms – kindergarten and pre-K. The program’s funding

depended on test scores, so — no surprise — teachers taught to the test. Kids who got low
scores, I was told, got extra drills in reading and math and didn’t get to go to art. They used
a computer program to teach 4 and 5 year-olds how to ‘bubble.’ One teacher complained to
me that some children go outside the lines.

In one of the kindergartens I visited, the walls were barren and so was the whole
room. The teacher was testing one little boy at a computer at the side of the room. There
was no classroom aide. The other children were sitting at tables copying words from the
chalk board. The words were: ‘No talking. Sit in your seat. Hands to Yourself.’ The teacher
kept shouting at them from her testing corner: Be quiet! No talking!

Most of the children looked scared or disengaged and one little boy was sitting alone. He
was quietly crying. I will never forget how these children looked or how it felt to watch them, I
would say, suffering in this context that was such a profound mismatch with their needs.

A few months ago, I was alarmed to read a report from the Department of Education
Office for Civil Rights showing that more than 8,000 children from public preschools across
the country were suspended at least once in a school year, many more than once. First of
all, who suspends a preschooler? The very concept is bizarre and awful. But 8,000? 29

18
Elementary

A private diocesan school in the Northern Virginia area had the following schedule

beginning in the third grade:

7:30- arrive at school and begin morning work before the 8:00 bell to start the day
8:00 - 3:00 school - 7 hours of school with only a 15 min. break for recess. This is assuming
the class makes it out to recess in a timely manner, which is not always the case.
Furthermore, recess is often taken away as a punishment for any infractions, including if
another child makes the “unforgivable” mistake of talking. If this were not bad enough,
children are also required to place their heads down on the tables throughout lunch period if
talking too loudly.
4:00 - get home have snack
4:30 - 6:30 begin homework for two hours depending on amount with reading, projects,
flashcards and studying for as many as 5 tests per week. (9 hour day plus weekends at
age 8)
6:30- dinner with family
7:30- shower and get ready for bed

Beginning in third grade, this school also sent home complicated monthly projects for weekend work.

In addition, when snow days occured teachers e-mailed a full day's worth of work home with the expectation

that the children would spend their off day completing their assignments. Many of the projects involved skills

that the youngsters do not possess, such as proficiency in powerpoint presentations. The complexity of the

projects clearly evinced the school's expectation that parents would be fully engaged in the completion of the

assignments. Indeed, the school had a term for these endeavors--"family projects." No child or family should

be expected to perform these excessive tasks. Extensive work is also given during spring, winter and summer

breaks.

Many parents at this school were told by teachers that their children had ADHD and required

medication. Also, teachers and the administration repeatedly emailed parents to have their children tested for

ADHD. Even after the parents indicated they were not interested in further testing, the school persisted in its

demands. Both the demand for testing and the recommendation of ADHD drugs violate state and federal laws

prohibiting school personnel from engaging in such conduct. (See Appendix A and B). 30

19
 One teacher even went so far as to tell parents to give their young children coffee if they would not put

them on the drugs. When children failed to toe this school's line, punishments were inflicted. For example, the

school required entire classes in grades 3 through 5 to spend their whole recess marching in lines if one of the

students spoke out of turn while waiting in the recess line.

Stepping out of line or completing in-class assignments incorrectly might result in a child being

screamed at by the teacher and sent to the Vice Principal's Office. Children would be forced to sit outside the

office for hours at a time. Furthermore, volunteers/parents were instructed not to discuss with others the

events they observed at the school throughout the day. Children wet themselves when they were not allowed

to go to the bathroom. Numerous children displayed tics, anxiety and depression. Also, there was a high

turnover rate in students and teachers.

In this private school setting, there were no checks and balances and no meaningful outlets for parents

to complain to a higher authority. The diocese instructs parents to address their grievances to the very

principal who enforces the policies that aggrieve them in the first place. When parents do complain, their

families are then targeted, with the school using the child as the means to exact revenge. Many families are

asked to leave with the classic private school catch phrase--“You just aren’t a good fit here." Also, the

administration fails to discourage teachers and families from going after parents who complain, causing further

victimization.

When comments were posted on Facebook pages under this school's control warning parents of the

long term side effects of ADHD medications, they were removed. When other posts sought to advise parents

of laws prohibiting school personnel from ADHD arm-twisting, they were removed. Not surprisingly, posts

discussing the over-labeling of ADHD met the same fate. Staff from the school even went so far as to cyber

bully parents on church and school sites for complaining to school officials about the lack of recess.31

20
Middle School

As children enter middle school and high school they lose the breaks they grew accustomed to in

elementary school—another result of NCLB. A twenty-five minute break is the norm for this academic level.

This dilemma pushes children even further beyond their ability to sit still and remain focused. As their bodies

continue to grow and their need to move persists, boys are then challenged to defy the natural instinct to be

physically active. They are further stagnated by the loss of breaks. Girls, in turn, begin cutting and displaying

other forms of self-injury due to the stress. Furthermore, there is a substantial increase in homework, usually

2-3 hours in middle school making it a 10 hour day and 3-4 hours minimal in high school for an 11 hour day.

The rate of ADHD diagnosis (categorized under a host of disorders) drastically increases during these school

years according to the Virginia Department of Education.

Stop Penalizing Boys for Not Being Able to Sit Still at School. Instead, help them channel their energy

into productive tasks written by Jessica Lahey, June 18, 2013 offers insights regarding the middle school

experience.

Something is rotten in the state of boys' education and I can't help but suspect that the
pattern I have seen in my classroom may have something to do with a collective failure to
adequately educate boys. The statistics are grim. According to the book Reaching Boys,
Teaching Boys: Strategies That Work and Why, boys are kept back in schools at twice the
rate of girls. Boys get expelled from preschool nearly five times more often than girls. Boys
are diagnosed with learning disorders and attention problems at nearly four times the rate of
girls. They do less homework and get a greater proportion of the low grades. Boys are more
likely to drop out of school and make up only 43 percent of college students.

A study released last year in the Journal of Human Resources confirms my suspicions.
It seems that behavior plays a significant role in teachers' grading practices and
consequently, boys receive lower grades from their teachers than testing would have
predicted. The authors of this study conclude that teacher bias regarding behavior,
rather than academic performance, penalizes boys as early as kindergarten. On
average, boys receive lower behavioral assessment scores from teachers and those
scores affect teachers' overall perceptions of boys' intelligence and achievement.

While I love teaching boys, many of my colleagues do not, particularly during the hormone-
soaked, energetic and distracted middle- and high-school years. Teachers and school
administrators lament that boys are too fidgety, too hyperactive, too disruptive, derailing the
educational process for everyone while sabotaging their own intellectual development.
21
 Peek into most American classrooms and you will see desks in rows, teachers pleading with
students to stay in their seats and refrain from talking to their neighbors. Marks for good
behavior are rewarded to the students who are proficient at sitting still for long periods of
time. Many boys do not have this skill.

In an attempt to get at what actually works for boys in education, Dr. Michael Reichert and
Dr. Richard Hawley, in partnership with the International Boys' School Coalition, launched a
study called Teaching Boys: A Global Study of Effective Practices, published in 2009. The
study looked at boys in the United States, United Kingdom, Canada, Australia, New Zealand
and South Africa, in schools of varying size, both private and public, that enroll a wide range
of boys of disparate races and income levels.

The authors asked teachers and students to ‘narrate clearly and objectively an instructional
activity that is especially, perhaps unusually, effective in heightening boys' learning.’ The
responses--2,500 in all--revealed eight categories of instruction that succeeded in teaching
boys. The most effective lessons included more than one of these elements:
● Lessons that result in an end product--a booklet, a catapult, a poem, or a comic strip, for
example.
● Lessons that are structured as competitive games.
● Lessons requiring motor activity.
● Lessons requiring boys to assume responsibility for the learning of others.
● Lessons that require boys to address open questions or unsolved problems.
● Lessons that require a combination of competition and teamwork.
● Lessons that focus on independent, personal discovery and realization.
● Lessons that introduce drama in the form of novelty or surprise.

Rather than penalize the boys' relatively higher energy and competitive drive, the most
effective way to teach boys is to take advantage of that high energy, curiosity and thirst for
competition. While Reichert and Hawley's research was conducted in all-boys schools,
these lessons can be used in all classrooms, with both boys and girls.32

When comparing the US education system to the Chinese system, which emphasizes technological

expertise and high academic levels at an early age, it is important to note that only 70% of Chinese students

advance from middle school to high school. Under 30% of Chinese high school graduates attend college

despite their long academic days. Chinese elementary students attend class for nine hours with a two-hour

break making it a seven hour day. Middle school students attend class from 7am to 9pm. With two 2-hour

breaks, this involves a ten hour work day. Students remain at school for homework and study hall, while

teachers assist them. However, it is important to note Chinese schools require students to exercise and take

two 2-hour breaks.33 VA parents are even required to supervise what little school breaks children do get.
22
High School

Dr. Guy Winch in his article How much work is too much discusses US high school students’ average

day. He stated:

I asked about Timothy's typical day. He awoke every morning at six thirty so he could get to
school by eight and arrived home around four thirty each afternoon. He then had a quick
snack, followed by either a piano lesson or his math tutor, depending on the day. He had
dinner at seven p.m., after which he sat down to do homework for two to three hours a night.
Quickly doing the math in my
head, I calculated that Timothy spent an average of thirteen hours a day hunched over a
writing desk. His situation is not atypical. Spending that many hours studying is the only way
Timothy can keep up and stay afloat academically.
But what if, for comparison's sake, we imagined Timothy spending thirteen hours a day
hunched over a sewing machine instead of a desk. We would immediately be aghast at the
inhumanity because children are horribly mistreated in such ‘sweatshops.’ ‘Timothy is far
from being mistreated, but the mountain of homework he faces daily results in a similar
consequence- he too is being robbed of his childhood.’ [This schedule allows only a 25
minute lunch break, which includes getting to the cafeteria and standing in lines, with no
time for bathroom breaks. This doesn't even account for school work on weekends,
holidays, snow-days and summer breaks.]34

Washington Post reporter and UVA Ph.D. candidate, Julia Fisher, details how charter schools’ punitive

systems stamp out the heart of students in Schools that accept ‘no excuses’ from students are not helping

them.

When I taught at a charter school, I once gave out 37 demerits in a 50-minute period. This
was the sort of achievement that earned a new teacher praise in faculty-wide emails at
Achievement First Amistad High School, in New Haven, Conn.
The programs are founded on the notion that there can be “no excuses” for the achievement
gap between poor minorities and their more affluent, white counterparts. To bridge that gap,
they set high expectations and strict behavioral codes. School days are long. Not a moment
is to be wasted. Classes even rehearse passing out papers quickly so they can save every
second for drilling academic content. . .
Posture and eye contact are important, even for 16-year-olds. Class is not to proceed
without total compliance. Such charter schools have often been criticized as excessively
harsh. A New York Times story last year described Success Academy students peeing their
pants because they were not permitted to go to the bathroom during practice tests. On my
first day teaching 10th-grade English, I broke with No Excuses protocol. I wanted my
students to fall in love with ideas; I wanted them — not me, and certainly not some figure
behind a desk at Achievement First headquarters — to control their own confrontation with
difficult concepts. So I had them rearrange their desks into a circle and gave them a short
but baffling text by Jorge Luis Borges. The kids struggled. More than a few of them broke
the behavioral code (slouching, talking to classmates, shouting out their reactions to the
23
reading or my queries). But they worked hard and asked questions. At the end of the class,
one student thanked me: “I’ve never thought about such big ideas before,” she said.
From that day, the school’s administration, which learned about the violation, had my
number. An administrator watched my class every day. If I didn’t fully enforce the school’s
code — under which demerits must be issued for slouching, looking at the wrong person or
even taking notes when not explicitly directed to — the administrator would correct me on
the spot.
Soon, questions were forbidden. In an email to the faculty, the school’s principal explained
that the 10th grade was not doing well. Evidence included the fact that students were
hugging each other in the halls. As a solution, the principal presented a rule: “There Are No
Questions.” He explained: “Every time you engage with a question, you effectively A) go off
your carefully planned lesson pacing, B) put one student over the rest of the class and C) kill
momentum.”
Amanda Pinto, the school’s communications director, told me last month that, at Amistad,
“kids are asking questions all the time.” She noted that banning “unsolicited questions
[during the] full class” didn’t mean that students couldn’t ask individual questions when their
peers were otherwise occupied.
Still, the questions rule turned my class to chaos. My students had read a bit of Machiavelli’s
“The Prince,” and I asked them to write briefly about Machiavelli’s morality. Following
protocol, I told the students to silently spend the next minute writing an answer. Two
students raised their hands. “Start working silently, and I’ll come answer your question once
everyone’s started,” I said, following the required script. They kept their hands defiantly in
the air.
With an administrator watching, I wasn’t allowed to hear their questions, so I kept pushing
back, telling the students to wait. Eventually, their protest turned vocal, and soon the whole
class was yelling and throwing things — open rebellion. Later, I learned that those two
students (good, focused kids) had raised their hands because they didn’t know the word
“morality.” The problem could have been easily solved.
Classes were designed to follow No Excuses dogma, in a way that precluded real
engagement. Discussion was considered a waste of time because it didn’t produce
measurable results. Teachers were forbidden from speaking for more than 5 percent of a
class period. That meant most of the time was devoted to worksheets.
Classrooms at Amistad were often unruly. My students’ favorite disruption strategy was to
make bird noises — a clever move, because it’s impossible to tell who is making the noises,
so no one ends up punished. One of my student advisees said to me, “I’ve been in charter
schools for 10 years, and the only way to have fun is to get in trouble.” Amistad officials
knew they had a morale problem. Still, an administrator once stopped me in the hall to say
(on her own initiative, not following policy) that she had seen me laughing in front of my
students, which was wholly inappropriate behavior.
I told a friend who had grown up in China about some of the struggles at Amistad. “That’s as
bad as Communist China!” she said. “They made us march at recess.” I told her that
Amistad does not have recess. The students’ only opportunity to socialize was during the
lunch period, half of which was devoted to silent study hall. For a few kids facing extra
punishment, lunch, too, was silent.
It’s much easier to teach behavioral management tactics than to foster deep passion and
knowledge about an academic field, and Achievement First provided all the scripts and

24
 coaching necessary to get a willing body functioning as part of its behavioral management
machine. Inspiring kids with academic content wasn’t really part of the picture. The inspiring
part of education is messy: Teenagers are excitable, emotional creatures, and when they
encounter ideas that thrill or upset them, things are bound to get a little chaotic. That’s a
sign that something good is happening — that ideas matter.
When I left Amistad, I went to teach at a progressive prep school in D.C., where the arts
thrived and students shaped the spirit of their school. Once, I looked around the room at my
students and noticed that, at that moment, every one of them — engrossed in discussion,
looking through their books to develop ideas, taking notes, sitting comfortably — was doing
something that would have earned a demerit at Amistad. Amistad, like its No Excuses
brethren, holds that no academic work can be done until and unless the classroom reaches
perfect behavioral compliance.
But it shows no sign that it will address its demeaning merit system, its fundamental
joylessness, or any of the other issues that cut closer to the core of the school’s problems
and those of others like it. That students are refusing to comply with their school’s draconian
system is a sign that Amistad hasn’t yet stamped out their heart.35

Fisher also pointed out that teacher and student turnover rates at Amistad were high. One can only

imagine what the rate of ADHD diagnosis and corresponding government funding is at this school.

Chinese high school students attend class from 7 am to 11 pm. With two 2-hour breaks that include

mandatory physical exercise, this involves a twelve hour work day. American high school students have an

eleven hour day with only a 25-minute break. According to China’s CDC, Chinese children have a high rate of

suicide, which is the top cause of death among children. Stress over school in China is a major factor and

jumping out a window is the most common method of suicide. It has become such a problem parents must

sign a waiver, holding schools harmless for student suicide.36 US students are spending as many or more

hours academically than their Chinese counterparts with fewer breaks. Both countries are facing high rates of

childhood suicide.

Instead of labeling children with numerous mental health diagnoses, schools should balance their

schedules and provide supportive environments that encourage physical activity outside the classroom. This

should be an essential part of the school day. Corporate fitness recognizes the need to keep employees fit

and healthy, which increases productivity and mental wellness. This should be a requirement in K-12 schools

as well.

25
The New York Times‘ Alan Schwarz writes:

Students revealed;

‘Once you break the seal on using pills, or any of that stuff, it’s not scary anymore —
especially when you’re getting A’s,’ said the boy who snorted Adderall in the parking lot. He
spoke from the couch of his drug counselor, detailing how he later became addicted to the
painkiller Percocet and eventually heroin.

Seeking Academic Edge, Teenagers Abuse Stimulants

Madeleine estimated that one-third of her classmates at her small school, most of whom she
knew well, used stimulants without a prescription to boost their scholastic performance.
Many students across the United States made similar estimates for their schools, all of them
emphasizing that the drugs were used not to get high, but mostly by conscientious students
to work harder and meet ever-rising academic expectations.
‘No one seems to think that it’s a real thing — adults on the outside looking in. The other
kids in rehab thought we weren’t addicts because Adderall wasn’t a real drug. It’s so
underestimated,’ said a recent graduate of McLean High School in Virginia, who was given a
diagnosis of ADHD and was prescribed Adderall.

Liz Jorgensen, a licensed addiction specialist who runs Insight Counseling in Ridgefield,
Conn., said her small center had treated ‘at least 50 or 60’ high school students from
southern Connecticut this school year alone who had abused prescription stimulants for
academics. Ms. Jorgensen said some of those teenagers landed in rehab directly from the
stimulants or, more often, grew comfortable with prescription drugs in general and began
abusing prescription painkillers like OxyContin.

Douglas Young, a spokesman for the Lower Merion School District outside Philadelphia,
said prescription stimulant abuse was covered in various student-wellness initiatives as well
as in the 10th-grade health curriculum. Mr. Young expressed frustration that many parents
seemed oblivious to the problem.

‘It’s time for a serious wake-up call,’ Mr. Young said. ‘Straight A’s and high SAT scores look
great on paper, but they aren’t reflective measures of a student’s health and well-being. We
need to better understand the pressures and temptations, and ultimately we need to
embrace new definitions of student success. For many families and communities, that’s
simply not happening.’

Fooling the Doctors

A number of teenagers interviewed laughed at the ease with which they got some doctors to
write prescriptions for ADHD. The disorder’s definition requires inattentiveness, hyperactivity
or impulse control to present ‘clinically significant impairment’ in at least two settings (school
and home, for example), according to the Centers for Disease Control and Prevention. 37

26
 Due to the elimination of scheduled breaks, recess and free time, children are now overwhelmed.

Teachers are given breaks when their pupils receive instruction from others in "specials" such as art, music

and foreign language. Children must work through the day without similar breaks. Children should not be

expected to work at this pace; it is no wonder they have trouble staying focused. Unstructured time is

necessary for a child to function throughout the day, otherwise, they become frustrated and incapable of

learning.

Middle school and high school children benefit from breaks. Currently, Fairfax County and Prince

William County, the two largest school districts in the state of Virginia, give only a 25 - 30 minute break for

lunch in middle school and high school. Some private and diocesan schools located within those districts

follow suit. This is less than child labor laws require. Most adults receive a one-hour lunch break.

The Virginia child labor law requires a 30-minute rest or meal period after five consecutive hours of

work. Code of Virginia § 40.1-80.1. School and homework constitute 11-hour days, yet only 25-minute breaks

are given. In keeping with child labor laws, breaks should be almost an hour. Furthermore, children are not

allowed to work over 8-hour days or 40-hour weeks according to the child labor laws of Virginia.38 School

children are now working in excessive of 55 hours a week. This figure does not even include weekend

homework. Recently, Prince William County lessened the homework in elementary and middle school as did

some diocesan and private schools in the county. Hopefully, others will follow.

An important fact to remember is that the number of subjects in school has increased since the 1990s

with the addition of computer and foreign language classes, along with double math or other subjects if a child

is testing below the standards. Adults cannot understand why life is harder for the child of today because the

older generations had fewer subjects, less homework and longer breaks. Studies have proven recess/breaks

raise test scores and promote physical and emotional wellbeing. Even child labor laws recognize the

importance of providing adequate breaks. Too often ADHD drugs are used as a chemical restraint by schools

to force children to adhere to their over-demanding schedules. Many, if not all, children are unable to sit or

retain information with schedules that go beyond their capability.

27
 Clearly not all public school schedules are like this, nor are all private or diocesan school schedules.

There are some exceptional public, private and diocesan schools in the area providing appropriate breaks.

Many parents in the area are driving as much as an hour to get children to more balanced schools. Others

have resorted to homeschooling in order to protect children from these types of schedules. Some schools now

mandate 30 minutes of recess, 30 minutes for lunch, and homework assigned on a 10-minutes-per-school-

grade ratio. They also allot 45-minute-to-one-hour breaks for middle school and high school. Study halls have

been returned in some schools to help students get on top of homework and provide time for teachers to help

students in need. Unfortunately, these schools are the exception, not the rule. If more schools adopted such

policies, it would help to bring down the number of children mislabeled with ADHD.

American children now have a 9-hour day in elementary school, 10-hour day in middle schoo,l and 11-

hour day in high school. Communist Chinese schools comparably work a 7-hour day in elementary, 10-hour

day in middle school, and 12-hour day in high school. American children have as long a work day, with fewer

breaks, than their Chinese counterparts.

The article Ritalin vs. Recess: Are Drugs Really the Answer to the ADHD Epidemic? offers insights by

author Michael Behar, a former science editor for National Geographic, a former senior editor for Wired, and a

contributing writer for Mother Jones.

Several factors may be behind these developments—and the soaring rates of ADHD. Our
schools’ single-minded emphasis on standardized testing since the No Child Left Behind Act
took effect in 2002, paired with larger classrooms, ‘encourage teachers to develop punitive
methods to force children to sit still and listen,’ said Ray. ‘[ADHD] has been highly correlated
with reduction in physical education and, worst of all, reduction of recess time.’ That leads to
‘boredom and distraction for children, which is often manifested in symptoms associated
with ADHD.’ In the first five years of No Child Left Behind, almost half of US school districts
took significant time away from recess and creative curricula in favor of the math and
reading that's subject to standardized tests, according to the Center on Education Policy. Yet
in 2010 the CDC found that physical activity in school improves academic performance,
including on standardized tests; there was ‘no evidence’ that recess was negatively
associated with cognitive skills or academics.’39

28
Guidelines

Physical Activity

Guidelines issued by the National Association for Sport and Physical Education, which have been

echoed by the National Academies’ Institute of Medicine, stress the importance of daily recess and physical

exercise to a healthy child. These guidelines advise:

Consider recess time alongside physical education (PE) requirements. One is not a
replacement for the other. Unlike PE, recess is unstructured time when children get to
choose their own play, which has its own value. How much time each is allotted can vary
according to each district’s needs and resources, but avoid scheduling recess and PE back
to back. The National Association for Sport and Physical Education (NASPE) recommends
that children pre-K through grade five or six have regularly scheduled recess every day.
Provide 30–60 minutes of physical activity each school day, including recess.
According to NASPE, children should get at least one hour of physical activity each day
whether in school or out. The National Academies' Institute of Medicine recommends that
all students ‘participate in a minimum of 30 minutes of moderate to vigorous physical activity
during the school day.’40

Teens who engage in daily sports and exercise activities are less likely to switch from opioid pain

reliever use to heroin, as stated in research funded by the National Institute on Drug Abuse (NIDA), and

published today in Pediatrics.41

Homework

The famous Duke University homework study set the guidelines of ten minutes per grade level for

homework. However, many schools that have this policy do not follow it.

One principal’s post on greatschools.com titled Rethinking Homework provides sound guidance to

schools.

More homework is being piled on children despite the absence of its value. Over the
last quarter-century the burden has increased most for the youngest children, for whom the
evidence of positive effects isn’t just dubious; it’s nonexistent.
It’s not as though most teachers decide now and then that a certain lesson really ought to
continue after school is over because meaningful learning is so likely to result from such an
assignment that it warrants the intrusion on family time. Homework in most schools isn’t
limited to those occasions when it seems appropriate and important. Rather, the point of
departure seems to be: ‘We’ve decided ahead of time that children will have to do
something every night (or several times a week). Later on we’ll figure out what to make
them do.’

29
 I’ve heard from countless people across the country about the frustration they feel
over homework. Parents who watch a torrent of busywork spill out of their children’s
backpacks wish they could help teachers understand how the cons overwhelmingly
outweigh the pros. And teachers who have long harbored doubts about the value of
homework feel pressured by those parents who mistakenly believe that a lack of afterschool
assignments reflects an insufficient commitment to academic achievement. Such parents
seem to reason that as long as their kids have lots of stuff to do every night, never mind
what it is, then learning must be taking place.
What parents and teachers need is support from administrators who are willing to
challenge the conventional wisdom. They need principals who question the slogans that
pass for arguments: that homework creates a link between school and family (as if there
weren’t more constructive ways to make that connection!), or that it ‘reinforces’ what
students were taught in class (a word that denotes the repetition of rote behaviors, not the
development of understanding), or that it teaches children self-discipline and responsibility
(a claim for which absolutely no evidence exists).
Above all, principals need to help their faculties see that the most important criterion
for judging decisions about homework (or other policies, for that matter) is the impact they’re
likely to have on students’ attitudes about what they’re doing. ‘Most of what homework is
doing is driving kids away from learning,’ says education professor Harvey Daniels. Let’s
face it: Most children dread homework, or at best see it as something to be gotten through.
Thus, even if it did provide other benefits, they would have to be weighed against its likely
effect on kids’ love of learning.
Principals deal with an endless series of crises; they’re called upon to resolve
complaints, soothe wounded egos, negotiate solutions, try to keep everyone happy, and
generally make the trains (or, rather, buses) run on time. In such a position there is a strong
temptation to avoid new initiatives that call the status quo into question. Considerable
gumption is required to take on an issue like homework, particularly during an era when
phrases like ‘raising the bar’ and ‘higher standards’ are used to rationalize practices that
range from foolish to inappropriate to hair-raising. But of course a principal’s ultimate
obligation is to do what’s right by the children, to protect them from harmful mandates and
practices that persist not because they’re valuable but merely because they’re traditional.42

Students now have homework over winter break, spring break and summer break. It has

now become a working vacation for students.

Nearly every day, after their ‘work,’ they are given more work to do. When my
children were in elementary and middle school, this homework often interfered with our
evening family plans. Now that they are in high school, it does so constantly. Even weekend
plans are often thwarted because of the amount of work they need to get done before
Monday. They frequently are up past midnight finishing assignments, then must try their best
to stay awake during school the next day. The famous Duke University homework study
concluded that students should get no more than 10 minutes per grade level, meaning a
first-grader should be assigned up to 10 minutes and a 12th-grader no more than 120
minutes. In our household, these guidelines are exceeded every year.
This generation of children is obese and anxiety ridden. They do not get a chance to
relax and be kids. They should have their weekends to be with their friends and family. And
that should definitely be true for their vacations.
Al Kaufman, Silver Spring43

30
Colleges

In Raising a Generation of Pill-Poppers; How Abuse of "Uppers,” “Downers,” and Stimulants

Threatens an Entire Generation, the findings of a CNN Health study were discussed.

Problems with misdiagnosis and use of ADHD drugs in colleges are now rampant. According to data from IMS
Health, a whopping 48.4 million prescriptions for ADHD stimulants were written in 2011, up 39 percent from
2007. As reported by CNN Health:

‘Prescription ADHD medications like Adderall, Ritalin and Vyvanse are becoming
increasingly popular for overworked and overscheduled college students -- who haven't
been diagnosed with ADHD...’

The numbers vary significantly by school, with the greatest proportion of users at private and
'elite' universities. Some researchers estimate about 30 percent of students use stimulants
non-medically.

'When we look at upperclassmen, the number really begins to jump,' says Alan DeSantis,
professor of communications at the University of Kentucky who has conducted research on
stimulant use in college. 'The more time you stay on campus, the more likely you are to
use.'‘

ADHD Drugs Are Far from Harmless

One 2008 study, which interviewed 1,800 college students, reported that 81 percent of them
perceived illicit use of ADHD drugs as being completely harmless, or only ‘slightly
dangerous.’

This is despite the fact that these drugs are Schedule II substances -- just like cocaine,
methamphetamines and morphine. As such, drugs like Ritalin, Vyvanse, Strattera and
Adderall have very real health risks. Commonly reported short-term side effects include:
● Sleep disturbances and Restlessness
● Headaches
● Irritability
● Accidental overdose and/or acute adverse effects are also quite possible, as recent statistics
demonstrate. According to a report published just last year, ADHD drugs were responsible
for nearly 23,000 emergency room visits in 2011.
This is a more than 400 percent increase in ER visits due to adverse reactions to ADHD
medication in a mere six years.
● Permanent brain damage
● Liver damage
● Heart and blood vessel damage
● Heart attack, stroke and sudden death
● Changes in personality, depression and/or hallucinations and suicide
● Increased cancer risk44

31
Results and Remedies

The over-diagnosing of learning disabilities such as the mental illness ADHD is a detriment to our

country. Many people are unaware of what is occurring. Many of these children will not be able to enter the

military45 and other professions. One wonders who will care for and protect our nation as these children no

longer qualify for these important positions because of ADHD labeling. Furthermore, who will care for these

children after the cognitive damage inflicted by ADHD drugs becomes apparent in their adulthood?

Children are no longer allowed to be children. Laws must be passed to protect these vulnerable

members of society. Governing bodies must mandate recess and break times. They must impose limits on

homework. Teachers, with no knowledge of a child’s personal circumstances and no training in the medical

field, should be prohibited from evaluating children’s medical or psychological statuses. The placement of

children on ADHD drugs by unskilled individuals violates the rights of the children and must be stopped.

Parents must be informed of their rights and the rights of their children. Many schools routinely violate

Virginia law by labeling children with ADHD and recommending the use of harmful drugs. Va. Code § 22.1-

274.3 provides, in pertinent part, "The Board of Education shall develop and implement policies prohibiting

school personnel from recommending the use of psychotropic medications for any student. . . . For the

purposes of this section, 'psychotropic medications' means those medications the prescribed intention of which

is to alter mental activity or state, including, but not limited to, antipsychotic, antidepressant and anxiolytic

medication and behavior-altering medication." This law may be on the books, but it is not on the minds of

many teachers and administrators. Furthermore, private and public schools must also be held accountable

and lose any funding they may be receiving if such laws are violated.

The Virginia General Assembly recently enacted legislation mandating minimum recess times

throughout the Commonwealth. It is sad that it took an Act of the Assembly to achieve this laudable yet

obvious change. Virginia now requires an absolute minimum of 100 minutes of physical activity per week for

elementary schoolers; that is an average of 20 minutes per day. Recall, however, that the National Association

for Sport and Physical Education and the National Academies' Institute of Medicine recommend 30 minutes per

32
day. The law is meant to promote physical health, but as Daniela Jacobs, principal of William Fox Elementary

School in Richmond, says, "getting outside and running around is also an important part of learning." “Children

cannot sit and learn all day long without active physical breaks and learn! A lot of research . . . support[s] the

fact that after about an hour, an hour and a half, of instruction, you need to get your children up and moving,”

says Jacobs.46

It should be noted, however, that this right to recess requires constant oversight and enforcement.

Every time recess is reinstated, schools use it as a weapon to enforce discipline, taking it away as a means of

punishment for the smallest of infractions. This behavior on the schools’ part loses sight of the very reason for

recess--children will become distracted and unruly without it. Taking recess away from boisterous children

defeats the very purpose behind laws requiring the break time.

ADHD medications are being used as chemical treatments to keep children robotic, to stop them from

moving too much in class and to remain focused. They are also given to help them physically keep up.

Furthermore, when children are simply not mature enough to perform at higher levels, they are given drugs in

an attempt to make them grow up. When children cannot reach academic levels or maintain schedules that

are proposed by government and in turn enforced by schools, they are labeled with ADHD. There is no pill that

is going to make a child smarter, more mature or in need of less unstructured activity. They have proven,

however, the drugs’ side effects are serious and life changing. To what lengths will we go to force children

beyond their ability and at what cost? We are already seeing the cost to life and economic stability in this

country.

An 11-year research study concluded ADHD drugs do not help children achieve higher levels of

academic success. This and other new studies provide a whole new reason why doctors and parents might

want to avoid them: they don’t work when it comes to improving academic performance.

Shirley S. Wang of The Wall Street Journal writes about one such study published in
June 2013 which looked at academic outcomes of Quebec students prescribed ADHD drugs
like Ritalin and Adderall over a span of 11 years. Researchers concluded that boys who were
taking drugs academically underperformed peers with the same symptoms who were not
medicated. The National Bureau of Economic Research also reported that girls who took
ADHD drugs had higher incidence of emotional problems than ones who did not.47
33
Side Effects

The Drugging of the American Boy

By Ryan D'Agostino, Mar 27, 2014, Published in the April 2014 issue of Esquire

By the time they reach high school, nearly 20 percent of all American boys will be diagnosed
with ADHD. Millions of those boys will be prescribed a powerful stimulant to ‘normalize’
them. A great many of those boys will suffer serious side effects from those drugs. The
shocking truth is that many of those diagnoses are wrong, and that most of those boys are
being drugged for no good reason—simply for being boys. It's time we recognize this as a
crisis.
The Drug Enforcement Administration classifies stimulants as Schedule II drugs, defined as
having a ‘high potential for abuse’ and ‘with use potentially leading to severe psychological
or physical dependence.’ (According to a University of Michigan study, Adderall is the most
abused brand-name drug among high school seniors.) In addition to stimulants like Ritalin,
Adderall, Vyvanse, and Concerta, Schedule II drugs include cocaine, methamphetamine,
Demerol, and OxyContin.

According to manufacturers of ADHD stimulants, they are associated with sudden death in
children who have heart problems, whether those heart problems have been previously
detected or not. They can bring on a bipolar condition in a child who didn't exhibit any
symptoms of such a disorder before taking stimulants. They are associated with ‘new or
worse aggressive behavior or hostility.’ They can cause ‘new psychotic symptoms (such as
hearing voices and believing things that are not true) or new manic symptoms.’ They
commonly cause noticeable weight loss and trouble sleeping. In some children, some
stimulants can cause the paranoid feeling that bugs are crawling on them. Facial tics. They
can cause children's eyes to glaze over, their spirits to dampen. One study reported fears of
being harmed by other children and thoughts of suicide.

Imagine you have a six-year-old son. A little boy for whom you are responsible. A little boy
you would take a bullet for, a little boy in whom you search for glimpses of yourself, and
hope every day that he will turn out just like you, only better. A little boy who would do
anything to make you happy. Now imagine that little boy—your little boy—alone in his bed in
the night, eyes wide with fear, afraid to move, a frightening and unfamiliar voice echoing in
his head, afraid to call for you. Imagine him shivering because he hasn't eaten all day
because he isn't hungry. His head is pounding. He doesn't know why any of this is
happening.

Now imagine that he is suffering like this because of a mistake. Because a doctor examined
him for twelve minutes, looked at a questionnaire on which you had checked some boxes,
listened to your brief and vague report that he seemed to have trouble sitting still in
kindergarten, made a diagnosis for a disorder the boy doesn't have, and wrote a prescription
for a powerful drug he doesn't need.
If you have a son in America, there is an alarming probability that this has happened or will
happen to you.

34
How do girls deal with the stress?

Stressed Out Teen Girls: Cutting to Cope posted Nov 28, 2012 in psychologytoday.com reveals how

girls are dealing with overwhelming stress, which often leads to them being mis-labeled with ADHD. The real

culprit is schedules and the pressure to succeed.

Meet Molly:
Molly is a high-performing 16-year-old teen girl in her junior year of high school. She has a
nice group of friends, works hard in school and gets excellent grades. Molly also has
multiple activities she admits she doesn’t really enjoy anymore but feels are necessary to
‘get into a good college.’

How It Starts
Cutting has a contagious element and therefore spreads in stressful environments that
contain greater numbers of vulnerable subjects. Eager to please, overly stressed teen girls
are at risk.

Many girls share that they are sickened yet fascinated when they first hear of cutting. From
there, the information is stored on a shelf in their consciousness. It is an option.

Depending on factors including stress level, stress sensitivity, emotional development,

emotional support and overall lifestyle health and balance, a teen girl either will or won’t
explore cutting herself.

Cutting Is A Symptom
It’s important to think of cutting as a symptom, which means it is secondary to a core
problem. The core problem is that fewer teens have an opportunity to experience full and
healthy development in a reasonably (not overwhelmingly) challenging environment.48

Reviews and testimonials concerning the use of Ritalin as a child

KURT’S STORY:

Rock legend Kurt Cobain started on Ritalin at age 7. This drug led to his later abuse of
stronger drugs. He committed suicide with a shotgun in 1994. Courtney Love was also
prescribed Ritalin as a child. She described the experience this way: ‘When you’re a kid and
you get this drug that makes you feel that [euphoric] feeling, where else are you going to
turn when you’re an adult?’

A study supported by the National Institute on Drug Abuse found that users of Ritalin and
similar drugs ‘showed the highest percentage of cocaine abuse.’
Because a tolerance builds up, abuse of Ritalin can lead users to consume stronger drugs
to achieve the same high. When the effects start to wear off, the person may turn to more
35
 potent drugs to rid himself of the unwanted conditions that prompted him to abuse the drug
in the first place.
In June 2005, the US Food and Drug Administration issued a series of public health
advisories warning that Ritalin and drugs like it may cause visual hallucinations,
suicidal thoughts and psychotic behavior, as well as aggression or violent behavior.

One writer put it this way: ‘Parents are never told: ‘Oh, by the way, once in a while a child
dies simply by taking their prescribed medication.’ Or children on stimulant medications
have twice the future rate of drug abuse.’ Or one third of all children on these medications
develop symptoms of obsessive-compulsive behavior within the first year.’’49

Many more stories of the side effects from those who have taken these drugs.

Disabled Vet's story by a family member

My brothers were the first round of boys put on the same ADHD drugs in the 60's. One
brother soon exhibited signs of depression due to the drug and was taken off the medicine.
We only found out much later he was simply bored in school; once in the military, he was
tested and found to be a genius. My other brother was left on the drugs from first to third
grade and then put back on much later in life due to an unfortunate event in the military
when he was beaten severely by three men. However, during the time he was off the drugs,
he earned his Master's Degree in teaching computer science and became a teacher.

So, why do I have problems with these drugs? Well, my brother is less than two years older
than I am and has had to live in an assisted living setting since his 40's. Now at age 53 he
cannot remember his keys, cell phone, address or my phone number. He cannot remember
to wear a coat when it is cold and he is no longer able to drive a car. His license, financial
responsibilities and career have all been taken away due to these drugs. He was an athlete
asked to train for the Olympics, was captain of his Track and Cross Country Teams from
middle school through college (where he was awarded scholarships to attend). He also did
some modeling. Now, he is severely overweight, has diabetes, hypertension and severe
cognition issues due to side effects from the drugs, which doctors at UVA, Georgetown and
the Veterans Affairs Administration have all confirmed due to brain shrinkage from the
medications as seen in numerous Cat scans, Pet scans and MRI's.50

Testimonials from former patients who took the drugs

My son took ritalin in the mid 80's into the mid 90's. He is now 36 and has uncontrollable
high blood pressure. They have tried everything to control it and nothing has worked. He
took it for 9 years. If I had known this was a forever side effect I would have never let him
take it. Shame on the doctors and makers of ritalin and shame on me for giving it to him. I
cut his life short. Is it worth it? NO!!

I took it from age 10 to 14. Every few years my doc would up my dose until I was maxed out
at the highest dose for my weight so she couldn't up it anymore and it was ineffective after 5
years. While on it, I lost so much weight I was borderline anorexic, I was already tiny only 4'

36
 8’ while other kids where 4' 11’ or over 5' because it severely stunted my growth and I only
weighed 78 lbs. at age 14.
I couldn't sleep at all but my parents insisted I keep taking it because if I didn't my grades
suffered and I was in trouble at school all the time. I developed uncontrollable tourettes-like
motor tics, like the need to make cat purring noises, shaking my head to the side abruptly,
clicking my tongue, or breathing in odd rhythmic patterns. It made me OCD to an extreme,
Also developed a sudden fear of people was afraid everyone was around me was laughing
at me, staring at me, judging me. I was normally an extreme people person with no fear of
public speaking or singing but I was afraid to even swallow in class, thought everyone could
hear it very loudly. My hair kept falling out in big chunks, luckily I have thick hair so it wasn't
too noticeable. Finally stopped taking it at age 14.

I am 41 years old. My parents put me on this medication when I was 2 years old. They
claimed it helped manage me. I claim it messed me up so badly that in my pre-high school
years, my parents took me to specialists all over North America to find out ‘what was wrong
with me’. The doctors kept upping my dosage. I told them I didn’t like what the medication
made me feel like, but parents back then didn’t listen to their kids.

At 16 I quit cold turkey (because my parents kicked me out of the house due to the side
effects of this drug). I experienced intense emotional distress, like paranoia, anxiety,
nervousness, etc. Today, I have gotten much better at managing my emotional issues
(WITHOUT DRUGS MIND YOU). But I still feel those emotions rather intensely. DO NOT
GIVE THIS DRUG TO YOUR CHILDREN. PLEASE DON’T.

If only my parents were more understanding and worked with me rather than shoving pills in
my face, I believe I would have grown up without any of the familial drama that led to me
being a street kid. I believe that constant attention to the child in positive, understanding
environments is THE BEST THING for a child. Listening to your child, I mean really listening,
can go a long way to alleviate much of the problems facing ADHD children.

Tourettes makes the sufferer highly sensitive to their environment and to certain foods,
which makes tics worse. I have reason to believe that Ritalin caused this seeing as how I
ticked while taking this and have never ticked prior. Also note that this drug contains
stimulants, so only take this if you have full blown ADHD without the risk of developing
Tourettes Syndrome.51

I was first given Ritalin at 6 years old. Ritalin made it hard for me to sleep. Being on Ritalin
made me feel nauseous. Ritalin caused tremors in my arms. Being forced to take Ritalin
made me self-conscious. Ritalin increased my anxiety. My anxiety turned into panic attacks,
so I was prescribed antidepressants like Zoloft, Wellbutrin and Effexor. I was also prescribed
Lamictal, an anti-convulsant. For me, Ritalin was the ‘gateway drug.52

Evidence proving the dangerous side effects of ADHD drugs continues to grow throughout

the world. The Toronto Star reported ADHD drugs suspected of hurting Canadian kids.

By David Bruser, News Reporter, and Andrew Bailey, Data Analyst

37
600 cases of Canadian kids suffering serious, sometimes fatal side effects suspected to
have been caused by ADHD medications in the past 10 years.
A Toronto Star investigation has found a growing number of doctors, nurses, pharmacists
and parents are reporting that they believe attention deficit drugs are causing major health
problems in patients, many as young as 6 and 7 years old.

The federal government is not listening.

Health Canada, which collects these adverse reaction reports, does not alert the public to
the magnitude of these side effects. This is because the regulator has not analyzed the data
it collects. It has allowed the industry to largely police itself. 'It is primarily the (drug
company’s) responsibility to monitor the safe use of their products,' Health Canada told the
Star. All parties involved agree that because doctors and nurses are not required by law to
report adverse effects the regulator only learns of a minority of cases. 'It boils down to a
simple thing: we need good safety monitoring for medication,' said Dr. Kenny Handelman,
an ADHD specialist in Oakville. 'That will help us be safer in prescribing medicines to
people.'

The Star’s data analysis revealed 7-year-olds were most likely to suffer a serious side effect.
Ten percent, or nearly 60 cases, of the nearly 600 reviewed involved boys and girls 7 years
old. A nurse said a boy suffered amnesia, mania and psychotic disorder while on Concerta.
A 7-year-old girl on the same drug developed Stevens-Johnson syndrome, a potentially life-
threatening skin disorder, as well as 13 other side effects, a doctor reported. A boy the same
age and on Strattera thought about killing himself. Twenty-two youths aged 8 to 18 tried to
kill themselves and two demonstrated suicidal behaviour. Seven completed the attempt. All
boys. An 11-year-old, one 14-year-old, two 13-year-olds and three 15-year-olds. One of the
15-year-olds who ended his life was on an antipsychotic that the reporting nurse believed
was partly to blame. The reports of the 11- and 14-year-old Canadian boys were found in
the US government side-effect database. The Star also found four deaths that were not
suicides, including an 18-year-old girl who died after a cerebral hemorrhage in 2011.

Each of the nearly 600 adverse reaction reports reviewed by the Star is the opinion of the
doctor, pharmacist or parent that a particular drug has caused a side effect. Anyone can
make a report but most of the time it is doctors who do so. Patients’ names are taken out of
the reports to protect their privacy. The drugs in the Star study are commonly prescribed to
help manage attention deficit hyperactivity disorder, a term used to describe people with
poor focus, impulsivity and hyperactivity. Though the number of Canadian kids with the
disorder is unclear — one estimate puts it at one in 20 children — parents are increasingly
turning to these drugs to deal with the diagnosis.

In the 10 years reviewed by the Star, 76 kids on ADHD medications thought about killing
themselves. One-third of these were children younger than 10, some as young as 6.
When presented with this number, Dr. Sohail Khattak, a behavioural pediatrician and ADHD
expert in Whitby, shook his head and said: 'This is an important number. I think (this)
information should be available to everyone. If I am going to be on the front line of
prescribing the medication, I need to know.' In 52 of these suicidal ideation reports, the
attention deficit drug Strattera is listed as the suspected cause of the side effect. In 12 of the
reports, Concerta is listed as the suspected cause. It is also listed as the suspected cause of
one completed suicide.

38
Canadian doctors also prescribe Adderall XR (an extended-release formula), Ritalin,
Vyvanse, Biphentin and generic versions to treat ADHD. Unlike other ADHD medications,
Strattera is not a stimulant. 'Additional scientific investigations are needed to establish a use
and effect relationship between a medication and an adverse reaction,' said a spokesperson
for Eli Lilly Canada, maker of Strattera.

The reports are supposed to play a crucial role in regulating the drug companies.
After a controlled-setting clinical trial involving thousands of participants, if a drug is
approved for sale, the reports are often the only way a government can monitor how a drug
performs in the much-larger general population. (A clinical trial may not reveal serious drug
reactions that occur infrequently or take a long time to materialize.)
The Star found the reports are piling up in Ottawa at an increasing clip: more than one-third
of the 600 serious ADHD medication side-effect reports were filed in the past two years
alone.

While the reports accumulate, the Canadian regulator says on its website it does not have
the expertise to analyze the information for trends and is relying on the US Food and Drug
Administration (FDA) for help. When asked about this in late August, the regulator told the
Star that the plan to partner with the FDA had been dropped and another strategy would be
launched this month.

Toronto psychiatrist Dr. William Wehrspann, who treats kids and adults, says this regulatory
system is like 'the police investigating themselves.' 'What bothers me is that it’s left to the
pharmaceutical companies to evaluate the effects of the drugs. That’s a conflict of interest,'
he said. 'It’s unfair.'

Dr. Derryck Smith, an ADHD specialist in B.C., says monitoring side effects is the
government’s job. 'That’s why we have Health Canada,' he said. 'There’s no point in making
the reports if (the regulator is) not going to be monitoring.' Though Health Canada told the
Star it does not have the technical expertise to analyze the adverse reaction reports, the
regulator said it does monitor drug safety by reading the reports and scientific literature and
gathering updates from other regulatory agencies.

The regulator — which a 2011 federal audit found 'does not take timely action' and is 'slow
to assess potential safety issues' — told the Star it has not investigated whether ADHD
drugs are leading to a disproportionately high number of suicide-related side effects.
'I’m almost certain no one actually evaluates these reports. Health Canada doesn’t have the
resources,' said Dr. Jack Uetrecht, a professor of pharmacy and medicine at the University
of Toronto who holds a Canada Research Chair in adverse drug reactions.
The Star conducted data analysis and made an unexpected discovery: ADHD medications
Strattera and Concerta were the second- and third-highest suspected causes of reported
serious side effects suffered by Canadian kids taking any drug in the past 10 years.

More than any cancer drug.

More than any powerful antipsychotic for kids with serious mental illness
More than nearly 1,800 other drugs reported to have been the suspected cause of a serious
side effect in a Canadian youth since 2001.
In more than 40 per cent of all cases where a youth thought about suicide, an ADHD drug is
listed as the suspected cause. The Star found side effects on most parts of the body — the
brain, respiratory system, several major organs, blood, skin, eyes, ears, and hair, including:
39
20 kids had psychotic disorders. More than 40 kids suffered depression. A doctor reported a
15-year-old felt 'worthless.' This teen, made aggressive and depressed by two different,
concurrent doses of Adderall XR, hurt himself and thought about killing himself. There were
24 convulsions, including a 7-year-old on Adderall XR in 2010.
Other side effects: 48 hallucinations, including 11 cases of kids hearing voices. 20
overdoses, eight of those intentional, including a 10-year-old boy on Ritalin. 3 strokes: an
11-year-old boy; a 16-year-old boy; and an 18-year-old girl also on birth control, 28 cases of
heart problems, including irregular heartbeats, blood pressure spikes, chest pain and one
ventricular fibrillation (severely abnormal heart rhythm). An 8-year-old girl suffered a heart
attack. Also, 23 cases involving side effects on the liver, including a 6-year-old boy on two
ADHD drugs with abnormal liver function, and a 12-year-old who died in 2007 after
developing a liver tumor.

Other side effects experienced by 7-year-olds include sleep terror, emotional disorder,
moaning, convulsion, weight loss, chest pain, muscle twitching, intentional self-injury,
depression and fecal incontinence. A long list of very rare but disturbing side effects,
including increased intracranial pressure; muscle coordination problems that made it difficult
for kids to walk or speak; involuntary and repetitive body movements; incoherent
talkativeness; eyes rolling into the head; blindness in a 14-year-old girl on two ADHD drugs;
rectal hemorrhage; angina; blisters covering the body; twisted neck; deafness; face swelling;
a tumor in an 8-year-old girl and growth retardation.

In each of the 600 reports, the youth either went to the hospital, suffered a disability or life-
threatening condition, or died. The drug companies refused, however, to say how many
Canadian kids are on their medications. Once completed, the reports are sent to Health
Canada, where officials take out much of the information, leaving only the barest of details,
before dumping the reports in a massive public database so difficult to search that doctors
and parents have little hope of extracting meaningful information.

The name of the doctor who treated the affected child is hidden from public view.
Information about whether side effects went away after the child stopped taking the ADHD
drug? Though doctors are asked to include this detail, none of the vetted reports in the
database included this information. The city, or even the province, where the child suffered
the side effect, Health Canada doesn’t want you to know.

The regulator says it is one of the few in the world to provide adverse-reaction data and that
the database increases transparency of drug safety. 'Health Canada’s priority remains the
health and safety of Canadians.' The drug companies say they face appropriate scrutiny
and oversight by Health Canada once their products hit the market. They point out that
important cardiac and psychiatric risk information is contained in their product information
document, called a monograph. (Strattera’s monograph carries warnings of increased risk of
suicidal thoughts or actions in some kids taking the drug.)

The monographs — lengthy documents, filled with medical jargon — also stress the
importance of swift reporting of side effects by doctors and patients. Yet none of the ADHD
drugmakers’ monographs mention specifics or numbers of suspected serious side effects,
especially psychiatric and heart-related ones, occurring in Canadian kids and reported to
Health Canada.

40
Strattera is listed as a 'suspect' drug in the highest number of reports of serious side effects
in children and teens, with 174. 'Lilly takes patient safety very seriously. We work to ensure
that health-care professionals and the public have the most up-to-date information on our
products'. None of the drug companies responded to Star requests to meet with company
officials in person. The total number of reports the Star found, 575, represents only a fraction
of side effects actually occurring in the youth population. Health Canada acknowledges that
side effects are under-reported.

This is in part the result of a flawed federal drug safety law that does not require doctors to
report serious side effects. Reporting — for doctors, nurses and pharmacists — is voluntary.
Several ADHD doctors told the Star the federal government should change the law.
'The more you report, the more red flags you can see,' said Khattak. 'Severe adverse event
(reporting) should be made mandatory. This type of information is very crucial.'

Thumbing through a stack of side-effect reports, Khattak was troubled by how many
Canadian kids were on multiple ADHD medications. The Star found 61 kids were on more
than one ADHD drug, some of them on three, when they experienced side effects. A 16-
year-old boy on two ADHD drugs suffered delusion, morbid thoughts and heard voices.
'I really, personally, pharmacologically, don’t understand the reason behind that,' Khattak
said. 'If you find that the one medication is not adequate, then stop using it and move to
something else.'

Khattak worries that the cases involving multiple ADHD drugs are the result of doctors
rushing into writing a prescription without first looking for other pre-existing problems like
anxiety, obsessive compulsive disorder or depression. Such conditions could explain why
the drugs do not work the way they should, he said.

Dr. Lily Hechtman, an ADHD expert in Montreal, said the reports in the database are missing
crucial information, such as the rate at which suicidal behaviour regularly occurs in the
general youth population. Without such information, she said, 'these reports have no credit.'
With a voluntary reporting system, the Star found it impossible to compare the rate of
suicidal behaviour on ADHD medication with the youth population as only a minority of
adverse effects are reported.

Hechtman, who has been treating and researching ADHD since 1975, added that the
reports do not reflect another important detail: 'The way in which medication is given is really
lousy . . . An average dose, for some children, is way too much. You’re supposed to start
very low and go up very slowly. To cut corners, to respond to very huge demands of patient
loads, sometimes physicians start with an average dose.'

The younger a child, the more difficult it is to definitively diagnose ADHD, said Khattak, who
wonders if 6 and 7 year-olds suffering side effects were misdiagnosed and incorrectly
medicated. 'That is probably where the problem is coming in. I think it’s a diagnostic (issue).'
The drug companies say their medications should not be used in children younger than 6.
The Star found 19 cases of side effects in kids aged 4 and 5. Ten of those reports were
serious, including a 5 year-old boy hallucinating and crying and 5 year –old girl suffering
amnesia, anxiety and a speech disorder.53

41
 Former Governor of New York David Paterson blames the current crisis of heroin overdoses on the

epidemic of medicating children for ADHD. The article Ex-Governor Paterson Blames Heroin Crisis on

Childhood Medication points out the connection between ADHD medications and the habit of seeking

pharmaceuticals to solve all our problems.

Former Gov. David Paterson told radio listeners today that he believes the recent
spike in heroin overdose deaths is a consequence of over-medicating children.
On the heels of a city report showing that unintentional fatal drug poisonings increased by
41 percent between 2010 and 2013, with heroin involved in 54 percent of all deadly
overdoses, Mr. Paterson blamed the epidemic on a culture of medicating children for
conditions like attention deficit hyperactivity disorder.

'There is a lot of misery, a lot of pain, and we are feeding it,' the former governor
said. 'I think there are more eight, nine, 10-year-olds who are on drugs that are legal.'
Mr. Paterson argued that putting children on substances like Ritalin and Adderall leaves
them seeking chemical relief later in life. 'I think we’re over diagnosing, and the industry is
making tons of money,' said Mr. Paterson. 'When they get older, it’s habit to go and find
some pharmaceutical solution.'

A 2007 study conducted in Hungary did find disproportionate number of heroin users
also had ADHD. The reasons for this correlation are unclear.
Many have theorized that the surge in heroin overdoses is influenced by people addicted to
prescription painkillers like oxycodone, which have become more difficult and expensive to
access amid crackdowns on the drugs, turning to heroin for a similar but cheaper high.

'New York City residents of low-income neighborhoods and white New Yorkers have
the highest heroin-involved mortality rates; however, 2013 data show the highest increases
are among residents of the wealthiest neighborhoods and younger New Yorkers,' the study
said.54

A 2012 survey by the federal Substance Abuse and Mental Health Services Administration
(PDF) found that about 669,000 people over age 12 had used heroin at some point in the
year. About 156,000 of those were first-time users, and roughly 467,000 were considered
heroin-dependent -- more than double the number in 2002.55 [The same time NCLB was
instituted]

US Dept. of Health and Human Services reported, Abuse of Prescription (Rx) Drugs Affects Young

Adults Most (June 2013)

Young adults (age 18 to 25) are the biggest abusers of prescription (Rx) opioid pain
relievers, ADHD stimulants, and anti-anxiety drugs. They do it for all kinds of reasons,
including to get high, or because they think Rx stimulants will help them study better. But Rx
abuse is dangerous. A new study shows users are combining those drugs with other
substances.56

42
 Scientists with NIH found long term effects of Ritalin included more evidence of dysfunctional brain and

depressive-like behaviors in adulthood. According to the Article, Biology of Mood Molecules on Your Mind by

Dr. William Carlezon, ADHD treatments lead to depression and despair behaviors.

New research by scientists from Harvard-affiliated McLean Hospital and the National
Institutes of Health, presented at the annual meeting of the American College of
Neuropsychopharmacology, provides a preliminary answer. It suggests that the
misdiagnosis of ADHD followed by treatment with Ritalin may lead to a risk that the patient
might develop depression in adulthood.

William Carlezon, PhD and Susan Anderson, PhD tested the long-term effects of Ritalin on
normal juvenile rats aged between four and twelve in equivalent human years. Dr. Carlezon
exposed the rats to twice-daily doses of Ritalin. As the rodents reached adulthood, they had
a lower than normal response to pleasure or reward. Scientists test a rat's response to
rewarding things such as, food, sexual behavior, cocaine or electrical brain stimulation. Rats
exposed to Ritalin in the developing years had a lower than normal response to these
stimuli.

Dr. Carlezon has also found that the Ritalin treated rats were more likely to show despair-
like behaviors in stressful situations. To test this, the rats are placed in large water tanks.
The scientists measure the amount of time the rat spends trying to find a way out. If a young
rat is exposed to Ritalin then tested as an adult, it will spend less time trying to get out and
float passively in the water.
Even though these initial findings are from studies done on rats, the doctors extrapolate that
stimulants like Ritalin may have long-term consequences on normally functioning human
brains.57

Prof. Joan Baizer of the University of Buffalo found that Ritalin causes long-lasting changes in brain cell

structure and function.

The changes appear to be similar to those that occur with other stimulant drugs such as
amphetamine and cocaine, said Joan Baizer, Ph.D., UB professor of physiology and
biophysics and senior author of the study.
Results of the research were presented Nov. 11, 2001 at the annual meeting of the Society
for Neuroscience.

'Clinicians consider Ritalin to be short-acting,' said Baizer. 'When the active dose has
worked its way through the system, they consider it 'all gone.' Our research with gene
expression in an animal model suggests that it has the potential for causing long-lasting
changes in brain cell structure and function.' Ritalin is the drug of choice for the treatment of
attention deficit disorder in children.58

43
 Studies confirm ADHD and antipsychotic drugs shrink the frontal lobe, which causes disabled

brain functioning resulting in loss of competency.

In an article by Kelly Patricia O’Meara discussing her interview of Dr. Nancy Anderson, who was

awarded the President’s National Medal of Science in 2000, the danger of psychiatric drugs was exposed. Dr.

Anderson proved antipsychotics cause brain shrinkage. Ms. O'Meara wrote:

'The use of antipsychotic drugs long has been referred to as a 'chemical lobotomy' because
they actually can disable normal brain function. Along with brain shrinkage, antipsychotics
also can cause obesity, high blood pressure, high cholesterol and diabetes.' Antipsychotic
drugs cause brain shrinkage. This is the conclusion of yet another study, considered the
largest longitudinal brain-scan data set ever compiled, documenting the adverse effects of
antipsychotic drugs on brain tissue. According to the study’s author, University of Iowa
professor, Nancy Andreasen, Ph.D., 'the higher the antipsychotic medication doses, the
greater the loss of brain tissue.' Andreasen further explained that 'antipsychotic treatment
has a negative impact on the brain, so…we must get the word out that they should be used
with great care, because even though they have fewer side effects than some of the other
medications, they are certainly not trouble free and can have lifelong consequences for the
health and happiness of the people we serve.'

Andreasen found the results 'very upsetting.' With more than six million people, including
nearly one million children, (28,000 of them under the age of five), taking Antipsychotics, it’s
understandable why the author of the study found the new data 'upsetting.'

Anyone in their right mind would find the data upsetting. Brain shrinkage for any reason
can't be a good thing, but it especially isn't a good thing when it is caused by the psychiatric
medication prescribed as a medicinal 'treatment.' Antipsychotic medications, such as
Seroquel, Abilify, Zyprexa, Risperdal and Geodon are not approved for the treatment of
children (18 and under) yet, there are nearly thirty thousand children under the age of
five currently prescribed this brain-destructive drug.

There also is the side effect called Tardive Dyskinesia, which is a potentially irreversible
neurological disorder resulting in involuntary and uncontrollable movements, including
slurred speech, tremors, anxiety, inability to sit still, inner restlessness, distress and
paranoia.

And the Food and Drug Administration, FDA, requires antipsychotics to carry a 'Black Box
Warning,' the most serious drug warning issued by the FDA, as the antipsychotics increase
the risk of death in elderly with dementia.

Between the FDA and other international drug regulatory agencies, there are no less than
55 warnings on antipsychotic drugs and the FDA, alone, has received more than 120,000

44
 adverse event reports associated with antipsychotic drugs, including diabetes mellitus,
pancreatitis, tremor and even death.

Professor Andreasen apparently was so surprised by the results of the study that it was held
for two years with the belief that the data may be inaccurate. Unfortunately, the data were
accurate and Andreasen pondered the effect the data would have on society.

Okay, let’s ponder the answer to this question. Antipsychotic drugs shrink the brain, cause
excessive weight gain, diabetes, Tardive Dyskinesia, tremors, anxiety, slurred speech, inner
restlessness and a host of other adverse effects.

Seems like a no-brainer. But, maybe, the wrong question is being asked. Maybe the
question should be: what exactly is the upside of taking an antipsychotic?

Dr. Nancy Anderson was awarded the President’s National Medal of Science in 2000. She
has also received many other awards, including the Interbrew-Baillet-Latour Prize from the
Belgian government, the Rhoda and Bernard Sarnat Prize from the Institute of Medicine, the
Lieber Prize for Outstanding Schizophrenia Research, the Sigmund Freud Award from the
American College of Psychoanalysis, the Kolb Award and the Sachar Award from Columbia
University. She was Editor-in-Chief of The American Journal of Psychiatry for 13 years,
completing her third term in 2005.
http://nancyandreasen.com/index.html

Kelly Patricia O’Meara is an award-winning former investigative reporter for the Washington Times,
Insight Magazine, penning dozens of articles exposing the fraud of psychiatric diagnosis and the dangers of
the psychiatric drugs—including her ground-breaking 1999 cover story, Guns & Doses, exposing the link
between psychiatric drugs and acts of senseless violence. She is also the author of the highly acclaimed book,
Psyched Out: How Psychiatry Sells Mental Illness and Pushes Pills that Kill. Prior to working as an
investigative journalist, O’Meara spent sixteen years on Capitol Hill as a congressional staffer to four Members
of Congress.59

Americans use more pharmaceuticals

Overall, Americans use more medicines than people in other developed countries.
They rank first for their use of antipsychotics as well as drugs for dementia, respiratory
problems and rheumatoid arthritis. Several factors may explain this, including high levels of
obesity and high rates of diagnosis.
Americans also have faster access to new drugs than patients in many other
countries. That’s in part because the US has always been a very attractive market for
pharmaceutical companies: It’s big, accounting for 34 percent of the world market; has low
levels of price regulation; and offers few barriers to market entry once FDA approval has
been secured. (By contrast, in some other countries there may be a time lag between
clinical approval of a drug and the point when it is added to official lists of reimbursable
drugs.) The result is that companies often choose the US to launch new products. And,
because the US market is so big and profitable, investments in research and development
have long been steered towards meeting its clinical needs.60
45
 The United States has one of the highest rates of death from dementia in the world. There is a growing

rate of dementia at a much younger age. Could this be because we are the largest user of pharmaceuticals?

As the children of pharmaceutical use age, the growth of deaths from dementia rises. Now that we are aware

of the frontal lobe shrinkage caused by ADHD drugs and other drugs used to treat their side effects, it seems

clear-we are now seeing the effects of their use.61

Other side effects include stunting children's growth, insomnia, weight loss, depression, cardiac

damage, anxiety and many others. ADHD medicine is also a gateway drug to other drugs due to the side

effects and addiction. The use of these drugs puts children at greater risk of being mislabeled with bipolar and

schizophrenic disorders.62 This is because the side effects of ADHD medication can include hearing voices

and behaving erratically. Many teachers recommend testing and 90% of the time, pediatricians, who lack

sufficient training on the subject, place these children on drugs after a 10-minute appointment, ruining these

children's lives.

These drugs change the chemicals in the child's brain. They were banned for three years by the FDA

due to the alarming increase in ADHD drug-related ER visits. Between 2005 and 2010, the number of

emergency department visits involving ADHD stimulant medications increased from 13,379 to 31,244 visits. 63

This increase coincided with the implementation of No Child Left Behind. When the FDA permitted the drugs

back on the market, it did so only after requiring them to carry a “black label” warning, which denotes that the

drugs can have serious high-risk and permanent side effects. The FDA added this requirement to alert parents

to the seriousness of these medicines.

A societal propensity toward prescription medications to solve all problems has permeated our culture.

When 60% of Americans are on five prescriptions or more, it is no wonder children are now following suit.64 As

many as 1 in 3 boys, not to mention many girls, in parts of Virginia are now being labeled with the mental

illness of ADHD according to the CDC. An increasing number of parents, with a lack of awareness concerning

black label, antipsychotic drugs, are placing their children on the medications upon the advice of a doctor or

teacher.

46
 These drugs are in the same category as cocaine and the side effects are devastating. The damage to

the frontal lobe after years of use can cause disabled brain functioning, now known as a chemical lobotomy.

This leaves individuals with two things: 1) no hope for a normal life; and 2) the necessity of having to live in

institutional housing. One wonders how this is worth the risk of taking the drugs. If cocaine was found in the

system of a woman having a newborn child, the child would be taken away from her. Yet nowadays, toddlers

as young as two years old are being prescribed Schedule II psychostimulants just because they move,

misbehave, or talk too much. With a growing propensity for using prescription drugs in the United States,

medications have become the answer to everything without weighing the risks involved with the side effects.

Journalist Robert Whitaker pointed out in a 2014 exchange with Dr. Allen Francis:

I believe there is clear evidence in the scientific literature of the following:

 Antipsychotics, antidepressants and benzodiazepines increase the chronicity of the disorders they are

used to treat, and increase the risk that a person will become disabled.

 Stimulants fail to provide a long-term benefit to children diagnosed with ADHD, and thus, once their

risks are considered, do more harm over the long-term.

 The cocktail of drugs given to bipolar patients is associated with a notable worsening over the long-term

outcomes, particularly in terms of how patients function.

“Given that evidence base, I believe that protocols for prescribing the drugs need to be dramatically changed.

The protocol for using antipsychotics in the Open Dialogue approach in northern Finland provides a model to

emulate. Try to minimize immediate use of the drugs in first-episode cases (and thus employ other non-drug

treatments first), and if the drugs are used, try to minimize long-term use. The protocol in northern Finland is

best described as a selective-use protocol, which has produced outcomes markedly superior to our own, and

thus there is an “evidence-based” rationale for using the drugs in this way.”65

47
Psychotropic Drugs and Violence

Long term cognitive deficits are not the worst side effect that can result from the use of psychotropic

drugs. These drugs have been linked with mass shootings and violent acts. Even short term use of such

drugs has been linked with episodes of extreme violence. One author, Dan Roberts, has noted the following.

On to the list of mass shooters and the stark link to psychotropic drugs.
● Eric Harris age 17 (first on Zoloft then Luvox) and Dylan Klebold aged 18 (Columbine school
shooting in Littleton, Colorado), killed 12 students and 1 teacher and wounded 23 others,
before killing themselves. Klebold’s medical records have never been made available to the
public.
● Jeff Weise, age 16, had been prescribed 60 mg/day of Prozac (three times the average
starting dose for adults!) when he shot his grandfather, his grandfather’s girlfriend and many
fellow students at Red Lake, Minnesota. He then shot himself. 10 dead, 12 wounded.
● Cory Baadsgaard, age 16, Wahluke (Washington state) High School, was on Paxil (which
caused him to have hallucinations) when he took a rifle to his high school and held 23
classmates hostage. He has no memory of the event.
● Chris Fetters, age 13, killed his favorite aunt while taking Prozac.
● Christopher Pittman, age 12, murdered both his grandparents while taking Zoloft.
● Mathew Miller, age 13, hung himself in his bedroom closet after taking Zoloft for 6 days.
● Kip Kinkel, age 15, (on Prozac and Ritalin) shot his parents while they slept then went to
school and opened fire killing 2 classmates and injuring 22 shortly after beginning Prozac
treatment.
● Luke Woodham, age 16 (Prozac) killed his mother and then killed two students, wounding
six others.
● A boy in Pocatello, ID (Zoloft) in 1998 had a Zoloft-induced seizure that caused an armed
standoff at his school.
● Michael Carneal (Ritalin), age 14, opened fire on students at a high school prayer meeting in
West Paducah, Kentucky. Three teenagers were killed, five others were wounded..
● A young man in Huntsville, Alabama (Ritalin) went psychotic chopping up his parents with an
ax and also killing one sibling and almost murdering another.
● Andrew Golden, age 11, (Ritalin) and Mitchell Johnson, aged 14, (Ritalin) shot 15 people,
killing four students, one teacher and wounding 10 others.
● TJ Solomon, age 15, (Ritalin) high school student in Conyers, Georgia opened fire on and
wounded six of his classmates.
● Rod Mathews, age 14, (Ritalin) beat a classmate to death with a bat.
● James Wilson, age 19, (various psychiatric drugs) from Breenwood, South Carolina, took a
.22 caliber revolver into an elementary school killing two young girls and wounding seven
other children and two teachers.
● Elizabeth Bush, age 13, (Paxil) was responsible for a school shooting in Pennsylvania
● Jason Hoffman (Effexor and Celexa) – school shooting in El Cajon, California
● Jarred Viktor, age 15, (Paxil), after five days on Paxil he stabbed his grandmother 61 times.
● Chris Shanahan, age 15 (Paxil) in Rigby, ID who out of the blue killed a woman.
● Jeff Franklin (Prozac and Ritalin), Huntsville, AL, killed his parents as they came home from
work using a sledge hammer, hatchet, butcher knife and mechanic’s file, then attacked his
younger brothers and sister.

48
● Neal Furrow (Prozac) in LA Jewish school shooting reported to have been court-ordered to
be on Prozac along with several other medications.
● Kevin Rider, age 14, was withdrawing from Prozac when he died from a gunshot wound to
his head. Initially it was ruled a suicide, but two years later, the investigation into his death
was opened as a possible homicide. The prime suspect, also age 14, had been taking Zoloft
and other SSRI antidepressants.
● Alex Kim, age 13, hung himself shortly after his Lexapro prescription had been doubled.
● Diane Routhier was prescribed Welbutrin for gallstone problems. Six days later, after
suffering many adverse effects of the drug, she shot herself.
● Billy Willkomm, an accomplished wrestler and a University of Florida student, was
prescribed Prozac at the age of 17. His family found him dead of suicide – hanging from a
tall ladder at the family’s Gulf Shore Boulevard home in July 2002.
● Kara Jaye Anne Fuller-Otter, age 12, was on Paxil when she hung herself from a hook in her
closet. Kara’s parents said ‘…. the damn doctor wouldn’t take her off it and I asked him to
when we went in on the second visit. I told him I thought she was having some sort of
reaction to Paxil…’)
● Gareth Christian, Vancouver, age 18, was on Paxil when he committed suicide in 2002,
● (Gareth’s father could not accept his son’s death and killed himself.)
● Julie Woodward, age 17, was on Zoloft when she hung herself in her family’s detached
garage.
● Matthew Miller was 13 when he saw a psychiatrist because he was having difficulty at
school. The psychiatrist gave him samples of Zoloft. Seven days later his mother found him
dead, hanging by a belt from a laundry hook in his closet.
● Kurt Danysh, age 18 and on Prozac, killed his father with a shotgun. He is now behind
prison bars and writes letters, trying to warn the world that SSRI drugs can kill.
● Woody ____, age 37, committed suicide while in his 5th week of taking Zoloft. Shortly before
his death his physician suggested doubling the dose of the drug. He had seen his physician
only for insomnia. He had never been depressed, nor did he have any history of any mental
illness symptoms.
● A boy from Houston, age 10, shot and killed his father after his Prozac dosage was
increased.
● Hammad Memon, age 15, shot and killed a fellow middle school student. He had been
diagnosed with ADHD and depression and was taking Zoloft and ‘other drugs for the
conditions.’
● Matti Saari, a 22-year-old culinary student, shot and killed 9 students and a teacher and
wounded another student, before killing himself. Saari was taking an SSRI and a
benzodiazapine.
● Steven Kazmierczak, age 27, shot and killed five people and wounded 21 others before
killing himself in a Northern Illinois University auditorium. According to his girlfriend, he had
recently been taking Prozac, Xanax and Ambien. Toxicology results showed that he still had
trace amounts of Xanax in his system.
● Finnish gunman Pekka-Eric Auvinen, age 18, had been taking antidepressants before he
killed eight people and wounded a dozen more at Jokela High School – then he committed
suicide.
● Asa Coon from Cleveland, age 14, shot and wounded four before taking his own life. Court
records show Coon was on Trazodone.
● Jon Romano, age 16, on medication for depression, fired a shotgun at a teacher in his New
York high school.66

49
 In Psychiatric Meds: Prescription for Murder?, Rebecca Terrell of The New American discusses the

connection between psychotropic drugs and violence. “In virtually every mass school shooting during the past

15 years, the shooter has been on or in withdrawal from psychiatric drugs,” observed Lawrence Hunter of the

Social Security Institute.

There is a striking connection between school shootings and psychotherapeutic drugs, also
known as psychotropics. Consider these examples:
• Toby Sincino, a 15-year-old who shot two teachers and himself in 1995 at his South Carolina
school, was taking the antidepressant Zoloft.
• Shawn Cooper fired two shotgun rounds in 1999 at his Idaho high school while on an
antidepressant.
• Jason Hoffman wounded five people with a shotgun at his California high school in 2001
while on two antidepressant medications, Celexa and Effexor.
• Matti Saari, a college student in Finland, shot and killed 10 people before committing suicide
at his university in 2008. The Finnish Ministry of Justice later reported he was taking an
antidepressant and an anti-anxiety medication.
• Steve Kazmierczak killed six including himself at Northern Illinois University in 2008 while in
withdrawal from the antidepressant Prozac.
• Tim Kretschmer murdered 15 students and teachers at his secondary school in Germany in
2009, and then committed suicide. Police reported Kretschmer was taking prescriptions to
treat depression.
A 2002 Fox News interview with Cory Baadsgaard sheds some light on the possible
mental state of these criminals. The year before, at age 16, Baadsgaard held a high-school
class hostage at gunpoint in Washington state. Fortunately, no one was killed or physically
hurt during the incident. The young man remembers the day in this way: “In the morning I
didn’t feel like going to school. I felt sick; didn’t feel like I could get up very well. So I went back
to bed. And the next thing I remember I’m in juvie in the detention center where I used to live.”
Baadsgaard says he has no memory of the incident. He was tried as an adult but spent only
14 months in prison because expert psychiatric testimony convinced the jury his crime was
the result of adverse reactions the antidepressants Effexor and Paxil.
CCHRI states that government officials are well aware of the connection. “Between
2004 and 2011, there have been over 11,000 reports to the US FDA’s MedWatch system of
psychiatric drug side effects related to violence,” including 300 homicides. The FDA estimates
this total is less than 10 percent of the actual number of incidents since most go unreported.
However, there has been little government action at all, with one exception. Due to the
“large body of scientific research establishing a connection between violence and suicide and
the use of psychotropic drugs,” the New York State Senate introduced a bill in 2000 to “require
police to report to the Division of Criminal Justice Services (DCJS), certain crimes and
suicides committed by persons using psychotropic drugs.” The bill died in committee, and the
issue remains unresolved.
Instead, in response to the Sandy Hook tragedy and ignoring the obvious, Senator Toni
Nathaniel Harp and Representative Toni E. Walker, both Democrats of the Connecticut
General Assembly, introduced Bill 374, “requiring behavioral health assessments for children,”
mandating psychiatric testing for public school students in grades 6, 8, 10, and 12 and for
homeschooled children at ages 12, 14, and 17.

50
 The assessments would have to be reported to the State Board of Education, and
there is great likelihood that more children would end up on psychiatric meds after such
tests.67

Excerpt from The Nazi Death Machine-Hitler's Drugged Soldiers By Andreas Ulrich

The stimulant Pervitin [a methamphetamine in the same category as ADHD

medications] was delivered to the at the soldiers front. In a letter dated November 9, 1939,
to his 'dear parents and siblings' back home in Cologne, a young soldier stationed in
occupied Poland wrote: 'It's tough out here and I hope you'll understand if I'm only able to
write to you once every two to four days soon. Today I'm writing you mainly to ask for some
Pervitin ...; Love, Hein.'
Pervitin, a stimulant, was the German army's -- the Wehrmacht's -- wonder drug.
On May 20, 1940, the 22-year-old soldier wrote to his family again: 'Perhaps you could get
me some more Pervitin so that I can have a backup supply?' And, in a letter sent from
Bromberg on July 19, 1940, he wrote: 'If at all possible, please send me some more
Pervitin.' The man who wrote these letters became a famous writer later in life. He was
Heinrich Boell and in 1972 he was the first German to be awarded the Nobel Prize for
Literature in the post-war period.
Many of the Wehrmacht's soldiers were high on Pervitin when they went into battle,
especially against Poland and France -- in a Blitzkrieg fueled by speed. The German military
was supplied with millions of methamphetamine tablets during the first half of 1940. The
drugs were part of a plan to help pilots, sailors and infantry troops become capable of
superhuman performance. But the Nazis were less than diligent in monitoring side-effects
like drug addiction and a decline in moral standards.
After it was first introduced into the market in 1938, Pervitin, a methamphetamine
drug newly developed by the Berlin-based Temmler pharmaceutical company, quickly
became a top seller among the German civilian population. According to a report in the
Klinische Wochenschrift (‘Clinical Weekly’), the supposed wonder drug was brought to the
attention of Otto Ranke, a military doctor and director of the Institute for General and
Defense Physiology at Berlin's Academy of Military Medicine. The effects of amphetamines
are similar to those of the adrenaline produced by the body, triggering a heightened state of
alert. In most people, the substance increases self-confidence, concentration and the
willingness to take risks, while at the same time reducing sensitivity to pain, hunger and
thirst, as well as reducing the need for sleep. In September 1939, Ranke tested the drug on
90 university students and concluded that Pervitin could help the Wehrmacht win the war. At
first Pervitin was tested on military drivers who participated in the invasion of Poland. Then,
according to criminologist Wolf Kemper, it was 'unscrupulously distributed to troops fighting
at the front.'
During the short period between April and July of 1940, more than 35 million tablets
of Pervitin and Isophan (a slightly modified version produced by the Knoll pharmaceutical
company) were shipped to the German army and air force. Some of the tablets, each
containing three milligrams of active substance, were sent to the Wehrmacht's medical
divisions under the code name OBM and then distributed directly to the troops. A rush order
could even be placed by telephone if a shipment was urgently needed. The packages were
labeled 'Stimulant,' and the instructions recommended a dose of one to two tablets 'only as
needed, to maintain sleeplessness.'
Even then, doctors were concerned about the fact that the regeneration phase after
taking the drug was becoming increasingly long and that the effect was gradually decreasing
51
 among frequent users. In isolated cases, users experienced health problems like excessive
perspiration and circulatory disorders and there were even a deaths. Leonardo Conti, the
German Reich's minister of health and an adherent of Adolf Hitler's belief in asceticism,
attempted to restrict the use of the pill, but was only moderately successful, at least when it
came to the Wehrmacht. Although Pervitin was classified as a restricted substance on July
1, 1941, under the Opium Law, ten million tablets were shipped to troops that same year.
Pervitin was generally viewed as a proven drug to be used when soldiers were likely to be
subjected to extreme stress. A memorandum for navy medical officers stated the following:
'Every medical officer must be aware that Pervitin is a highly differentiated and powerful
stimulant, a tool that enables him, at any time, to actively and effectively help certain
individuals within his range of influence achieve above-average performance.'
'Their spirits suddenly improved'
The effects were seductive. In January 1942, a group of 500 German soldiers
stationed on the eastern front and surrounded by the Red Army were attempting to escape.
The temperature was minus 30 degrees Celsius. A military doctor assigned to the unit wrote
in his report that at around midnight, six hours into their escape through snow that was
waist-deep in places, 'more and more soldiers were so exhausted that they were beginning
to simply lie down in the snow.' The group's commanding officers decided to give Pervitin to
their troops. 'After half an hour,' the doctor wrote, 'the men began spontaneously reporting
that they felt better. They began marching in orderly fashion again, their spirits improved and
they became more alert.'
Towards the end of the war, Germany used younger and younger soldiers. More and
more of them relied on drugs or alcohol for courage and endurance. It took almost six
months for the report to reach the military's senior medical command. But its response was
merely to
issue new guidelines and instructions for using Pervitin, including information about risks
that barely differed from earlier instructions. The 'Guidelines for Detecting and Combating
Fatigue,' issued June 18, 1942, were the same as they had always been: 'Two tablets taken
once eliminate the need to sleep for three to eight hours and two doses of two tablets each
are normally effective for 24 hours.'
Toward the end of the war, the Nazis were even working on a miracle pill for their
troops. In the northern German seaport of Kiel, on March 16, 1944, then Vice-Admiral
Hellmuth Heye, who later became a member of parliament with the conservative Christian
Democratic party and head of the German parliament's defense committee, requested a
drug 'that can keep soldiers ready for battle when they are asked to continue fighting beyond
a period considered normal, while at the same time boosting their self-esteem.'
Drugs were also a problem on the home front, but the Nazis tried harder to control
their abuse. The Nazi leadership was more lenient with those who became drug-addicted
as a result of the war than with alcoholics, probably because the Wehrmacht was concerned
that it could be sued for damages, because it was in fact responsible for dispensing the
drugs in the first place.68

Germany then supplied the US with the same or slightly modified drugs for ADHD diagnosed children.

These drugs brought with them the same side effects discussed above. Prior to being acquired by other

companies the two German drug makers Temmler69 and Knoll manufactured and distributed Adderall70 and

Isophan to the US.71 72

52
Hitler
Hitler was a meth addict, records show, By Lazar Berman

German dictator Adolf Hitler was a drug addict and used crystal meth regularly,
[Methamphetamines are used to treat ADHD] according to the 47-page World War II US
Military Intelligence dossier. The dossier alleges that the fuehrer took methamphetamines
before his July 1943 meeting with Italian dictator Benito Mussolini, during which Hitler, sick
and under stress, berated his Italian ally for hours. Hitler became addicted to drugs after
meeting Berlin doctor Theodor Morell. He provided intravenous glucose and meth when
Hitler needed a shot of energy, especially before his speeches. Morell prescribed barbiturate
tranquilizers for insomnia and Coramine stimulants if Hitler was over-sedated. The
methamphetamine might have contributed to Hitler showing signs of Parkinson’s disease as
the war dragged on, with one of his top generals, Heinz Guderian, writing that 'it was no
longer his left hand but the whole of his left side of his body that trembled… He walked
awkwardly, stooped more than ever and his gestures were both jerky and slow.' [Now it
would have been diagnosed as Tardive Dyskinesia, which is a potentially irreversible
neurological disorder resulting in involuntary and uncontrollable movements, including
slurred speech, tremors, anxiety, inability to sit still, inner restlessness, distress and
paranoia. This is the side effect of methamphetamine's like Ritalin, Pervitin, Concerta and
other ADHD medications] Before Hitler left to confront Mussolini in 1943, Morell wrote in his
diary: 'Fuehrer had me sent for at ten-thirty A.M., said he has had the most violent stomach
pains since three A.M. and hasn’t slept a wink. His abdomen is as taut as a board, full of
gas, with no palpation pains anywhere.' Looking very pale and exceptionally jumpy: facing a
vital conference with the Duce in Italy tomorrow.
'Diagnosis: Spastic constipation caused by overwork over the last few days — three days
with virtually no sleep, one conference after another and working far into the night.' [Fecal
incontinence and insomnia are side effects of ADHD methamphetamine drugs]73

Plying individuals with methamphetamines to help them cope with unyielding schedules and undue

stress. Sound familiar? Modern medicine and academia have conspired to form what one might refer to as a

"Hitlerian" approach to child rearing. When one can see similarities between Nazi Germany and modern

American academia, it is time to effect a change.

As if drugging children like Hitler drugged his soldiers is not enough, these drugs make one capable of

acts the normal person would never consider. The cocktails of drugs now given to children to deal with the side

effects of the ADHD drugs can have disastrous consequences. The German company who supplied these

drugs in WWII is now supplying the US with Adderall.74

The Journal Injury Prevention report, published online, found there were 154 school shootings between

2013 and 2015. The number rose from 35 in 2013, to 55 in 2014, to 64 in 2015. This is an average of more

than one school shooting per week in the United States.75

53
Drugs on the Firing Line
Antidepressants are psychiatric drugs that form a common thread in school shootings.
There are five categories of antidepressants: selective serotonin reuptake inhibitors (SSRI),
selective norepinephrine reuptake inhibitors (SNRI), monoamine oxidase inhibitors (MAOI),
tricyclic antidepressants (TCA), and atypical antidepressants. Despite the moniker, doctors
prescribe these medicines for much more than depression. They use them to treat such
ailments as obsessive-compulsive disorder (OCD), bipolar disorder, bulimia nervosa, panic
disorder, social anxiety disorder (SAD), premenstrual dysphoric disorder (PMDD), and
attention deficit hyperactivity disorder (ADHD). Other suspect medications, such as Ritalin,
Adderal, and Concerta, are sympathomimetic amines, prescribed to treat ADHD.
These medicines act on the body’s nervous system — altering its chemical
communication pathways to affect areas of the brain involved in judgment, abstract reasoning,
memory, emotions, and the fight-or-flight response — explains Michelle Morrison-Valfre, MHS,
FNP in her 2005 book, Foundations of Mental Health Care. The expected result is a calm
mood and clear thinking. However, in some cases unexpected results occur.
The Physicians’ Desk Reference (PDR), an authoritative source of all FDA-approved
drug labeling information, identifies the potential hazardous side effects of
psychotherapeutics, including suicidal and homicidal ideation. Unfortunately, such effects are
not uncommon. In fact, when taking a particular medication poses serious risks, the FDA
requires drug manufacturers to highlight the dangers in eye-catching boxes on pharmaceutical
packaging. A drug’s “black box warning” alerts consumers to the major hazards they face
when taking that medicine. Most prescriptions do not have black box warnings — only those
that can cause extreme adverse reactions compared to the potential benefit. Among
psychotherapeutics’ black box warnings are:

• “Increased risk of suicidal ideation in short-term studies in children and adolescents with
ADHD.” (Strattera, SNRI)
• “Antidepressants increased risk of suicidal thinking and behavior (suicidality) in short-term
studies in children, adolescents and young adults with major depressive disorder and other
psychiatric disorders.” (Zoloft, SSRI)
• “Monitor appropriately and observe closely for clinical worsening, suicidality or unusual
changes in behavior for all patients who are started on antidepressant therapy.” (Parnate,
MAOI)
• “High potential for abuse; avoid prolonged use. Misuse of amphetamine may cause sudden
death and serious cardiovascular events.” (Adderal, sympathomimetic amine)

Additionally, all depression and ADHD therapies contain FDA-mandated warnings for
caregivers to monitor for suicidal thinking, worsening of depression symptoms, and unusual
changes in behavior. Patients taking the tricyclic Elavil are cautioned to “seek medical
attention for symptoms of mania, increasing psychosis or paranoia.” Literature warns parents
of children on Ritalin that “stimulants at usual doses can cause treatment emergent psychotic
or manic symptoms (hallucinations, delusional thinking, mania) in children and adolescents
without prior history of psychotic illness.” (Emphasis added.) The PDR also reports clinical
trials have identified aggressive behavior and hostility as notable side effects of ADHD
medications.
The advent of these drugs coincides disturbingly with a rise in the adolescent suicide
rate. Ritalin was introduced in 1956. Antidepressants made their debut in the early 1960s,
according to Morrison-Valfre, who noted elsewhere in her text that statistics from the US
Bureau of the Census reveal, “from 1960 to 2000 the rate of adolescent suicide more than

54
doubled.” This may be coincidental, but it is unnerving in light of these drugs’ well-known
adverse effects.
One thing, however, is certain. Prior to the advent of antidepressants, there was little
relation between depression and violent behavior. “One of the things in the past that we’ve
known about depression is that it very, very rarely leads to violence,” observed psychiatrist
Peter Breggin in a Fox News report. “It’s only been since the advent of these new SSRI drugs
that we have murderers, sometimes even mass murderers, taking antidepressant drugs.”
Dr. Breggin is an expert in the mental health field and an outspoken critic of psychiatric
drug overuse. Among his more than 20 books on the topic is Brain-Disabling Treatments in
Psychiatry (2008), in which he recounts a significant clinical trial involving children taking
Prozac. Fourteen percent of the study’s subjects became aggressive and even violent on the
drug, but the experience of a 12-year-old boy is particularly disturbing. Quoting the study,
Breggin writes:
Thirty-eight days after beginning the protocol, F. experienced a violent nightmare about
killing his classmates until he himself was shot. He awakened from it only with difficulty, and
the dream continued to feel “very real.” He reported having had several days of increasingly
vivid “bad dreams” before this episode; these included images of killing himself and his
parents dying. When he was seen later that day he was agitated and anxious, refused to go to
school, and reported marked suicidal ideation that made him feel unsafe at home as well.
Breggin notes the boy cannot be labeled a copycat since the study was conducted in
1991, long before the highly publicized school shootings of more recent years. Once the child
stopped taking Prozac, his symptoms disappeared.

The Drug Pushers

Instead of investigating psychiatric drugs’ connection to acts of mass violence, public
policymakers and healthcare professionals actually promote the use of psychotropic drugs by
children and adolescents. The New York Review of Books published a June 2011 review by
Dr. Marcia Angell, former editor of The New England Journal of Medicine, called “The
Epidemic of Mental Illness: Why?” She summed up the problem saying:
The tally of those who are so disabled by mental disorders that they qualify for
Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased
nearly two and a half times between 1987 and 2007 — from one in 184 Americans to one in
seventy-six. For children, the rise is even more startling — a thirty-five-fold increase in the
same two decades. Mental illness is now the leading cause of disability in children, well ahead
of physical disabilities like cerebral palsy or Down syndrome, for which the federal programs
were created.
Angell relates that psychiatric treatment shifted from “talk therapy” to drug therapy in
the 1950s when doctors noticed new drugs meant to treat infections also “blunted disturbing
mental symptoms” by affecting the levels of certain chemicals in the brain. Out of that
observation was born the theory that mental illness is a result of chemical imbalances. “Thus,
instead of developing a drug to treat an abnormality, an abnormality was postulated to fit a
drug,” observed Angell. “That was a great leap in logic.” She noted that subsequent studies
have proven such chemical imbalances do not in fact exist in patients diagnosed with
psychiatric disorders such as depression. It is only after a person takes a psychiatric
medication that the brain begins to function abnormally.
Moreover, diagnosing mental illness is largely a subjective endeavor, unlike other fields
of medicine that rely on objective lab data or scans and x-rays for diagnosis. So says
psychiatrist Daniel Carlat in his 2010 book Unhinged: The Trouble With Psychiatry — A
Doctor’s Revelations About a Profession in Crisis. “Our diagnoses are subjective and

55
expandable, and we have few rational reasons for choosing one treatment over another,”
admits Carlat.
Eager to exploit the benefits of the chemical theory and aware of the “subjective and
expandable” nature of diagnosing mental illness, drug companies vigorously subsidize the
psychiatric profession. In his 2010 exposé Anatomy of an Epidemic, Robert Whitaker notes
that besides the gifts and fringe benefits given directly to psychiatrists, especially those at
influential academic centers, drug companies generously support psychiatric associations,
patient advocacy groups, and educational organizations. They fund around one-fifth of the
budget of the American Psychiatric Association. In the first quarter of 2009 alone,
pharmaceutical company Eli Lilly donated more than $1.2 million to mental health non-profits.
Angell goes on to explain how drug companies peddle their wares. In order to have a
drug approved, pharmaceutical manufacturers must submit to the FDA two clinical trials
proving a product more effective than a placebo. Drug companies can perform as many trials
as they wish in order to achieve the two successful tests they need. Positive studies are highly
publicized while the negative are suppressed. In a review of tests for the six most widely used
antidepressants between 1987 and 1999 — Prozac, Paxil, Zoloft, Celexa, Serzone, and
Effexor — Angell reported, “Most of them were negatives. Overall, placebos were 82 percent
as effective as the drugs.… The average difference between drug and placebo … was
clinically meaningless.”
Convinced by positive reports of the drugs’ benefits, doctors prescribe them liberally.
The Centers for Disease Control and Prevention divulged in 2011 that 11 percent of
Americans age 12 years and over take antidepressant medication. CDC statistics also
revealed a 400-percent increase in the rate of antidepressant use in the United States
between 1988 and 2008. As of 2008, antidepressants were the most frequently used drug by
persons aged 18-44 years.
The problem is not confined to the United States. Last year the Guardian reported
prescriptions for Ritalin in the UK quadrupled from 2000 to 2010, and between 2006 and 2010
the United States witnessed an 83-percent increase in sales. The UK’s Association of
Educational Psychologists complains that physicians are ignoring the professional union’s
recommendation not to prescribe ADHD medication to most children under age six. “We need
to show young people how to deal with the normal stresses and strains of growing up,” argues
Member of Parliament Tessa Munt. “Resorting to powerful drugs only stores up trouble for the
future.”
The University of Utah’s Genetic Science Learning Center says that Ritalin is currently
prescribed to approximately six million people in the United States, of which 75 percent are
children. Its data also confirm between 30 and 50 percent of adolescents in drug treatment
centers report abusing Ritalin. And because of the medication’s similarity to cocaine, once
these teens reach adulthood they are more prone to cocaine addiction.
She quotes several psychiatric researchers, including a former director of the National
Institute of Mental Health, who contend that by upsetting normal brain chemistry, these
medications cause brain cells to become desensitized to or overcompensate for the
disturbances the drugs cause. In other words, the drugs can trigger chemical imbalance
where none existed in the first place, hence the emergence of adverse effects like mania and
suicidal/homicidal ideation, especially when a psychotropic drug is first started or stopped.
Other research shows a relation between these drugs and brain atrophy, an often irreparable
decrease in the size and number of brain cells.
The Connecticut Case
Fox News reported, after an initial search of [Newton Killer Adam] Lanza’s home,
investigators found no indication the 20-year-old was taking prescriptions. Other evidence
suggests he was. Louise Tambascio, a friend of Lanza’s mother, told CBS News’ Scott Pelley
56
 on 60 Minutes, “I know he was on medication and everything.” ABC News also interviewed
Tambascio, who repeated, “I knew he was on medication.”
Connecticut’s chief medical examiner, H. Wayne Carver II, is currently conducting
toxicology exams to determine if Lanza was using any behavior-modifying drugs. Many think it
likely. Days after the Sandy Hook massacre, standing outside Lanza’s home, CNN’s chief
medical correspondent Dr. Sanjay Gupta commented, “What medications was he on? I’m
specifically talking about antidepressants. If you look at the studies of other shootings like this
that have happened, medications like this were a common factor.” In a December 16 Fox
News interview, former Secretary of Homeland Security Tom Ridge also warned of the
undeniable link between youth violence and psychiatric drugs.
Most media choose to ignore such warnings and even downplay the obvious. The
Associated Press published a January 11 report entitled, “Connecticut shooting: Medical
examiner says gunman’s body won’t reveal much.” It claims that “Connecticut’s chief medical
examiner says he doubts toxicological tests and genetic analysis of the body of the gunman
who fatally shot 20 children and six educators at an elementary school will explain his
actions.” In a glaring contradiction the same article later notes, “The toxicology exam, which
could take several weeks, involves testing body fluids for psychiatric medications or illegal
substances. Carver said the result could provide ‘potentially valuable information’ in creating a
full picture of Lanza.”76

Pharmaceutical Companies

The following are excerpts from articles concerning pharmaceutical companies and the plan to market

medications as safe and necessary for everyone to succeed. However, these medications are far from safe

and have proven to have serious long term side effects. Furthermore, the pharmaceutical industry is guilty of

false advertising as seen in countless lawsuits.

Close to retirement at the time, Merck’s (pharmaceutical company) aggressive chief

executive, Henry Gadsden, told Fortune magazine of his distress that the company’s
potential markets had been limited to sick people. Suggesting he’d rather Merck to be more
like chewing gum maker Wrigley’s, Gadsen said it had long been his dream to make drugs
for healthy people. Because, then, Merck would be able to ‘sell to everyone.’ —Ray
Moynihan and Alan Cassels, Selling Sickness: How the World’s Biggest Pharmaceutical
Companies are Turning Us All Into Patients.
O'Meara (55) 77

The Selling of Attention Deficit Disorder, by Alan Schwarz explains how

pharmaceutical companies market to consumers.

After more than 50 years leading the fight to legitimize attention deficit hyperactivity
disorder, Keith Conners could be celebrating. Severely hyperactive and impulsive children,
once shunned as bad seeds, are now recognized as having a real neurological problem.
Doctors and parents have largely accepted drugs like Adderall and Concerta to temper the
traits of classic ADHD, helping youngsters succeed in school and beyond.

57
 But Dr. Conners did not feel triumphant this fall as he addressed a group of fellow
ADHD specialists in Washington. He noted that recent data from the Centers for Disease
Control and Prevention show that the diagnosis had been made in 15 percent of high
school-age children, and that the number of children on medication for the disorder had
soared to 3.5 million from 600,000 in 1990. He questioned the rising rates of diagnosis and
called them 'a national disaster of dangerous proportions.' 'The numbers make it look like
an epidemic. Well, it’s not. It’s preposterous,' Dr. Conners, a psychologist and professor
emeritus at Duke University, said in a subsequent interview. 'This is a concoction to justify
the giving out of medication at unprecedented and unjustifiable levels.'
The rise of ADHD diagnoses and prescriptions for stimulants over the years
coincided with a remarkably successful two-decade campaign by pharmaceutical companies
to publicize the syndrome and promote the pills to doctors, educators and parents. With the
children’s market booming, the industry is now employing similar marketing techniques as it
focuses on adult ADHD, which could become even more profitable.
The disorder is now the second most frequent long-term diagnosis made in children,
narrowly trailing asthma, according to a New York Times analysis of CDC data. Behind that
growth has been drug company marketing that has stretched the image of classic ADHD to
include relatively normal behavior like carelessness and impatience, and has often
overstated the pills’ benefits. Advertising on television and in popular magazines like People
and Good Housekeeping has cast common childhood forgetfulness and poor grades as
grounds for medication that, among other benefits, can result in 'schoolwork that matches
his intelligence' and ease family tension. A 2002 ad for Adderall showed a mother playing
with her son and saying, 'Thanks for taking out the garbage.'
The Food and Drug Administration has cited every major ADHD drug — stimulants
like Adderall, Concerta, Focalin and Vyvanse, and nonstimulants like Intuniv and Strattera —
for false and misleading advertising since 2000, some multiple times. Sources of
information that would seem neutral also delivered messages from the pharmaceutical
industry. Doctors paid by drug companies have published research and delivered
presentations that encourage physicians to make diagnoses more often that discredit
growing concerns about overdiagnosis. Many doctors have portrayed the medications as
benign — 'safer than aspirin,' some say — even though they can have significant side
effects and are regulated in the same class as morphine and oxycodone because of their
potential for abuse and addiction. Patient advocacy groups tried to get the government to
loosen regulation of stimulants while having sizable portions of their operating budgets
covered by pharmaceutical interests.
Companies even try to speak to youngsters directly. Shire Pharmaceuticals — the
longtime market leader, with several ADHD medications including Adderall — recently
subsidized 50,000 copies of a comic book that tries to demystify the disorder and uses
superheroes to tell children, 'Medicines may make it easier to pay attention and control your
behavior!' Profits for the ADHD drug industry have soared. Sales of stimulant medication in
2012 were nearly $9 billion, more than five times the $1.7 billion a decade before, according
to the data company IMS Health.
Even Roger Griggs, the pharmaceutical executive who introduced Adderall in 1994,
said he strongly opposes marketing stimulants to the general public because of their
dangers. He calls them 'nuclear bombs,' warranted only under extreme circumstances and
when carefully overseen by a physician.
Psychiatric breakdown and suicidal thoughts are the most rare and extreme results
of stimulant addiction, but those horror stories are far outnumbered by people who, seeking
to study or work longer hours, cannot sleep for days, lose their appetite or hallucinate. More
can simply become habituated to the pills and feel they cannot cope without them. Tom
58
Casola, the Shire Pharmaceuticals vice president who oversees the ADHD division, said in
an interview that the company aims to provide effective treatment for those with the disorder,
and that ultimately doctors were responsible for proper evaluations and prescriptions. He
added that he understood some of the concerns voiced by the Food and Drug
Administration and others about aggressive ads, and said that materials that run afoul of
guidelines are replaced.
Now targeting adults, Shire Pharmaceuticals and two patient advocacy groups have
recruited celebrities like the Maroon 5 musician Adam Levine for their marketing campaign,
'It’s Your ADHD – Own It.' Online quizzes sponsored by drug companies are designed to
encourage people to pursue treatment. A medical education video sponsored by Shire
Pharmaceuticals portrays a physician making a diagnosis of the disorder in an adult in a six-
minute conversation, after which the doctor recommends medication.
Like most psychiatric conditions, ADHD has no definitive test, and most experts in
the field agree that its symptoms are open to interpretation by patients, parents and doctors.
The American Psychiatric Association, which receives significant financing from drug
companies, has gradually loosened the official criteria for the disorder to include common
childhood behavior like 'makes careless mistakes' or often has difficulty waiting his or her
turn.' The idea that a pill might ease troubles and tension has proved seductive to worried
parents, rushed doctors and others.
'Pharma pushed as far as they could, but you can’t just blame the virus,' said Dr.
Lawrence Diller, a behavioral pediatrician in Walnut Creek, Calif. 'You have to have a
susceptible host for the epidemic to take hold. There’s something they know about us that
they utilize and exploit.'

Selling to Doctors
Modern marketing of stimulants began with the name Adderall itself. Mr. Griggs
bought a small pharmaceutical company that produced a weight-loss pill named Obetrol.
Suspecting that it might treat a relatively unappreciated condition then called attention deficit
disorder, and found in about 3 to 5 percent of children, he took 'A.D.D.' and fiddled with
snappy suffixes. He cast a word with the widest net.
All.
For A.D.D.
A.D.D. for All.
Adderall.
'It was meant to be kind of an inclusive thing,' Mr. Griggs recalled.

Roger Griggs, who introduced Adderall in 1994 before ads portraying medication as
a way to improve grades and behavior were allowed, said, 'There’s no way on God’s green
earth we would ever promote' stimulants directly to consumers, as reported by Karsten
Moran for The New York Times.
Adderall quickly established itself as a competitor of the field’s most popular drug,
Ritalin. Shire Pharmaceuticals, realizing the drug’s potential, bought Mr. Griggs’s company
for $186 million and spent millions more to market the pill to doctors. After all, patients can
buy only what their physicians buy into.
As is typical among pharmaceutical companies, Shire Pharmaceuticals gathered hundreds
of doctors at meetings at which a physician paid by the company explained a new drug’s
value. Such a meeting was held for Shire Pharmaceuticals long-acting version of Adderall,
Adderall XR, in April 2002, and included a presentation that to many critics, exemplifies how
questionable ADHD messages are delivered.

59
 Dr. William W. Dodson, a psychiatrist from Denver, stood before 70 doctors at the
Ritz-Carlton Hotel and Spa in Pasadena, Calif., and clicked through slides that encouraged
them to 'educate the patient on the lifelong nature of the disorder and the benefits of lifelong
treatment.' But that assertion was not supported by science, as studies then and now have
shown that perhaps half of ADHD children are not impaired as adults, and that little is known
about the risks or efficacy of long-term medication use.
The PowerPoint document, obtained by The Times, asserted that stimulants were
not 'drugs of abuse' because people who overdose 'feel nothing' or 'feel bad.' Yet these
drugs are classified by the government among the most abusable substances in medicine,
largely because of their effects on concentration and mood. Overdosing can cause severe
heart problems and psychotic behavior.
Slides described side effects of Adderall XR as 'generally mild,' despite clinical trials
showing notable rates of insomnia, significant appetite suppression and mood swings, as
well as rare instances of hallucinations. Those side effects increase significantly among
patients who take more pills than prescribed. Another slide warned that later in life, children
with ADHD faced 'job failure or underemployment,' 'fatal car wrecks,' 'criminal involvement,'
'unwanted pregnancy' and venereal diseases, but did not mention that studies had not
assessed whether stimulants decreased those risks.
In an interview last month, Dr. Dodson said he makes a new diagnosis in about 300
patients a year and, because he disagrees with studies showing that many ADHD children
are not impaired as adults, always recommends their taking stimulants for the rest of their
lives. He said that concern about abuse and side effects is 'incredibly overblown,' and that
his longtime work for drug companies does not influence his opinions. He said he received
about $2,000 for the 2002 talk for Shire Pharmaceuticals. He earned $45,500 in speaking
fees from pharmaceutical companies in 2010 to 2011, according to ProPublica, which tracks
such payments.
'If people want help, my job is to make sure they get it,' Dr. Dodson said. Regarding
people concerned about prescribing physicians being paid by drug companies, he added:
'They like a good conspiracy theory. I don’t let it slow me down.'
Many of the scientific studies cited by drug company speakers involved Dr. Joseph
Biederman, a prominent child psychiatrist at Harvard University and Massachusetts General
Hospital. In 2008, a Senate investigation revealed that Dr. Biederman’s research on many
psychiatric conditions had been substantially financed by drug companies, including Shire
Pharmaceuticals. Those companies also paid him $1.6 million in speaking and consulting
fees. He has denied that the payments influenced his research.
Dr. Conners called Dr. Biederman 'unequivocally the most published psychopharmacology
maven for ADHD,' one who is well known for embracing stimulants and dismissing
detractors. Findings from Dr. Biederman’s dozens of studies on the disorder and specific
brands of stimulants have filled the posters and pamphlets of pharmaceutical companies
that financed the work. Those findings typically delivered three messages: The disorder was
underdiagnosed; stimulants were effective and safe; and unmedicated ADHD led to
significant risks for academic failure, drug dependence, car accidents and brushes with the
law.
Dr. Biederman was frequently quoted about the benefits of stimulants in interviews
and company news releases. In 2006, for example, he told Reuters Health, 'If a child is
brilliant but is doing just O.K. in school, that child may need treatment, which would result in
their performing brilliantly at school. 'This year, Dr. Biederman told the medical newsletter
Medscape regarding medication for those with ADHD, 'Don’t leave home without it.'Dr.
Biederman did not respond to requests for an interview.

60
 What concerned many doctors was how Dr. Biederman’s high-profile and
unwavering promotion of stimulants armed drug companies with the published science
needed to create powerful advertisements — many of which cast medications as benign
solutions to childhood behavior falling far short of legitimate ADHD. He gave them
credibility,' said Richard M. Scheffler, a professor of health economics and public policy at
the University of California, Berkeley, who has written extensively on stimulants. 'He didn’t
have a balance. He became totally convinced that it’s a good thing and can be more widely
used.'

Building a Message
Drug companies used the research of Dr. Biederman and others to create compelling
messages for doctors. 'Adderall XR Improves Academic Performance,' an ad in a psychiatry
journal declared in 2003, leveraging two Biederman studies financed by Shire
Pharmaceuticals. A Concerta ad barely mentioned ADHD, but said the medication would
'allow your patients to experience life’s successes every day.'
Some studies had shown that stimulant medication helped some elementary school
children with carefully evaluated ADHD to improve scores in reading and math tests,
primarily by helping them concentrate. The concern, some doctors said, is that long-term,
wider academic benefits have not been proved — and that ads suggesting they have can
tempt doctors, perhaps subconsciously, to prescribe drugs with risks to healthy children
merely to improve their grades or self-esteem.

Advertising Disorder
Drug companies have shifted marketing for ADHD medication through the years.
Most recently, problems like divorce and auto accidents have been used to appeal to adults.
Ads in the 1990s advertised improved grades at school as a central benefit. Early ads
focused on depression and 'the problem child.'
'There are decades of research into how advertising influences doctors’ prescribing
practices,' said Dr. Aaron Kesselheim of Brigham and Women’s Hospital in Boston, who
specializes in pharmaceutical ethics. 'Even though they’ll tell you that they’re giving patients
unbiased, evidence-based information, in fact they’re more likely to tell you what the drug
company told them, whether it’s the benefits of the drugs or the risks of those drugs.'
Drug company advertising also meant good business for medical journals – the same
journals that published papers supporting the use of the drugs. The most prominent
publication in the field, The Journal of the American Academy of Child & Adolescent
Psychiatry, went from no ads for ADHD medications from 1990 to 1993 to about 100 pages
per year a decade later. Almost every full-page color ad was for an ADHD drug.
As is legal and common in pharmaceutical marketing, stimulants’ possible side
effects like insomnia, irritability and psychotic episodes were printed in small type and
dominated by other messages. One Adderall XR brochure included the recording of a man’s
voice reassuring doctors: 'Amphetamines have been used medically for nearly 70 years.
That’s a legacy of safety you can count on.' He did not mention any side effects.
Drug companies used sales representatives to promote the drugs in person. Brian
Lutz, a Shire Pharmaceuticals salesman for Adderall XR from 2004 to 2009, said he met
with 75 psychiatrists in his Oakland, Calif., territory at least every two weeks — about 30 to
40 times apiece annually — to show them posters and pamphlets that highlighted the
medicine’s benefits for grades and behavior. If a psychiatrist asked about issues like side
effects or abuse, Mr. Lutz said, they were played down. He said he was told to acknowledge

61
risks matter-of-factly for legal reasons, but to refer only to the small print in the package
insert or offer Shire Pharmaceuticals phone number for more information.
'It was never like', ‘This is a serious side effect, you need to watch out for it,’ Mr. Lutz
recalled. 'You wanted to give them more information because we’re talking about kids here,
you know? But it was all very positive.' Mr. Lutz, now pursuing a master’s degree and
hoping to work in mental health, recalled his Shire Pharmaceuticals work with ambivalence.
What he regrets, he said,; 'is how we sold these pills like they were cars, when we knew
they weren’t just cars.'

Selling to Parents
In September 2005, over a cover that heralded Kirstie Alley’s waistline and Matt
Damon’s engagement, subscribers to People magazine saw a wraparound advertisement
for Adderall XR. A mother hugged her smiling child holding a sheet of paper with a ‘B+’
written on it.
'Finally!' she said. 'Schoolwork that matches his intelligence.'
When federal guidelines were loosened in the late 1990s to allow the marketing of controlled
substances like stimulants directly to the public, pharmaceutical companies began targeting
perhaps the most impressionable consumers of all: parents, specifically mothers. A
magazine ad for Concerta had a grateful mother saying, 'Better test scores at school, more
chores done at home, an independence I try to encourage, a smile I can always count on.' A
2009 ad for Intuniv, Shire Pharmaceuticals nonstimulant treatment for ADHD, showed a child
in a monster suit taking off his hairy mask to reveal his adorable smiling self. 'There’s a great
kid in there,' the text read.
'There’s no way in God’s green earth we would ever promote' a controlled substance
like Adderall directly to consumers’, Mr. Griggs said as he was shown several
advertisements. 'You’re talking about a product that’s having a major impact on brain
chemistry. Parents are very susceptible to this type of stuff.'
The Food and Drug Administration has repeatedly instructed drug companies to
withdraw such ads for being false and misleading, or exaggerating the effects of the
medication. But no science determined that stimulant treatment has the overarching benefits
suggested in those ads, the F.D.A. has pointed out in numerous warning letters to
manufacturers since 2000.
Shire Pharmaceuticals agreed last February to pay $57.5 million in fines to resolve
allegations of improper sales and advertising of several drugs, including Vyvanse, Adderall
XR and Daytrana, a patch that delivers stimulant medication through the skin. Mr. Casola of
Shire Pharmaceuticals declined to comment on the settlement because it was not fully
resolved. He added that the company’s current promotional materials emphasize how its
medications provide 'symptom control' rather than turn monsters into children who take out
the garbage. He pointed to a Shire Pharmaceuticals brochure and web page that more
candidly than ever discuss side effects and the dangers of sharing medication with others.
However, many critics said that the most questionable advertising helped build a market that
is now virtually self-sustaining. Drug companies also communicated with parents through
sources who appeared independent, from support groups to teachers. The primary ADHD
patient advocacy group, Children and Adults with Attention-Deficit/Hyperactivity Disorder, or
CHADD, was founded in 1987 to gain greater respect for the condition and its treatment with
Ritalin, the primary drug available at the time. Considerable funding was provided several
years later by Ciba-Geigy Pharmaceuticals, Ritalin’s primary manufacturer. Further drug
company support helped create public service announcements and pamphlets, some of

62
 which tried to dispel concerns about Ritalin; one CHADD 'fact sheet' conflicted with 60 years
of science in claiming, 'Psychostimulant drugs are not addictive.'
Advocates Answer
The chief executive of CHADD, Ruth Hughes, said in an interview that most disease-
awareness groups receive similar pharmaceutical support. She said drug companies did not
influence the group’s positions and activities, and noted that CHADD receives about
$800,000 a year from the CDC as well. 'One pharma company wanted to get CHADD
volunteers to work at their booth to sort of get peer counseling, and we said no, won’t do
that, not going there,' Dr. Hughes said, adding, 'It would be seen as an endorsement.'
The idea of unleashing children’s potential is attractive to teachers and school
administrators, who can be lured by ADHD drugs’ ability to subdue some of their most
rambunctious and underachieving students. Some have provided parents with pamphlets to
explain the disorder and the promise of stimulants.
Susan Parry, who raised three boys in a top public school system on Mercer Island,
outside Seattle, in the 1990s, said teachers pushed her into having her feisty son Andy
evaluated for ADHD She said one teacher told her that her own twins were thriving on
Ritalin.
Mrs. Parry still has the pamphlet given to her by the school psychologist, which
states: ‘Parents should be aware that these medicines do not ‘drug’ or ‘alter’ the brain of the
child. They make the child ‘normal.’ ‘She and her husband, Michael, put Andy on Ritalin. The
Parrys later noticed that on the back of the pamphlet, in small type, was the logo of Ciba-
Geigy. A school official told them in a letter, which they provided to The Times, that the
materials had been given to the district by a Ciba representative.
‘They couldn’t advertise to the general public yet,’ said Michael Parry, adding that his
son never had ADHD and after three years was taken off Ritalin because of sleep problems
and heart palpitations. ‘But somebody came up with this idea, which was genius. I definitely
felt seduced and enticed. I’d say baited.’
‘They were telling me, ‘Honey, there’s something wrong with your brain and this little
pill’s going to fix everything,’ ‘said Micaela Kimball, who received the diagnosis in 1997 as a
high school freshman in Ithaca, N.Y., and is now a freelance writer in Boston. ‘It changed my
whole self-image, and it took me years to get out from under that.’78

The Justice Department has recovered more than $22.4 billion from the pharmaceutical industry

through False Claims Act cases and more than $14.2 billion has been recovered in cases involving fraud

against federal health care programs. These cases involved ADHD drugs, false promises in advertising and

kickbacks to doctors and pharmacists. Furthermore, these lawsuits involved use of chemical restraints in

elderly nursing home residents and children receiving Medicaid/Medicare in foster care settings. This is no

different than what is happening to children in schools. Once again the weak are taken advantage of through

medications.

63
Department of Justice
Office of Public Affairs

FOR IMMEDIATE RELEASE

Monday, November 4, 2013

Johnson & Johnson to Pay More Than $2.2 Billion to Resolve Criminal and Civil
Investigations

Allegations Include Off-label Marketing and Kickbacks to Doctors and Pharmacists

WASHINGTON - Global health care giant Johnson & Johnson (J&J) and its subsidiaries will
pay more than $2.2 billion to resolve criminal and civil liability arising from allegations
relating to the prescription drugs Risperdal, Invega and Natrecor, including promotion for
uses not approved as safe and effective by the Food and Drug Administration (FDA) and
payment of kickbacks to physicians and to the nation’s largest long-term care pharmacy
provider. The global resolution is one of the largest health care fraud settlements in US
history, including criminal fines and forfeiture totaling $485 million and civil settlements with
the federal government and states totaling $1.72 billion.
'The conduct at issue in this case jeopardized the health and safety of patients and
damaged the public trust,' said Attorney General Eric Holder. The resolution includes
criminal fines and forfeiture for violations of the law and civil settlements based on the False
Claims Act arising out of multiple investigations of the company and its subsidiaries.
'When companies put profit over patients’ health and misuse taxpayer dollars, we demand
accountability,' said Associate Attorney General Tony West. 'In addition to significant
monetary sanctions, we will ensure that non-monetary measures are in place to facilitate
change in corporate behavior and help ensure the playing field is level for all market
participants.'
This agreement is designed to increase accountability and transparency and prevent future
fraud and abuse. 'As patients and consumers, we have a right to rely upon the claims drug
companies make about their products,' said Assistant Attorney General for the Justice
Department’s Civil Division Stuart F. Delery. 'And, as taxpayers, we have a right to ensure
that federal health care dollars are spent appropriately. That is why this Administration has
continued to pursue aggressively – with all of our available law enforcement tools -- those
companies that corrupt our health care system.'
J&J and Janssen Settle Civil Allegations of Targeting Vulnerable Patients with the
Drugs Risperdal and Invega for Off-Label Uses
In a related civil complaint filed today in the Eastern District of Pennsylvania, the
United States alleges that Janssen marketed Risperdal to control the behaviors and conduct
of the nation’s most vulnerable patients: elderly nursing home residents, children and
individuals with mental disabilities. The government alleges that J&J and Janssen caused
false claims to be submitted to federal health care programs by promoting Risperdal for off-
label uses that federal health care programs did not cover, making false and misleading
statements about the safety and efficacy of Risperdal and paying kickbacks to physicians to
prescribe Risperdal.
'J&J’s promotion of Risperdal for unapproved uses threatened the most vulnerable
populations of our society – children, the elderly and those with developmental disabilities,'
said U.S. Attorney for the Eastern District of Pennsylvania Zane Memeger. 'This historic

64
settlement sends the message that drug manufacturers who place profits over patient care
will face severe criminal and civil penalties.'
In addition to promoting Risperdal for elderly dementia patients, from 1999 through
2005, Janssen allegedly promoted the antipsychotic drug for use in children and individuals
with mental disabilities. The complaint alleges that J&J and Janssen knew that Risperdal
posed certain health risks to children, including the risk of elevated levels of prolactin, a
hormone that can stimulate breast development and milk production. Nonetheless, one of
Janssen’s Key Base Business Goals was to grow and protect the drug’s market share with
child/adolescent patients. Janssen instructed its sales representatives to call on child
psychiatrists, as well as mental health facilities that primarily treated children, and to market
Risperdal as safe and effective for symptoms of various childhood disorders, such as
attention deficit hyperactivity disorder, oppositional defiant disorder, obsessive-compulsive
disorder and autism. Until late 2006, Risperdal was not approved for use in children for any
purpose, and the FDA repeatedly warned the company against promoting it for use in
children.
The government’s complaint also contains allegations that Janssen paid speaker
fees to doctors to influence them to write prescriptions for Risperdal. Sales representatives
allegedly told these doctors that if they wanted to receive payments for speaking, they
needed to increase their Risperdal prescriptions.
In addition to allegations relating to Risperdal, today’s settlement also resolves
allegations relating to Invega, a newer antipsychotic drug also sold by Janssen. Although
Invega was approved only for the treatment of schizophrenia and schizoaffective disorder,
the government alleges that, from 2006 through 2009, J&J and Janssen marketed the drug
for off-label indications and made false and misleading statements about its safety and
efficacy.
As part of the global resolution, J&J and Janssen have agreed to pay a total of $1.391 billion
to resolve the false claims allegedly resulting from their off-label marketing and kickbacks for
Risperdal and Invega. This total includes $1.273 billion to be paid as part of the resolution
announced today, as well as $118 million that J&J and Janssen paid to the state of Texas in
March 2012 to resolve similar allegations relating to Risperdal. Because Medicaid is a joint
federal-state program, J&J’s conduct caused losses to both the federal and state
governments. The additional payment made by J&J as part of today’s settlement will be
shared between the federal and state governments, with the federal government recovering
$749 million, and the states recovering $524 million. The federal government and Texas
each received $59 million from the Texas settlement.
In a complaint filed in the District of Massachusetts in January 2010, the United
States alleged that J&J paid millions of dollars in kickbacks to Omnicare under the guise of
market share rebate payments, data-purchase agreements, 'grants' and 'educational
funding.' These kickbacks were intended to induce Omnicare and its hundreds of consultant
pharmacists to engage in 'active intervention programs' to promote the use of Risperdal and
other J&J drugs in nursing homes. Omnicare’s consultant pharmacists regularly reviewed
nursing home patients’ medical charts and made recommendations to physicians on what
drugs should be prescribed for those patients. Although consultant pharmacists purported
to provide 'independent' recommendations based on their clinical judgment, J&J viewed the
pharmacists as an 'extension of [J&J’s] sales force.'
J&J and Janssen have agreed to pay $149 million to resolve the government’s
contention that these kickbacks caused Omnicare to submit false claims to federal health
care programs. The federal share of this settlement is $132 million, and the five
participating states’ total share is $17 million. In 2009, Omnicare paid $98 million to resolve

65
 its civil liability for claims that it accepted kickbacks from J&J and Janssen, along with
certain other conduct.
'Consultant pharmacists can play an important role in protecting nursing home
residents from the use of antipsychotic drugs as chemical restraints,' said US Attorney for
the District of Massachusetts Carmen Ortiz. 'This settlement is a reminder that the
recommendations of consultant pharmacists should be based on their independent clinical
judgment and should not be the product of money paid by drug companies.'
Non-Monetary Provisions of the Global Resolution and Corporate Integrity
Agreement
In addition to the criminal and civil resolutions, J&J has executed a five-year
Corporate Integrity Agreement (CIA) with the Department of Health and Human Services
Office of Inspector General (HHS-OIG). The CIA includes provisions requiring J&J to
implement major changes to the way its pharmaceutical affiliates do business. Among other
things, the CIA requires J&J to change its executive compensation program to permit the
company to recoup annual bonuses and other long-term incentives from covered executives
if they, or their subordinates, engage in significant misconduct. J&J may recoup monies
from executives who are current employees and from those who have left the company.
The CIA also requires J&J’s pharmaceutical businesses to implement and maintain
transparency regarding their research practices, publication policies and payments to
physicians. On an annual basis, management employees, including senior executives and
certain members of J&J’s independent board of directors, must certify compliance with
provisions of the CIA. J&J must submit detailed annual reports to HHS-OIG about its
compliance program and its business operations.
'OIG will work aggressively with our law enforcement partners to hold companies
accountable for marketing and promotion that violate laws intended to protect the public,'
said Inspector General of the US Department of Health and Human Services Daniel R.
Levinson. 'Our compliance agreement with Johnson & Johnson increases individual
accountability for board members, sales representatives, company executives and
management. The agreement also contains strong monitoring and reporting provisions to
help ensure that the public is protected from future unlawful and potentially harmful off-label
marketing.'79

Department of Justice Office of Public Affairs

FOR IMMEDIATE RELEASE

Wednesday, September 24, 2014

Pharmaceutical company Shire Pharmaceuticals LLC will pay $56.5 million to

resolve civil allegations that it violated the False Claims Act as a result of its marketing and
promotion of several drugs, the Justice Department announced today. Shire
Pharmaceuticals, located in Wayne, Pennsylvania, manufactures and sells pharmaceuticals,
including Adderall XR, Vyvanse and Daytrana, which are approved for the treatment of
attention deficit hyperactivity disorder (ADHD).
'Patients and health care providers must receive accurate information about
available prescription drugs so that they can make safe and informed treatment decisions,'
said Acting Assistant Attorney General Joyce R. Branda for the Justice Department’s Civil
Division. 'The Department of Justice will be vigilant to hold accountable pharmaceutical
companies that provide misleading information regarding a drug’s safety or efficacy.'
The settlement resolves allegations that, between January 2004 and December
2007, Shire Pharmaceuticals promoted Adderall XR for certain uses despite a lack of clinical
66
 data to support such claims and overstated the efficacy of Adderall XR, particularly relative
to other ADHD drugs. Among the allegedly unsupported claims was that Adderall XR was
clinically superior to other ADHD drugs because it would 'normalize' its recipients, rendering
them indistinguishable from their non-ADHD peers. Shire Pharmaceuticals allegedly stated
that its competitors’ products could not achieve similar results, which the government
contended was not shown in the clinical data that Shire Pharmaceuticals collected. Shire
Pharmaceuticals also allegedly marketed Adderall XR based on unsupported claims that
Adderall XR would prevent poor academic performance, loss of employment, criminal
behavior, traffic accidents and sexually transmitted disease. In addition, Shire
Pharmaceuticals allegedly promoted Adderall XR for the treatment of conduct disorder
without approval from the Food and Drug Administration (FDA).
The settlement further resolves allegations that, between February 2007 and
September 2010, Shire Pharmaceuticals sales representatives and other agents allegedly
made false and misleading statements about the efficacy and 'abuseability' of Vyvanse to
state Medicaid formulary committees and to individual physicians. For example, one Shire
Pharmaceuticals medical science liaison allegedly told a state formulary board that Vyvanse
'provides less abuse liability' than 'every other long-acting release mechanism' on the
market. However, the government contended that no study Shire Pharmaceuticals
conducted had concluded that Vyvanse was not abuseable, and, as an amphetamine
product, the Vyvanse label included an FDA-mandated black box warning for its potential for
misuse and abuse. Shire Pharmaceuticals also made allegedly unsupported claims that
treatment with Vyvanse would prevent car accidents, divorce, arrests and unemployment.
'Marketing efforts that influence a doctor’s independent judgment can undermine the
doctor-patient relationship and short-change the patient,' said US Attorney Zane David
Memeger for the Eastern District of Pennsylvania. 'Where children’s medication is
concerned, it can interfere with a parent’s right to clear information regarding the risks to the
safety and health of their child. Shire Pharmaceuticals cooperated throughout this
investigation and, in advance of this settlement, began to correct its marketing activities.''80

U.S. Justice Dept. sues GA for segregating students with disabilities – Posted in Education Votes by

Félix Pérez

Georgia ‘relegated thousands of students with behavior-related disabilities to

separate, segregated and unequal settings, . . dilapidated buildings that were formerly used
for black children during segregation’ charges the U.S. Justice Department in a lawsuit filed
last week.
By placing students with behavior-related disabilities in segregated buildings or
classrooms, the lawsuit maintains, the state ‘discriminates against thousands of public
school students . . . by unnecessarily segregating them, or by placing them at serious risk of
such segregation, in a separate and unequal educational program known as the Georgia
Network for Educational and Therapeutic Support,’ or GNETS.
The legal challenge, filed in the U.S. District Court for the Northern District of
Georgia, argues that GNETS violates the American with Disabilities Act and Olmstead v
L.C., a U.S. Supreme Court ruling that requires states to make services available to people
with disabilities – including children with behavioral disabilities – in the most integrated
setting appropriate to their needs.
U.S. Attorney John A. Horn of the Northern District of Georgia said:

67
 This complaint alleges that many children in the GNETS program are consigned to
dilapidated buildings that were formerly used for black children during segregation, or to
classrooms that are locked apart from mainstream classrooms, with substantially fewer
opportunities of participating in extracurricular activities like music, art and sports. The law
mandates that all children, including those with behavior-related disabilities, must have
equal opportunities for education, and several existing programs within our Georgia schools
show that with appropriate support and services, these students can enjoy far greater
integration with their peers.
GNETS serves 4,600 students from more than half of Georgia’s public schools and
receives $72 million in state and federal funding. Fifty-four percent of students in GNETS
are African American compared with 37 percent of all Georgia public school students.
One mother of a student in a GNETS center in Cobb County said, at the time the
federal government began its investigation, ’He has been in the same room for five years.
He doesn’t ride the same bus, isn’t included in things like the school play or other activities
and his academics are completely suffering,’ She added, ‘He hates going to school and says
it feels like a prison. He has trust issues and doesn’t like adults. It’s a very isolating
situation.’
The lawsuit describes how GNETS students in one area of Georgia were educated in
a single classroom in the basement of a general education school with its own separate
entrance. The students never left the basement or interacted with any other students during
the school day. Hanging at the front of their classroom was a large sign that said
‘DETENTION,’ because the classroom was also used for detention outside regular school
hours. Other students in the GNETS program are entirely segregated from their peers
outside GNETS and attend school in ‘often old, poorly maintained buildings, some of which
formerly served as schools for black students under Jim Crow laws.’
In July 2015, the Justice Department issued a ‘findings letter,’ notifying the state that
it was violating the ADA by unnecessarily placing students with behavior-related disabilities
in segregated settings, denying them opportunities for meaningful interaction with their
peers without disabilities. The department found that most students in GNETS spend their
entire school day, including meals, exclusively with other students with disabilities.
Specifically, more than two-thirds of GNETS students are assigned to attend school in
regional GNETS centers that exclusively serve students with disabilities in buildings that are
often located far from students’ homes. Other students are assigned to regional GNETS
classrooms located within general school buildings, but often in separate wings or isolated
sections of the buildings.
Georgia School Superintendent Richard Woods, in a statement said, ‘We are
disappointed in the DOJ’s decision to sue, especially given the tremendous efforts we’ve put
into enhancing the educational experience for the small percentage of children who receive
education services from GNETS programs. We believe these efforts are working.’81

Funding

Educational policies which focus on outcomes and emphasize standardized test scores incentivize

schools to apply the ADHD label to students. The rules governing such programs often permit schools to offer

accommodations to the labeled student that will improve his test scores. Furthermore, schools may be

permitted to drop his scores altogether so as not to affect overall class performance. Thus, applying the ADHD

68
label to students enables schools to manipulate their actual achievement records. School budgets benefit from

this manipulation. When principals’ and teachers’ promotions and pay raises are linked to test scores, ADHD

labels rise.

In a report for the Los Angeles Times titled “The ADHD Explosion: Myths, Medication,

Money and Today’s Push for Performance,” Melissa Healy reported:

The authors of the new book--psychology professor Stephen P. Hinshaw and health
economist Richard M. Scheffler, both of UC Berkeley wrote:
'But the ADHD diagnosis rate in the U.S. is quite high compared to that of other highly
developed countries. If you believe the most current data from the Centers for Disease
Control and Prevention, the latest figure is that 11% of all kids 4 to 17 have at some point
gotten an ADHD diagnosis from a professional. And after first grade, it’s 20% of all boys and
about 10% of all girls. If you believe those data, which appear to be accurate, we have gone
too far. That’s higher than the diagnostic rate should be.'
There are too many diagnoses made in children on the basis of maybe a 10- to 15-
minute visit to a pediatrician’s office, where there’s no corroborating information from the
child’s school, no ratings from his or her parents, no thorough history taken of the kid. And at
the end of such a brief office visit, a prescription for stimulant medication is often written.
Now, that’s a formula for overdiagnosis, since the symptoms of ADHD are also the
symptoms of some learning disabilities, of depression, of having been mistreated, or of a
chaotic classroom. ADHD too often can be a convenient label to describe problems that
have other origins.
Professional groups—the American Academy of Pediatrics, the American Academy
of Child and Adolescent Psychiatry, the American Psychiatric Assn.—have all published very
clear guidelines as to what a thorough assessment for ADHD requires. But there’s no
enforcement of those guidelines. And there’s usually no insurance reimbursement to
physicians for making such a thorough assessment.
Scheffler: There is no blood test, no brain scan, no X-ray you can point to and say, 'There it
is!' So it can be a matter of judgment from the parents, clinicians, even the children
themselves. There’s some fuzziness around the edges of this diagnosis.
In the absence of clear physical basis for a diagnosis, our changing societal
expectations and economic conditions can play a role in how willing people are to diagnose
and medicate a child for ADHD. After all, this is a disorder whose hallmarks are impulsive,
disruptive and inattentive behavior and academic underperformance. So, part of the
explosion we have seen in ADHD diagnoses comes from escalating academic pressure that
teachers and parents have placed on their children to perform better at school, to get into a
better college, to get a good job.

Q. What do state policies on educational accountability have to do with ADHD?

Scheffler: There’s been a recent history of trying to get our schools to perform better.
Fifteen or 20 years ago, the philosophy was to get class sizes down and to fund schools
69
better: In efforts to improve education, the focus was on inputs. Then, with [the federal] No
Child Left Behind [law]—and a wide range of state educational accountability measures that
came before it—the focus of improving education shifted to output: better test scores, higher
graduation rates, etc.
This enormous 'push for performance' unleashed a whole new focus on testing and
on generating positive test results. The movement tied school and school district budgets,
teachers’ salaries and principals’ promotions to these test scores.
But let’s look at the incentives this creates for diagnosing ADHD in children who
might be bringing down their school’s average test scores, or who may be disruptive forces
in their classrooms. First, of course, there’s this belief that diagnosing and medicating kids
with ADHD will help them do better. But it goes beyond that: Once a child is diagnosed with
ADHD, the school is also allowed to make accommodations in his or her testing, for
instance, which can help him or her get better test scores. And sometimes, diagnosing a
child with ADHD allowed the school to exempt that child’s scores from the measures by
which the school and its administrators are evaluated and either rewarded or punished.
In some sense, we can see the societal pressure pushing everyone to diagnose.
These state and eventually federal policies incentivized schools to do that. A fairly clever
natural experiment helped us to measure this effect. One by one in the 1990s, 30 states
passed these kinds of accountability laws incentivizing test scores and achievement. Those
states were mostly in the US South. And sure enough, through the late 1990s and in the
first years of the new century, those states saw dramatically increased rates of ADHD
diagnoses.
Then in 2002, along came the No Child Left Behind law, which made these
performance-based standards for education the law of the land. The day it takes effect in
2003, the law brings 20 states into this new push-for-performance scheme. And it’s targeting
public schools and especially public schools in low-income communities—schools that
received a lot of funding for free and reduced-price lunch programs.
Hinshaw: Now, the law takes effect in 2003. And, as luck would have it, 2003 is when the
CDC conducts the first national survey that asks a representative sample of parents whether
their child had ever been diagnosed with ADHD by a professional. And then, four years later,
they ask the same question in another representative survey.
By 2007, those states that first got 'accountability' under No Child Left Behind in the
2002-2003 school year saw a 59% increase in ADHD diagnoses among their poorest kids,
but under 10% in kids from middle- and upper- income families in those states.
And in the states that already had accountability laws before? Everybody — poor and
wealthy — rose about 20% during that period, consistent with the overall national rate of
increase.
So when you make accountability 'count,' the rates of diagnoses of the poorest kids
go up shockingly. Short of designing a randomized control trial to determine whether these
policies are driving up diagnoses, that’s our clearest evidence. And the evidence is
especially strong for schools with a lot of poor kids in them.
Scheffler: And there were other factors at work as well: The diagnosis and treatment of
ADHD started to become more popular because we passed child health insurance programs
back in the 1990s. So if they were diagnosed, they were covered and could get treatment.
70
 Most state Medicaid programs started to pay for them as well, making it easier for poor kids
to get diagnosed and treated. After years of seeing far higher ADHD diagnosis rates in
wealthier kids, we found that the differential in diagnoses between wealthier kids and poor
kids disappeared.
Q. Is ADHD a class thing? An ethnic thing? Who’s most likely to get diagnosed and
how has that changed as rates of diagnoses have exploded?
Hinshaw: When I was in graduate school 30 years ago, hyperactivity was a white middle-
class male phenomenon: ADD (the new name in 1980) was about the disruptive boy--
Dennis the Menace. It was the Tom Sawyer syndrome. And the field said girls can’t get
hyperactivity. We used to think the same things about autism—a wealthy white boy thing--
and eating disorders, which only happened to upper-middle-class girls. This, of course, was
referral bias: Those were the kids whose parents had the wherewithal to bring them to the
specialized clinics that diagnosed these conditions.

Q. Why not accept that using 'smart pills' to enhance our academic performance and
productivity is a privilege of being a developed society?
Scheffler: It’s like steroids and sports. Most of us think it’s not. It’s not a fair way to play the
game and we don’t want that. I think society is not very favorably disposed to enhancing
people’s performance through medication unless they have a clinical reason for it. It’s not
only the cost and who pays for it, but whether it’s the right thing. I think it’s not.
Hinshaw: Should we accept neuro-enhancement as the wave of the future? I long thought
maybe it’s a personal choice: After all, we are a productive society; there’s a high demand
for productivity. But, as this book went to bed, I began seeing some new research and have
been changing my thinking on this.
We know that pretty much anyone who takes a stimulant will stay alert longer. But
the question has always been whether, for people who don’t really have ADHD, does the
medication really improve cognitive performance?
The world’s first really good study came out in January 2013, published in the journal
Neuropharmacology. Researchers from University of Pennsylvania recruited 46 college
students and put them in a rigorous experimental trial of stimulants vs. placebo, across
seven weeks.
There were 13 rigorous measures of cognitive performance. How many of these
measures did these college kids show improvement on? Zero.
But there was a 14th measure: The researchers also asked the subjects, 'How much
did the drug improve your performance on the tests?' The medication led to a decided
improvement on how well the subjects thought they did.
So, it would seem that medication bolsters a false sense of confidence: You feel
more alert, you thought you aced it. But you didn’t.82

The relationship between ADHD diagnosis and school funding was the subject of Congressional

testimony given by a former Colorado State Board of Education member, Patti Johnson. In the year 2000 she

testified in the US House of Representatives regarding private and public schools' use of learning disabilities

71
funding as a money-making means of addressing their budget deficits. The direct relationship between

increased school funding and increased rates of ADHD diagnosing was discussed. Schools benefit financially

when the number of their students diagnosed with ADHD and other labels increases.

Ms. Johnson testified that the rate of ADHD diagnoses increases every time increased funding is made

available to schools for children with learning disabilities. She explained that so-called learnings disorders

became a way for financially-strapped schools to gain funding. Many schools became authorized Medicaid

providers empowered to collect funds on behalf of children labeled with a learning disorder. Ms. Johnson

termed the program a ‘lucrative cash cow.’ As she testified, ‘the potential for the dollars is limitless.’

Federal funds are also available to private schools through their local school district or local educational

agency (LEA). These funds are distributed through a contract agency, Nonpublic Educational Services, Inc.

(NESI), providing an avenue for federal funds to be distributed without violating the law of Virginia to provide

funds to religious schools.83

Testimony of Patti Johnson Colorado State Board of Education member 2nd Congressional District
before the U.S. House of Representatives Subcommittee on Oversight and Investigations hearing entitled
‘Behavioral Drugs in Schools: Questions and Concerns’

Educators are not allowed by law to practice medicine. Yet, the adjudication a child has one
of these 'disorders' and should be placed on 'medication' and into special education is often
done by a team which includes the parent, a teacher, a social worker, a special education
teacher and the principal. The above factors led me to introduce a resolution before the
Colorado State Board of Education entitled 'Promoting the use of academic solutions to
resolve problems with behavior, attention and learning.' It reminded educators that their role
was to teach and urged them to refrain from advising parents on medical matters. This was
passed by a vote of 6 to 1 by the Board in November 1999.

Unfortunately, financial incentives exist for schools to label children with learning disorders.
Understanding these incentives requires a brief review of the laws that affect special
education. The legislation which is now the Individuals With Disabilities Education Act
(IDEA) was originally the Education for all Handicapped Children Act of 1975. The intent of
this legislation was to ensure that children with actual physical handicaps -- sight
impairment, hearing loss, etc. -- were given the public education they are entitled to. This
law was reauthorized in 1990 and the name changed to the Individuals with Disabilities
Education Act. There were few procedural changes but the term 'handicapped' was changed
to 'disabilities.' The following year a memo was issued by the US Dept. of Education Office

72
of Special Education and Rehabilitative Services which stated a child could qualify for
special education if he was determined to have ADHD.

At this time, the IDEA legislation provided schools with an additional $400 per year for each
child in special education. There followed a dramatic spike in the amount of methylphenidate
consumed in the US. According to the DEA, the production and use of methylphenidate
increased almost 6 fold between 1990 and 1995.
In IDEA as passed in 1999, the impairment category of 'emotional disturbance.' is defined in
part to say the child has 'An inability to learn that cannot be explained by intellectual,
sensory, or health factors.' There is no mention of the fact that this may be due to a failure to
instruct properly.

In December 1999, the Los Angeles Times reported that tens of thousands of California's
special education students were placed there not because they have a serious mental or
emotional handicap, but because they were never taught to read properly. Reid Lyon, head
of the federal government's research efforts into reading and writing told the Times, 'It is
where children who weren't taught well go in many cases.'

The intent of the original law, the Education for all Handicapped Children Act of 1975, was to
ensure those with physical disabilities received a free and appropriate public education.
These children are now being shortchanged because such a large percentage of special
education funds are being diverted to vague psychiatric diagnoses. In 1998, 51.1 percent of
special education children were in the category of 'specific learning disabilities.' These are
the psychiatric diagnoses such as Mathematics Disorder, Disorder of Written expression and
ADHD. Other disability categories also include psychiatric diagnoses. IDEA legislation also
contains a 'child find' provision which requires states to actively seek out any children who
may qualify for special education in order to receive federal special education funds. The
child find program starts at birth in Colorado. This, of course, serves to push up the numbers
of children labeled with ADHD.

The so-called learning disorders have, sadly, become a way for financially strapped schools
to make ends meet. In many states, schools have become authorized Medicaid providers
and funds can be collected in behalf of a child labeled with one of the learning or behavior
disorders. This can be such a lucrative cash cow that in a letter dated October 8, 1996, the
Illinois State Board of Education strongly encouraged the superintendent of one of its
districts to participate in Medicaid incentives. The letter stated that Illinois had received
$72,500,000 in federal Medicaid money in 1996 and that Medicaid dollars have been used
for a variety of non-medical purposes and that 'the potential for the dollars is limitless.'

To assist schools in identifying children to label with 'learning disorders,' a number of

checklists are made available to schools through the ERIC (Educational Resource and
Information Center) database, which is a federal clearinghouse for educational materials.
Yet, despite the expense created by such actions, these children are not receiving the

73
 education they are entitled to. Though the standards set for special education children are
often lower, their graduation rate in the 1995 -1996 year was only 28.9 percent!

To the degree educators are expected to diagnose children, they are being distracted from
their main duty which is to provide our children a quality education. Our schools are the only
institution entrusted to attend to the academic needs of our children and their mission must
not be diluted. I urge this committee to do everything in its power to get schools out of the
business of labeling children and back to the job of teaching.84

Concerns

Currently, parents are transferring public school children with learning disabilities to private schools.

The problem with this proposal is that private schools have even less resources than public schools. Many

private schools expect an even higher level of academic success. The likelihood is that the child will end up

with more homework and fewer resources. This in turn would force the parents to place the child on ADHD

drugs as a last resort since there is no accountability for private school administrators. If a problem arises,

there is no higher authority. This proposal ignores the underlying problems of the ADHD epidemic.

The problem is children have too much work and too little free time. The academic and behavioral

standards are beyond what can be achieved by most children. The rates of children cutting themselves and

suffering from eating disorders, anxiety and depression have all gone up, as have suicide rates. No Child Left

Behind has pushed the standards up with testing and lack of resources, leaving overwhelmed teachers with

large classrooms and no alternatives. The only option then becomes ADHD drugs and misdiagnosis. The

school systems need to provide a more child-friendly atmosphere. Honors classes can be offered, but the

average child does not have the capability to withstand what changes have been put in place. No pill is going

to make a child more mature or placed at an academically higher level. As a result of NCLB, statistics show

fewer children are graduating.

As far back as 1996, the DEA became aware of the growing trend of abuse using these drugs.

Mr. Gene R. Haislip,

Deputy Assistant Administrator
Office of Diversion Control
Drug Enforcement Administration
74
 United States Department of Justice
Washington, DC
Conference of Stimulant Use in the Treatment of ADHD
In San Antonio, December 10 - 12, 1996
Today, we have concluded a national conference of experts from the fields of research,
medicine, public health and law brought together by the US Drug Enforcement
Administration (DEA) to examine issues concerning the prescribing of stimulants to school
age children for the treatment of Attention Deficit Hyperactive Disorder (ADHD). The
principal drug used for this purpose is methylphenidate, commonly known as 'Ritalin'.
Like many others, the DEA has become alarmed by the tremendous increase in the
prescribing of these drugs in recent years. Since 1990, prescriptions for methylphenidate
have increased by 500 percent, while prescriptions for amphetamine for the same purpose
have increased 400 percent. Now we see a situation in which from seven total percent of the
nation's boys are on these drugs at some point as well as a rising percentage of the girls.
When so many children are involved in the daily use of such powerful psychoactive drugs, it
is important for all of us to understand what is going on and why. The DEA has a
responsibility to the nation to control such abusable legal drugs and to insure that their use
is confined to legitimate medical need. Certain things have become clear from our
deliberations of the last several days and the public, parents and decision-makers need to
hear them.
There is also strong evidence that the drugs have been greatly over prescribed in
some parts of the country as a panacea for behavior problems. These drugs have been
over-promoted, over-marketed and over-sold, resulting in profits of some $450 million
annually. This constitutes a potential health threat to many children and has also a created a
new source of drug abuse and illicit traffic. The data shows that there have been a 1,000
percent increase in drug abuse injury reports involving methylphenidate for children in the
10 to 14 year age group. This now equals or exceeds reports for the same age group
involving cocaine. The reported numbers are still small, but experts feel that this is only the
'tip of the iceberg.'
When we see that in some localities as many as 15 to 20 percent of the children
have been put on Ritalin or a similar stimulant, there is good reason to conclude that this is
'quick-fix', bogus medical practice which is nevertheless producing large profits. This far
exceeds any professional estimates of actual need.
Parents need to understand that we are talking about very potent, addictive and
abusable substances; a potency that can help in the right situation but can destroy in the
wrong situation. Above all, parents need to educate themselves and protect their children by
adopting an attitude of proper parental caution. Regrettably, much of the literature and
promotion of the drug in recent years has ignored or understated the potency and abuse
potential of methylphenidate and Ritalin. This appears to have misled many physicians into
prescribing the drug as a quick fix for the problems of actual behavior.
I want to emphasize that matters of this kind are vital but cannot be simplified. There
is a legitimate place for these drugs, but we have become the only country in the world
where children are prescribed such a vast quantity of stimulants that share virtually the

75
 same properties as cocaine. We must find a better balance. We must turn down the flow,
which is rapidly becoming a flood.
In conclusion, I want to call upon the drug industry, the parent support groups, the
researchers and medical authorities to get a better, more accurate message out to the
public. I want to call upon law enforcement authorities to root out this new illicit traffic before
it spreads. And I want to urge parents to educate themselves, protect their children and
teach them a healthy respect for both the good and evil which drugs can do.85

Doctors' opinions

Dr. Jerome Kagan, ranked as one of the 100 most eminent psychologists of the 20th century, has been

studying developmental psychology at Harvard University for his entire professional career. He stated in the

last fifty years ADHD has become a catch-all term for children who suffer from any ailment due to the

pharmaceutical push to mislabel children for any type of common childhood behavior. Spiegel International’s

interview with Dr. Kagan.

SPIEGEL: Experts speak of 6.4 million American children who display the symptoms typical
of ADHD. Are you saying that this mental disorder is just an invention?
Kagan: Every child who's not doing well in school is sent to see a pediatrician and the
pediatrician says: 'It's ADHD; here's Ritalin.' In fact, 90 percent of these 6.4 million kids don't
have an abnormal dopamine metabolism. The problem is, if a drug is available to doctors,
they'll make the corresponding diagnosis.
SPIEGEL: So the alleged health crisis among children is actually nothing but a bugaboo?
Kagan: We could get philosophical and ask ourselves: 'What does mental illness mean?' If
you do interviews with children and adolescents aged 12 to 19, then 40 percent can be
categorized as anxious or depressed. But if you take a closer look and ask how many of
them are seriously impaired by this, the number shrinks to 8 percent. Describing every child
who is depressed or anxious as being mentally ill is ridiculous. Adolescents are anxious,
that's normal. They don't know what college to go to. Their boyfriend or girlfriend just stood
them up. Being sad or anxious is just as much a part of life as anger or sexual frustration.
SPIEGEL: What does it mean if millions of American children are wrongly being declared
mentally ill?
Kagan: Well, most of all, it means more money for the pharmaceutical industry and more
money for psychiatrists and people doing research.
SPIEGEL: And what does it mean for the children concerned?
Kagan: For them, it is a sign that something is wrong with them -- and that can be
debilitating. I'm not the only psychologist to say this. But we're up against an enormously
powerful alliance: pharmaceutical companies that are making billions and a profession that
is self-interested.86

76
THE RISE AND FALL OF ADD/ADHD by Fred A. Baughman Jr., MD 9/25/00

In 1948, 'neuropsychiatry' was divided into ‘neurology,’ dealing with organic/physical

diseases of the brain and ‘psychiatry,’ dealing with emotional/behavioral conditions in normal
human beings. The 1950s were the dawn of the ‘age of psychopharmacology’--drugs for
emotional/behavioral problems in physically, normal persons.
Between 1952 and 1994, the American Psychiatric Association’s (APA) Diagnostic
and Statistical Manual (DSM) grew from 112 ‘disorders’/ ‘diseases’ in 1952, to163 in 1968,
224 in the 1980, 253 in 1987 and 374 in the 1994.
The ADHD, ‘epidemic’ (by whatever name) has grown from 150,000 in 1970, to a half
million in 1985, a million in 1990 and to 6 million today.
In the 60’s, psychiatry and pharmaceutical industry launched a psychopharmacology
marketing strategy. They would call all emotional/behavioral problems 'brain diseases.' Thus,
the public came to believe in 'chemical balancers'—pills--for 'chemical imbalances' (of the
brain). Moreover, they have ceased to understand what 'normal' is.
On October 12, 1970, Congressman, Cornelius Gallagher wrote to Secretary of the
Department of Health Education and Welfare, Elliott Richardson, stating, '… a NIMH witness
testified that at least one hundred fifty thousand children around the nation were receiving
drugs.' 'I have received letters from people highly critical of the focus of the medical side of
minimal brain dysfunction, which is, incidentally, one of at least thirty-eight names attached
to this condition…Such a high incidence in the population- as high as thirty percent in ghetto
areas…may not be pathological at all…Amphetamines now rival and perhaps exceed hard
drugs as a source of abuse.
In 1980, Attention Deficit Disorder (ADD) was invented, in-committee, for DSM-III. In
1987, ADD was revised, becoming ADHD (Attention Deficit Hyperactivity Disorder) for DSM-
III-R. Any 8 behaviors from a list of 14, qualifies a child for the ‘diagnosis.’ In 1994, ADHD is
again ‘re-conceptualized’, this time for DSM-IV . Six of the nine behaviors from one of two
lists qualifies for the ‘inattentive,’ the ‘hyperactive-impulsive’ or the ‘combined’ type.
On July 15, 1996, Congressman Christopher Shays testified: 'In ADHD, we are trying
to draw the line between personality and pathology and we are placing millions of children
and adults on either side of the social, medical and legal boundary that divides the healthy
from the sick. We should do so only with the greatest care and with particular reticence to
make our children medical patients because as a culture we have lost our patience with
them.'
At the same hearing, Jensen, of the NIMH and CHADD (he is a member of their
Professional Advisory Board), assured the Congressman: '…studies have consistently
pointed towards disturbances in brain functioning, particularly in brain areas responsible for
attention and memory.' Jensen used the wording: 'pointed toward disturbances in brain
functioning' because there was no proof of brain malfunction at the time. Just as there is
none today.
On September 23, 1993, Baughman testified to the Panel on NIH Research on
Antisocial, Aggressive and Violence-Related Behaviors and their Consequences: 'If, as I am
convinced, these entities are not diseases, it would be unethical to initiate research to
evaluate biological interventions—unethical and fatally flawed scientifically.'
77
 In December, 1994, Pearlman, wrote: 'I take issue with Pincus’ (for the APA)
assertion that elimination of the term 'organic' in the DSM-IV has served a useful purpose for
psychiatry… elimination of the term 'organic' conveys the impression that psychiatry wishes
to conceal the nonorganic character of many behavioral problems that were, in previous
DSM publications, clearly differentiated from known central nervous system diseases.'
Baughman, also responding to Pincus’ APA assertion, wrote: '…to contend that something is
a disease when that has not been established is to fail to provide the patient with information
sufficient to make an informed decision.'
On December 24, 1994, Leber of the FDA wrote me: '…as yet no distinctive
pathophysiology for the disorder has been delineated.' On October 25, 1995, Haislip of the
DEA wrote me: 'We are also unaware that ADHD has been validated as a biologic/organic
syndrome or disease.'
In 1996, Schiller, of the US Department of Education, Jensen (NIMH, CHADD) and
Swanson (UC, Irvine, CHADD), wrote, 'Once parents and teachers…recognize that children
with ADD are not lazy or 'bad', but have a biological disorder, they can stop blaming
themselves or their children and take appropriate steps to prevent a pattern of failure.'
There can be no doubt here, that they are calling ADD/ADHD a disease; the children
abnormal, diseased.
On April 15, 1998, I wrote to Attorney General, Janet Reno, stating: 'The single,
biggest health care fraud in US history—the representation of ADHD to be an actual disease
and the drugging of millions of entirely normal American children, as 'treatment,' is spreading
like a plague…That ADHD is wholly devoid of validity as a disease, a medical syndrome or,
anything biologic or organic, is the pivotal element of the fraud.'
On October 8, 1998, Diller, author of Running on Ritalin wrote to Sue Parry, a
concerned mother: 'The reason why you have been unable to obtain any articles or studies
presenting clear and confirming evidence of a physical or chemical abnormality associated
with ADHD is that there are none. Not that medical science, especially in recent years,
hasn’t tried. However the search for a biological marker is doomed from the outset because
of the contradictions and ambiguities of the diagnostic construct of ADHD as defined by the
DSM. I liken efforts to discover a marker to the search for the Holy Grail.'
On March 7, 1998, Swanson, of the University of California, Irvine and CHADD (a
member of their Professional Advisory Board) stated: 'I would like to have an objective
diagnosis for the disorder (ADHD). Right now psychiatric diagnosis is completely
subjective…' On May, 13, 1998, Castellanos or the NIMH wrote me: '… we have not yet met
the burden of demonstrating the specific pathophysiology that we believe underlies this
condition.'
Opening the November, 1998, NIH, Consensus Conference on ADHD, Hyman,
Director of the NIMH stated: 'ADHD affects from 0-3% in some school districts up to 40% in
others. Surely this cannot be right.' Addressing the Consensus Conference, Carey
concluded: 'What is now most often described as ADHD in the United States appears to be
a set of normal behavioral variations…' Critiquing the report of the Consensus Conference
Panel, Degrandpre observed,'… it appears that you define disease as a maladaptive cluster
of characteristics…in the history of science and medicine, this would not be a valid definition
of disease.' Having failed to validate ADHD as a disease, they seek to change the definition.
78
Baughman testified at the Consensus Conference: 'Without an iota of proof or credible
science, the National Institute of Mental Health (NIMH) has proclaimed the … children
'brain-diseased,' 'abnormal.' CHADD, funded by Ciba-Geigy, manufacturer of Ritalin, has
spread the 'neuro-biological' lie. NPR’s Joe Palca, chided the Panel: ‘What you're telling us
is that ADHD is like the Supreme Court's definition of pornography, 'You know it when you
see it.’
The final statement of the Consensus Conference Panel, delivered to attendees and
the press, November 18, 1998, read: ' ...we do not have an independent, valid test for ADHD
and there are no data to indicate that ADHD is due to a brain malfunction.'
On April 29, 1999, Baughman responded to Report of the Council on Scientific Affairs
of the American Medical Association: 'Once children are labeled with ADHD, they are no
longer treated as normal. Once Ritalin or any psychotropic drug courses through their brain
and body, they are, for the first time, physically, neurologically and biologically, abnormal.'
On November 28, 1999, I wrote to Matthew D. Cohen, Esq. President of CHADD, stating:
'You and I know that whether or not ADHD is an actual disease with a confirmatory, physical
or chemical abnormality, (detectable, patient-by-patient) is more fundamental to the debate
now raging over the Colorado State Board of Education’s resolution, than whether or not
psychotropic drugs cause violence or, are addictive, dangerous and deadly. You at CHADD,
including all members of your Professional Advisory Board, are aware that actual, bona fide
diseases, are characterized and validated by a confirmatory, physical or chemical
abnormality. You are aware of this, even if the general public is not and is inclined to trust
and believe anything physicians tell them. Thus the widespread belief, by the public, in
ADHD as a disease, something 'neurobiologic', when there is no research-empirical proof.
This brings me to ADHD and to your letter to Mr. Clair Orr, Chairman of the Colorado State
Board of Education, of 11/2/99. You state: ‘Attention Deficit/Hyperactivity Disorder is a
severe neurobiological condition…’ The term 'neurobiologic condition' says to the public that
there is something wrong or abnormal with the brain or nervous system of the child/person
with ADHD. How can CHADD make such a statement to the public and now, to the Colorado
State Board of Education, when there is no objective evidence or proof anywhere in the
peer-reviewed literature, that there is any neurological (brain) abnormality in children
(persons) said to have ADHD, or that there is anything physically, chemically, or biologically
abnormal, at all. How does CHADD justify calling so many normal children diseased,
abnormal--for surely you do--for purposes of justifying prescriptions for them, mostly of
addictive, controlled, Schedule II, psychostimulant medications?'
I have never heard back from Mr. Cohen. However CHADD repeated its claim, still
with no scientific evidence with which to back it up, that ‘Attention Deficit/Hyperactivity
Disorder is a severe neurobiological condition…’ in testimony to the Arkansas State House
of Representatives, May, 3, 2000.
On December 13, 1999, Surgeon General, David Satcher released his Report on
Mental Health. In it he alleged: 'Mental illness is no different than diabetes, asthma or other
physical ailments…Mental illnesses are physical illnesses…We know the chemical disorders
we are treating…' In a letter of January 25, 2000, I responded: 'Having gone to medical
school and studied…disease, then, diagnosis, you and I and all physicians, know that the
presence of any bona fide disease, like diabetes, cancer, or epilepsy is confirmed by an
79
 objective finding--a physical or chemical abnormality. No demonstrable physical or chemical
abnormality: no disease! You also know, I am sure, that there is no physical or chemical
abnormality to be found, in life, or at autopsy in 'depression, bipolar disorder and other
mental illnesses…' Why, then, are you telling the American people that 'mental illnesses' are
'physical' and that they are due to 'chemical disorders'?…Your role in this deception and
victimization is clear. Whether you are a physician, so unscientific, that you cannot read their
contrived, 'neurobiologic' literature and see the fraud, or whether you see it and choose to
be an accomplice--you should resign.'
In January, 2000 Castellanos, summarized the state of ADHD science:
'Incontrovertible evidence is still lacking…In time I’m confident we’ll confirm the case for
organic causes.'
On May 1, 2000, the law firm of Waters and Kraus of Dallas, Texas filed the first class action
suit charging that the APA, CHADD and Novartis: 'planned, conspired and colluded to
create, develop, promote and confirm the diagnoses of Attention Deficit Disorder and
Attention Deficit Hyperactivity Disorder, in a highly successful effort to increase the market
for its product Ritalin.' As of September, 2000, five or six or such class action suits had been
filed, 2 in California.87 [These law suits were prior to the long term studies exposing brain
damage and many other life altering effects.]

Foster Care, Doctors and Corruption

In 2014, The Mercury News’ published a multi-part article titled “Drugging our kids.” PART III, written by
Karen De Saꞌ focuses on the relationship between drug makers and doctors. The following is an excerpt from
De Saꞌs article, “The RX ALLIANCE That drugs our kids: The doctors get rewarded, the drug companies get
rich and foster children get more meds.”

Targeting doctors
The newspaper’s analysis provides a glimpse into how pharmaceutical companies
are targeting these doctors. The ones who received the highest payments range from child
psychiatrists in rural outposts to top-tier researchers at publicly funded universities, including
UCLA and UC San Francisco. The data showed:
Foster care prescribers reap nearly 2½ times more than the typical California doctor:
From 2010 to 2013, almost 30 percent of all California doctors — and about 35 percent of
foster care prescribers — received at least $100 from drug companies. But while the
California doctors in that group received an average of $10,800 apiece over the four-year
period, foster care prescribers typically received far more, nearly $25,000 each
Frequent prescribers are generally rewarded the most: Doctors who wrote more than 75
prescriptions to foster children in a year received more drug company payments than those
who wrote fewer. While the margin fluctuated from year to year, on average the higher
prescribers in the most recent fiscal year collected almost four times — or about $10,000
more — than the lower prescribers in 2013.
The bulk of the payments fund drug company-sponsored research: The 17 drugmakers
who reported payments steered more than $11.3 million in research funds to doctors who

80
prescribe psychotropic drugs to the state’s foster kids, with Eli Lilly — maker of the
antipsychotic drug Zyprexa — leading the pack by spending $6 million.
The companies kept some of their big researchers busy in other ways: Six of the
doctors who earned among the largest research grants also tallied a cumulative total of
almost $400,000 in speaking and consulting fees and another $45,000 in travel and meals.

The debate over sponsored research

The drug companies’ reports give no specifics on how their research money is spent,
but doctors conducting the research say the funds are used on a variety of expenses to run
clinical trials of the companies’ drugs. Many doctors say industry-sponsored research is a
must with so little federal funding available to advance medicine.
'It’s only fair that pharmaceutical companies fund the research that they’re going to
be reaping profits from,' said George Fouras, a San Francisco child psychiatrist and
spokesman for the American Academy of Child and Adolescent Psychiatry. 'I know that it
has to happen this way, but as a consumer of the research I might be somewhat skeptical.'
Numerous studies in recent years confirm that skepticism. For example, a 2007 study in
BMJ, formerly known as the British Medical Journal, found 'results and conclusions of
randomized, controlled trials with financial ties to one drug company are more likely to favor
the sponsor’s products.'
'Many people claim that ‘science is science,’ but it’s not that hard to find what you
want with most research studies,' said Jerome Hoffman, an emergency medicine specialist
at UCLA and critic of the pharmaceutical industry’s influence. Even negative studies can
often be made to look positive.' Drug companies buy doctors lunch or sponsor speaker
dinners to discuss their latest products. Pfizer picked up the tab for more than $105,000 on
dining, more than any other company in the newspaper’s analysis, which also found that 7
percent of all foster care prescribers took at least $1,000 in meals during the four-year
period, compared with 2 percent of all California doctors.
Adriane Fugh-Berman, a pharmacology professor at Georgetown University's
Medical Center in Washington D.C., says doctors are influenced by pharmaceutical
companies' swag, meals and other gifts. 'People are more receptive to messages of any
kind when they’re eating,' said Adriane Fugh-Berman, an associate pharmacology professor
at Georgetown University’s Medical Center who has published extensively on drug company
influence. 'Food is the great lubricant.' In a study of doctors in the nation’s capital, Fugh-
Berman and colleagues also found that psychiatrists who accepted Medicaid were top
targets of antipsychotic drugmakers and received a disproportionate share of gifts.
Like most states, California has no restrictions to prevent doctors who treat patients
on Medi-Cal, the state’s public health system, from accepting payments from drugmakers.
Massachusetts’ Physician Gift Ban Law prohibits the industry from treating doctors to trips
and other types of entertainment, but it rolled back a provision that outlawed most gifts or
meals. The pharmaceutical industry has instituted its own voluntary code with similar
restrictions.
But even small gestures such as meals and free samples pay dividends, experts say.
'As doctors, we like to think and will often say that we are not influenced much by marketing,'
said Pennsylvania neurologist Richard Paczynski, who has testified against drug companies
81
over the illegal promotion of antipsychotics. 'But we shouldn’t be naive and think these drug
companies would be spending as much as they do reaching out to us if it wasn’t paying off.'

‘Key opinion leaders’

While some doctors may be dubious of drug company sales reps dropping off
cookies to get their foot in the door, they are more inclined to listen to one of their peers —
especially one who prescribes a drug, experts say. Drug companies dub them 'key opinion
leaders.' Among them is Dr. Janak Mehtani, a Sacramento psychiatrist who state records
show prescribed psychiatric medications to foster children from 2008 to 2012 — although
that appears to be a small part of his practice. He’s also a fixture on the speaking circuit,
with records showing Mehtani or his Fair Oaks Psychiatric Association chalking up well over
$300,000 in the past five years from a who’s who of pharmaceutical giants: $97,000 from
AstraZeneca, $86,000 from Eli Lilly, $42,000 from Forest Laboratories, $44,000 from Merck,
$52,000 from Novartis. Mehtani collected another $19,000 in consulting gigs, travel and
meals from Otsuka America Pharmaceutical, maker of the country’s top-selling drug, Abilify,
in the last five months of 2013.
Earlier this year, he gave a talk at a dinner in Reno called 'Discover a New Option for
the Treatment of Major Depressive Disorder' to tout Forest Laboratories’ new drug Viibryd.
In an interview, Mehtani said some of those payments went to six other doctors in his
practice — although he didn’t provide specifics. He said he is the sole proprietor of the
practice and other doctors used his tax ID number.
When physicians ask him about using antipsychotics and other psychiatric drugs on
children, Mehtani insists he only advises them about Food and Drug Administration-
approved treatments and calls drugs a 'last resort.' It isn’t clear what types of psych meds
Mehtani or the other doctors on the state’s list prescribed to foster children, because the
state has not provided the newspaper that level of detail. Mehtani said he sees no conflict in
his work: 'My conflict is essentially neutralized because I speak on almost all brand-name
drugs.'
Lynne Pappas, a Shasta County psychiatrist who treats foster children, accepted
more than $125,000 from a variety of drug companies for speaking, meals and travel.
She said she often talks about medications such as the stimulant Intuniv, which is FDA-
approved for use in children. 'Whether I teach about a medication or not,' Pappas said, 'I do
not believe that impacts how I prescribe, or my decision-making on how to treat an individual
patient.'
Dr. Raman Sankar, the chief of pediatric neurology at UCLA, also is quick to defend
doctors who speak on behalf of pharmaceutical companies. 'There is nothing sinister about
experts on specific topics giving talks,' said Sankar, who treats some foster youth at UCLA
and in Kern County.
As a member of GlaxoSmithKline’s speaker’s bureau, Sankar received $75,000 from
2010 to 2013 to give talks on medications that treat pediatric epilepsy, his specialty. 'A lot of
physicians rely on my expertise,' he said. 'Doctors say to the sales reps, ‘I don’t want to hear
from you and cannot get comfortable with a new medication just from the package insert,
but I would like to hear from Dr. Sankar.’ ' Sankar said accepting money from drug
companies doesn’t taint him or influence how he treats his patients; he is paid because his
82
time is worth money. 'I honestly believe I have brought a lot of value to the community,’ he
said, ‘and these efforts involve preparation and time. I believe it is reasonable to be
compensated for time.'
A painful journey
Hernandez called it 'pathetic' that three of the psychiatrists she saw while bouncing
among nine physicians in foster care turned up on the newspaper’s list of prescribers who
accepted meals, travel and speaking engagements. As a teenager, she spent two years on
a painful journey through foster care when her mother died. At the time, she said she was
prescribed a panoply of psychotropic drugs, including Prozac, Wellbutrin, Klonopin, Ativan,
Depakote, Geodon, Abilify and trazodone. Many of the drugs are either not FDA-approved
for children or have only limited approval, but doctors have the discretion to prescribe them
'off-label.'
From 2010 to 2013, one of her psychiatrists is listed as receiving more than $26,000
in meals, travel and speaking engagements paid for by Pfizer (which makes the
antipsychotic Geodon), Eli Lilly (maker of Prozac) and Forest Laboratories — although it
isn’t clear which medications he prescribed to Hernandez. Two of her doctors accepted
more than $1,800 each in meals and gifts. None of her doctors responded to inquiries for
comment. 'If I was a doctor,’ said Hernandez, a third-year psychology major at UCLA, ‘I
would want to be more responsible — especially with kids.'
Behind Zyprexa marketing machine
By spending almost $6.5 million on California foster care prescribers, Eli Lilly topped
the 16 other drug companies in the newspaper’s analysis, more than doubling the second-
biggest spender, Pfizer. Its aggressive campaign to promote the blockbuster antipsychotic
Zyprexa, revealed in federal court documents, is a case study in how companies use
marketing savvy to help boost prescriptions of their drugs. One of the promising markets it
identified, according to an internal email: 'the treatment of disruptive kids.' In the early
2000s, sales directives show the company had 'unleashed more than 130 psychs and PCPs
(primary care physicians) who are chomping at the bit to help you sell Zyprexa.'
The company’s so-called 'High Flyer' prescriber profile described general and family
practice physicians who typically are 'treating symptoms rather than a diagnosis' and who
are 'willing to push the dosage of medications they are comfortable with.' The company also
targeted child psychiatrists, documents from the federal whistleblower suit show.
Not much was said about the hazards of olanzapine, the drug marketed as Zyprexa. Since
1996, federal and state health officials in California had written to Eli Lilly, concerned about
patients on Zyprexa gaining weight and developing diabetes. The company repeatedly was
warned in letters from the FDA about false and misleading advertising that encouraged use
of the drug as a treatment for unapproved conditions.
'All the antipsychotics were originally intended to treat schizophrenia and classic
manic depression, but with Zyprexa the goal was to become the best-selling psychotropic
drug of all time,' said Glen Spielmans, a psychology professor at Metropolitan State
University in St. Paul, Minnesota who studied the Zyprexa promotion. 'So they essentially
watered down bipolar disorder quite a bit to come up with this thing called ‘complicated
mood.' The symptoms included anxiety, irritability, disrupted sleep and mood swings. 'It’s a

83
fantastic disorder,’ Spielmans said, ‘because everyone has it.' Sales reps were instructed to
avoid the dicey topics of side effects, company documents show.
'For Zyprexa, weight gain is the ultimate topic to handle with skill,' one company
document stated. A slide to sales reps, titled 'Weight Gain Management,' simply advised:
'Don’t Introduce the Issue!!' Promotional material from 2001 noted that 'the competition wins
if we are distracted into talking about diabetes.' Shahram Ahari, a former drug rep for Eli
Lilly’s neuroscience team from 1998 to 2000, said his team would do its best to 'cloud up'
and 'muddle' any potentially sales-impacting discussions with doctors. And when the
friendly banter turned to science, the studies Ahari would discuss with doctors 'were
embarrassingly cherry-picked perceptions of the drug,' he said. 'These companies put profits
before science and before the patients. They make the physician the target and leverage the
physician against the patient.'
Rochelle Trochtenberg, a former foster youth who now lives in Eureka, Calif., says
she's angry about the drug companies' influence over doctors. Former foster youths such
as Trochtenberg see Zyprexa’s marketing as a scandal. She nearly doubled her weight after
being prescribed the antipsychotic and a host of other medications during her tumultuous
teenage years in foster care growing up in Los Angeles. 'I feel angry that they got away with
such deception,' said Trochtenberg, 32, who now lives in Eureka. 'The fines they faced are
nothing compared with what they’re making off these kids.'
'If it was any other population this happened to, the whole world would be outraged.'
Legal battles fail to slow sales?
In recent years, each of the manufacturers of the top five antipsychotic medications
billed to Medi-Cal — Abilify, Risperdal, Geodon, Seroquel and Zyprexa — have been
prosecuted by the US Justice Department for illegal marketing to children and seniors. Eli
Lilly, Johnson & Johnson, Pfizer, Bristol-Myers Squibb and AstraZeneca have collectively
paid $4.6 billion in fines, in some cases the largest healthcare fraud settlements in US
history.
Eli Lilly spokesman Scott MacGregor would not discuss the Zyprexa case, but he
referred a reporter to a statement the company issued in 2009, when a settlement with the
Justice Department resulted in a $1.4 billion fine. He said the company has not marketed
Zyprexa in the US since 2011 when its patent expired.
The statement reiterates that Zyprexa is not approved for patients younger than 18 and
describes the risks of weight gain, a worsening of diabetic conditions and the potentially
irreversible condition known as 'tardive dyskinesia,' which can cause uncontrollable
movements.
In each case, the drug companies settled with US justice officials and admitted no
wrongdoing. And the legal battles have done little to slow record-setting sales. From 2004
to 2013, sales of the five antipsychotic drugs most often prescribed to children on Medi-Cal
skyrocketed 128 percent. Last year, Bristol-Myers Squibb’s Abilify was the top-selling drug in
the United States, with more than $6.8 billion in sales.
And researchers across the country have seen evidence of the drug company-doctor
alliance behind the trend. A 2010 Arkansas study found Abilify had 'the highest level of non-
evidence-based use' of all psychotropic medications prescribed to children on Medicaid in
that state: 77 percent of the time, Abilify was used with 'no strong or plausible evidence' that
84
 it would be effective 'to treat any condition.' Yet from 2003-2005, Abilify use in Arkansas
soared by roughly 350 percent.
'I could see immediately that there was a huge problem with the growth of antipsychotics
that was out of proportion with the growth of the benefit to the patient,’ said study co-author
Mark Helm, a former pharmaceutical market researcher. ‘It was an effect of marketing to
physicians.'
In the end, the least suspecting patients suffer because foster children do not even
consent for their care, said Cohen, the UCLA social welfare professor. They are easy targets
for irresponsible prescriptions, he added — especially when taxpayers pay the bill.
'They’re the canaries in the coal mine,' he said. 'The experimentation, the drug
cocktails, the first-line drugging typically starts with the group that’s the least protected —
and foster kids are at the bottom of the ladder in our society and so it’s easier to do this to
them.'
'Since the drug companies know well how to influence doctors to prescribe this way,
then what happens to the kids happens to everybody next. We all need to wake up because
it’s our doctor next.'88

Consequences

Where do many of the misdiagnosed children who suffer from the side of effects of ADHD drugs end

up? They are in state hospitals, juvenile detention centers and jails, some are declared incompetent, became

homeless, or worse.

State Hospitals

AMERICA’S OVERMEDICATED CHILDREN By Vera Sharav

YOUTH and MEDICINES in June 1-3, 2005
KILEN: Consumers Institute for Medicines and Health
‘Forgotten Children’ is an investigative report by Carole Keeton Strayhorn, the Texas
Comptroller (2004) who uncovered evidence that 60% of children in the Texas foster care
system are being drugged with powerful psychotropic drugs, most of which have not been
tested in or approved for use by children. The Food and Drug Administration (FDA)
acknowledges that many of these drugs have serious adverse side effects, both physical
and psychological. The Comptroller said she was alarmed that in her review of a single
month (November 2003), two powerful antipsychotic drugs — Risperdal and Zyprexa —
made up half of the drugs prescribed to foster children in Texas. These two drugs have
been approved only for adults for the treatment of psychosis – primarily schizophrenia – yet,
she found that children as young as four, were receiving these powerful, mind-altering
drugs.
The number of American children under 19 years of age who are prescribed psychotropic
drugs is staggering – the use of these drugs eclipses all other categories for this age group.
Between 2000 and 2003, the use of these drugs among teenagers increased threefold, and
the number of children treated for ‘severe behavioral conditions’ related to conduct disorder
and autism jumped more than 60%. The FDA estimates 11 million antidepressant
85
prescriptions were written in 2003 for under 19 year olds–a 27% increase in 3 years. Drugs
used primarily to treat attention deficit/ hyperactivity (ADHD), which remains a controversial
‘condition,’ increased the most. In 5 to 9 year old children the use of drugs increased 85%,
and in preschoolers usage was up 49%. Physicians prescribe mind-altering drugs even as
they know that for this age group the developing brain is undergoing extraordinary changes.
They acknowledge: ‘we have very little information about the long-term impact of treatment
with these drugs early in development.’
The unprecedented number of children being diagnosed with psychiatric conditions, then
prescribed psychotropic drugs can be traced to the collaborative efforts of the drug industry
and its paid collaborators: professional associations of psychiatrists, leading psychiatrists at
prestigious universities, and government health care agencies that are financially dependent
on drug companies. Beginning in the 1990s a series of federally sponsored ‘mental health’
initiatives promoted the idea that children’s mental health was in crisis, that they were
suffering from undiagnosed depression, and that early treatment is essential to prevent
suicide. These influential collaborators flooded the channels of communication with
misinformation, persuading doctors and parents that children’s mental health was a major
problem and that ‘safe and effective’ remedies were at hand.
Hundreds of news stories including dozens of peer reviewed journal articles repeated the
message: the new antidepressants, Prozac and its cousins–sertraline (Zoloft), seroxat
(Paxil) – were described as ‘safe and effective’ magic bullets. Unlike the old imprecise,
sedating antidepressants, these drugs, we were told, are ‘selective serotonin reuptake
inhibitors’ (SSRIs) – the implication being that they act with precision on the serotonin
receptors. Parents were misled to believe that SSRIs were ‘safe and effective and well
tolerated in children,’ when they had shown no benefit greater than placebo, while producing
severe adverse effects in children. A mental health epidemic was created (critics believe) to
provide an expanded market for new drugs. Even infants and toddlers are prescribed
Prozac with the blessing of the medical / psychiatric establishment. In 1998, an FDA
contracted survey found that 3,000 Prozac prescriptions had been written for infants.
Of note: Before Prozac antidepressants had been used only for severely depressed,
hospitalized patients who were at high risk of suicide. The advent of Prozac changed all that
– anyone expressing a sign of unhappiness, anxiety, or moodiness from the ebb and flow of
life, was diagnosed as suffering from depression. When tested in controlled trials, the new
generation antidepressants have failed to demonstrate a benefit either for severely
depressed hospitalized patients or for troubled children. The business success of Prozac is
attributable to creative aggressive marketing. However, the new antidepressants – SSRIs
and SNRIs (selective serotonin norepinephrine reuptake inhibitors)–pose significant life-
threatening risks of harm which, for almost two decades, had been concealed from the
public. The most serious documented harm links SSRIs /SNRIs to increased risk of suicide
and violence in youth.
Prescribing physicians in Europe and the US were kept in the dark about the serious risks
until paroxetine (Paxil) was exposed by the BBC (2003). The drug was shown to cause
severe withdrawal symptoms – a sign of drug dependency – and it triggered violent
outbursts and suicide. The UK medicines authority (MHRA) was first to issue a public
warning about the dangers of Paxil in June 2003, and to ban the use of SSRIs / SNRIs in
children, save Prozac. In March 2004, the US FDA followed, issuing extensive bold
warnings about the increased risk of suicidal behavior in both children and adults who take
an antidepressant – for any condition ‘psychiatric or non-psychiatric.’ In October 2004, the

86
 FDA issued black box warnings about the twofold increased risks of suicidal behavior in
youth taking any antidepressant, including Prozac.
The European Medicines Agency (EMA) is the last regulatory agency to catch up. In April
(2005), the EMA’s scientific committee (CMHU) issued a press release recommending
warnings on the labels of all the new SSRI / SNRI antidepressants to reflect the evidence:
SSRIs/SNRIs should not be used in the treatment of children and adolescents unless
specifically authorised. Suicide-related behaviours (suicide attempt and suicidal thoughts),
and hostility (predominantly aggression, oppositional behaviour and anger) were more
frequently observed in clinical trials among children and adolescents treated with
antidepressants compared to those treated with placebo. The EMA added Strattera
(atomoxetine) to the list of drugs prescribed for children, noting its ‘lack of efficacy in
depression.’ Strattera is approved only for the treatment of ADHD for adults and children:
but it poses increased risks which constitute the very symptoms that constitute a diagnosis
of ADHD: ‘hostility, aggression, oppositional behavior, and anger.’
Antipsychotics are the most powerful, most toxic psychotropic drugs that have neither been
tested in, nor approved for use by children, yet they are the second most widely prescribed
drugs for children. Although the scientific evidence for their effectiveness is tenuous,
nevertheless, these powerful drugs are widely prescribed primarily for off-label uses.
Antipsychotics were approved for the treatment of psychosis in adults, primarily for
schizophrenia and short-term use for bipolar disorder. These drugs induce severe,
potentially fatal adverse effects and now carry FDA required warnings that they impair
judgment, thinking, and motor skills. Since 2003 the labels carry black box warnings about
potentially fatal diabetes mellitus, especially in youth. They also carry risks of prolonged
heart QT interval, cardiac arrhythmia and stroke. Antipsychotics are the fourth highest
selling class of prescribed drugs in the US– sales in 2002 reached $6.4 billion. The greatest
spending increase for the treatment of children diagnosed with behavior problems, is due to
skyrocketing use of the most expensive drugs to treat ADHD, conduct disorder, autism, and
affective disorders such as depression.
These drugs are known to induce severe, potentially fatal adverse effects and now carry
FDA required warnings about the risks of cardiac arrhythmias, impaired judgment, thinking,
and motor skills. Since 2003 the labels carry black box warnings about potentially fatal
diabetes mellitus, especially in youth. Concerns are being raised about why young people
who are not psychotic are being prescribed these powerful drugs for unapproved uses
without evidence of their safety.
Investigations across the US corroborate the abusive use of psychotropic drugs:
 The Massachusetts Behavioral Health Partnership reported that almost two thirds of
children in state care were treated for behavioral disorders in 2003.
 An analysis of the medical records of 300,000 children aged 2 through 18 who were enrolled
in the Tennessee Medicaid healthcare program for the poor and uninsured found that the
use of antipsychotics for children nearly doubled in six years. Nearly one in every 100
adolescents covered under the Tennessee program was being prescribed antipsychotics in
2001. The increases were most dramatic among children aged 6 to 12 (a 93% rise) and
those aged 13 to 18 (a 116% increase). The use of antipsychotics among preschool children
increased 61%.
 An investigative series in Columbus Ohio found that 40,000 children aged 6-18 who were
covered by Medicaid were prescribed psychotropic drugs: 31% of those children were in

87
 foster care, and 22% were in juvenile detention. Medicaid spent $65.5 million for drugs used
primarily as ‘chemical restraints.’ Among these:
o Chelsey Kennedy, 15, says she ‘slept for four days and was in a drug-induced fog for
a week’ after being subdued with three shots of a powerful drug at a Dayton
treatment center. Now she’s at a Columbus center, but her mother worries about the
number of medications she takes daily – 14, of which 11 are psychotropic drugs,
compared with two when she went into treatment two years ago.
o A 10-year-old boy was chemically restrained 69 times over 80 days. Doctors
prescribed up to six drugs at a time – no one has ever determined which pills worked
for what symptoms or disorders.
o A 12-year-old girl was injected six times over nine months with high doses of
Thorazine, a powerful sedative that can knock kids out and cause painful muscle
spasms and twitches. She also was physically restrained 31 times by as many as
three men, despite a history of being physically and sexually abused.
 A Texas mother reported that starting at age five her son was variously diagnosed as
suffering from ADHD, bipolar disorder, schizophrenia, or sociopathy – diagnosis depended
on the doctor in charge. The boy was put on powerful psychotropic drugs which, she says,
made him hear voices, and resulted in troubles in school, with the law, and repeated
hospitalizations. When he was put on Zyprexa ‘he put on a tremendous amount of weight,
85 pounds to be exact.’ Since being weaned off the drugs, she reported that her son is
much improved.
 A five month investigation by the Tampa Florida Tribune shows how misprescribing
psychiatric drugs can precipitate life-threatening tragedies. For example, 9- year old Lee
who had been diagnosed with bipolar disorder descended into suicidal violence after she
had been haphazardly prescribed a combination of four powerful drugs – two
antidepressants and two antipsychotics. She developed an obsessive fear of germs, for
which the psychiatrist suggested an antidepressant (Paxil). Within weeks, Lee’s mother
noticed a surge in her aggression. She told the doctor, but he said it was an acceptable side
effect and she would be fine. Well, she was not fine: ‘Emergency workers cornered her
behind the office and tied her to a gurney. She screamed and thrashed the whole way to the
Community Hospital emergency room and screamed throughout the afternoon as nurses
tried to sedate her. They finally succeeded by giving her a shot of Thorazine.’
How can such abuse possibly be therapeutic for any 9 year old child?
 A series in the California Sacramento Bee described what happened to 12-year old Zach
during a period of 18 months. Zach was diagnosed with anxiety, depression and ADHD: he
was first prescribed Ritalin, then Prozac, then paroxetine (Paxil) which made him manic.
Then, he was back to Prozac plus the antipsychotic, Zyprexa, which made him gain 40 lbs
within 5 months. He was then prescribed quitiapine (Seroquel), the dose was raised but his
psychiatrist said he is ‘disappointed’ because Zach is still irritable, so he’s considering the
newest antipsychotic, ziprasidone (Geodon). The drug label carries bold warnings about
rapid heart beats and cardiac arrest: ‘sudden unexplained deaths have been reported in
patients taking ziprasidone at recommended doses.’
 A Dallas Fort Worth investigation found that in one month (November 2003), some doctors
were writing as many as 486 prescriptions for psychotropic drugs for children in foster care.
One psychiatrist explained to the reporter in an e-mail: ‘I am often pressured by providers to
aggressively medicate children in an attempt to control their behavior.’

88
Dr. Ellen Bassuk, professor at Harvard University who examined children’s medical records
said: ‘It’s scandalous that medications are used to subdue kids for the convenience of
overworked and underpaid staff or as punishment for bad behavior.’ The Texas comptroller
agrees: she believes the drugs are prescribed for children in order to make them ‘more
docile.’ And, she deplores that ‘doctors and drug companies are pushing them to make a
buck.’ And a neuropsychologist from Florida who examined the Texas records said that by
numbing children with psychotropic drugs:
‘We’re taking away their future.’ By blunting their emotion, we take away children’s ability to
relate to people, to trust, love, to care for others or to put themselves in another person’s
shoes to see how it feels.
To make matters even worse, the US government has begun to implement a mental health
screening policy recommended by the President’s New Freedom Commission on Mental
Health (NFC). According to the BMJ, President Bush instructed more than 25 federal
agencies to develop an implementation plan to screen America’s 52 million school children
and 6 million school personnel – for hidden mental illness. The rationale behind this mind-
boggling initiative is, in part, evidence of America’s abiding faith in science and technology
to provide solutions for complex human and societal problems. In no other democratic
country has the government adopted a policy to screen the entire population – children first
– for presumed, undetected, mental illness.
The methodology used to screen for mental and behavioral problems remains rooted in the
flawed methods used by the discredited eugenics movement which sought to screen for
mental ‘defectives.’ Eugenics and psychiatry suffer from a common philosophical fallacy that
undermines the validity of their theories and their prescriptions. Both are rooted in ‘faith-
based’ ideological assumptions that mental and behavior problems are biologically
determined, and can, therefore, be resolved through biological interventions.
However, the diagnosis of mental illness lacks scientific validity – it relies entirely on the
subjective assessment by mental health professionals and normative check lists. This flaw
was acknowledged by the US Surgeon General report: ‘mental health is not easy to
define·.what it means to be mentally healthy is subject to many different interpretations that
are rooted in value judgments that may vary across cultures.’ Another shortcoming: mental
health professionals have an interest in expanding the patient roster to guarantee their
employment. Therefore, screening will most likely inflate the number of American children
(and adults) labeled with a mental illness.
The New Freedom Commission Report praised two mental health programs: TeenScreen
and TMAP. TeenScreen is a questionnaire devised by psychiatrists at Columbia University
‘to ensure that every teen in the US has access to free mental health check-up.’
TeenScreen is already operating in more than 100 schools in 34 states and as the executive
director told a congressional committee: ‘In 2003, we were able to screen approximately
14,200 teens…; among those students, we were able to identify approximately 3,500 youth
with mental health problems and link them with treatment. This year, we believe we will be
able to identify close to 10,000 teens in need, a 300 percent increase over last year.’
Unfortunately this is not science fiction: this is a policy driven by commercial interests.
TMAP (Texas Medication Algorithm Project) is an industry sponsored set of flow charts
designed to guide mental health providers’ selection of psychotropic drugs– ‘Psychiatry for
Dummies.’ TMAP was launched in 1995, when Bush was governor of Texas. TMAP
recommends the most expensive drugs as first line treatment – these are the SSRI and
SSNRI antidepressants and antipsychotics. At least twelve states have adopted the TMAP
model: Texas and Ohio were among the first. State mental health officials across the US
89
see nothing wrong with prescribing drugs irresponsibly, thereby violating medicine’s first
principle–‘do no harm’ – to increase profits. Of note, Ohio’s executive director of the
Department of Mental Health, Michael Hogan, who has played a major role in promoting the
use of psychotropic drugs, was chairman of the New Freedom Commission. He said that
although: ‘It’s true children are more likely to get medication than counseling or other
behavioral therapy, at the end of the day, meds are quite safe and effective.’ Hogan says
the biggest danger facing children is depression.
Screening for mental illness serves no medical purpose – it is but the first step toward
expanded use of drugs. Given its large margin of error, screening for mental illness is of
dubious value for individuals, but that same margin of error is of great value for the drug
industry. An evaluation by the authoritative US Preventive Services Task Force concluded
that the mental health screening instruments have not been validated, and there is no
evidence to demonstrate that screening reduces suicide. The escalating expenditure for
psychotropic drugs since TMAP leaves little doubt as to its value for the drug industry. The
impact of TMAP is already evident in the skyrocketing increased prescriptions for
antipsychotics which are being prescribed widely for unapproved, off-label uses, mostly to
control conduct and behavior, including ADHD. US spending for drugs to treat ADHD rose
astronomically among 5 to 9 year olds spending rose 174%, and for preschool children
spending rose by 369%. These extraordinary spending increases reflect the increased use
of the most expensive drugs to treat newly minted behavioral problems in children who are
increasingly diagnosed with ADHD and bipolar disorder (a.k.a. manic-depression).
Indeed, the Wall Street Journal reported: ‘The number of children diagnosed as bipolar rose
26% from 2002 to 2004, to 19,776 cases,’ noting that until recently, children under 18 were
very rarely diagnosed with bipolar disorder. Yet, today, children as young as four are being
diagnosed with bipolar. The Journal also notes that: ‘increased use of antipsychotic
medicines, such as Seroquel and Risperdal, was a big driver of pediatric drug costs last
year.’ Indeed, overall spending on psychotropic drugs for children increased by 77%, and
increased by 142% for severe conduct disorder.
Screening will do much to expand the number of patients relegated to mental health
providers and to increase profit margins for drug manufacturers. In the last two years,
107,000 children in Texas have been prescribed psychotropic drugs at a cost of $167
million. The experience of 15-year old Aliah Gleason, encapsulates the abuse a child is
likely to be subjected to after being screened and (often as not) misdiagnosed as having a
mental disorder.
MEDICATING ALIAH (excerpt)
In the early part of seventh grade, Aliah was a B and C student who got in trouble ‘for
running my mouth.’ School officials considered Aliah disruptive, deemed her to have an
‘oppositional disorder,’ and placed her in a special education track. Her parents viewed her
as a spirited child who was bright but had a tendency to argue and clown. Then one day,
psychologists from the University of Texas (UT) visited the school to conduct a mental
health screening for sixth- and seventh-grade girls, and Aliah’s life took a dramatic turn.
A few weeks later, the Gleasons got a ‘Dear parents’ form letter from the head of the
screening program. ‘You will be glad to know your daughter did not report experiencing a
significant level of distress,’ it said. Not long after, they got a very different phone call from a
UT psychologist, who told them Aliah had scored high on a suicide rating and needed
further evaluation. The Gleasons reluctantly agreed to have Aliah see a UT consulting
psychiatrist. She concluded that Aliah was suicidal but did not hospitalize her, referring her
instead to an emergency clinic for further evaluation. Six weeks later, in January 2004, a
90
child-protection worker went to Aliah’s school, interviewed her, then summoned her father to
the school and told him to take Aliah to Austin State Hospital, a state mental facility. He
refused, and after a heated conversation, Aliah was placed in emergency custody and a
police officer drove her to the hospital.
The Gleasons would not be allowed to see or even speak to their daughter for the next five
months. Aliah would spend a total of nine months in a state psychiatric hospital and
residential treatment facilities. While in the hospital, she was placed in restraints more than
26 times and medicated-against her will and without her parents’ consent-with at least 12
different psychiatric drugs, many of them simultaneously.
On her second day at the state hospital, Aliah says she was told to take a pill to ‘help my
mood swings.’ She refused and hid under her bed. She says staff members pulled her out
by her legs, then told her if she took her medication, she’d be able to go home sooner. She
took it. On another occasion, she ‘cheeked’ a pill and later tossed it into the garbage. She
says that after staff members found it, five of them came to her room, one holding a needle.
‘I started struggling, and they held my head down and shot me in the butt,’ she says. ‘Then
they left and I lay in my bed crying.’
In addition to the antidepressants Zoloft, Celexa, Lexapro, and Desyrel, as well as Ativan,
an antianxiety drug, Aliah was given two newer drugs known as ‘atypical antipsychotics’–
Geodon and Abilify–plus an older antipsychotic, Haldol. She was also given the
anticonvulsants Trileptal and Depakote-though she was not suffering from a seizure
disorder-and Cogentin, an anti-Parkinson’s drug also used to control the side effects of
antipsychotic drugs. At the time of her transfer to a residential facility, she was on five
different medications, and once there, she was put on still another atypical-Risperdal.
At times Aliah “was on five different medications, putting her on the extreme end of a
growing practice known as polypharmacy that worries many doctors.” Dr. Joseph Woolston,
a Yale University professor and chief of child psychiatry at Yale said: “If you or I were on that
regimen we would have a lot of trouble attending to work or school. We don’t have any idea
what that combination of medications does to a developing child. It may have a number of
long-term side effects.” He also suspects “that the drugs may have been used as much to
control the angry reactions of a girl who was hospitalized against her will as to treat any
mental and emotional problems.”
Aliah was a victim of mental health screening. Screening for mental illness serves no
medical or societal purpose – screening will, however, do much to increase the profit
margins for drug manufacturers and the mental health provider industry. A label of mental
illness all too often signifies loss of autonomous decision-making authority for parents who
may be reluctant to give permission for their children to be treated with psychotropic drugs.
A dark side of screening is the stigma that accompanies those labeled as having a mental
disorder. Being so classified all too often signifies loss of autonomy and decision-making
authority. Parents who are reluctant to give permission for their children to be treated with
psychotropic drugs – such as Aliah Gleason’s parents – face state agents who impose their
authority over parental objections.
Questions:
Who will bear responsibility for the harms that may follow from mental health
screening when children are wrongly labeled as having a mental illness, and on that
basis will be prescribed mind-altering drugs that cause them harm?
Who will compensate children who will be deprived of a normal childhood? 89

91
Juvenile Detention Centers
The Virginia Department of Juvenile Justice Data Resource Guide for 2015 indicates the following:
84.4% of juvenile intakes appeared to have significant symptoms of ADHD, Conduct Disorder, Oppositional
Defiant Disorder, Substance Abuse Disorder, or Substance Dependence Disorder; 64.3% appeared to have
significant symptoms of other mental health disorders; 92.7% had aggression management treatment needs;
and 83.3% had substance abuse treatment needs. The majority of admissions were prescribed
psychotropic medications. The Department of Juvenile Justice expenditures in Fiscal Year 2015 totaled
$198,642,588.
The Virginia Juvenile Community Crime Control Act (VJCCCA) was enacted by the General Assembly
“to establish a community-based system of progressive intensive sanctions and services that correspond to the
severity of offense and treatment needs” of juvenile offenders. Formula-based funding is available to each
local governing body under the Act. In order to participate in the VJCCCA, each locality must develop a plan
for using the funding and is given substantial autonomy and flexibility to address local juvenile offense patterns.
The Virginia Department of Education funds educational instruction within the juvenile justice system.
Furthermore, the ADHD, Conduct Disorder and Oppositional Defiant Disorder labels trigger additional funding
from the Department of Education to the Juvenile Detention Centers (JDC). Children as young as eight years
old are in Juvenile Detention Centers. Larceny is the most common offense followed by assault. Larceny is
theft greater than $5 and can be a crime of survival seeking food or clothing. 40% of the juveniles committed
in the juvenile justice system come from the Tidewater area, where the highest percentage of children labeled
and placed on antipsychotics for ADHD resides (greater than 1 out of 3 boys).
Solitary confinements in Juvenile Detention Centers can last for 72 hours with only one hour out per
day. For confinements exceeding 72 hours, a report to an official above the level of superintendent must be
filed. To confine a child for 72 hours is inhumane regardless of any associated requirements. Even so, these
requirements are frequently violated. For example, there were either no confinement forms or incomplete
forms in 8 of 10 confinement incidents on 5/11/16 and 8/9/16 at one particular juvenile correctional center.
Further, there was no documentation of a report to a position above the level of superintendent when a
resident was confined for more than 72 hours in one incident. A 2/11/16 audit found 11 out of 16 confinements
were not documented at all. Isolation has proven to cause psychosis and an increased risk of suicide. Periods
of isolation also provide staff opportunities to sexually assault juveniles. Furthermore, it has been established
that isolation has pushed juveniles to commit murderous attacks on large groups of people and terrorism
attacks. Isolation and antipsychotics form a recipe for disaster—juveniles killing themselves or others!90
Recidivism rates for juveniles assigned aggression management or substance abuse treatment needs
are greater than recidivism rates for those assigned sex offender treatment needs as seen on page 69 of the
2015 VDJJ Data Resource Guide. (1/3 of juveniles are estimated to be sexually abused in the system
nationwide).

America's Largest Mental Hospital Is a Jail, written by Matt Ford.

At Cook County Jail, an estimated one in three inmates has some form of mental
illness. At least 400,000 inmates currently behind bars in the United States suffer from some
type of mental illness—a population larger than the cities of Cleveland, New Orleans, or St.
Louis—according to the National Alliance on Mental Illness. NAMI estimates that between
25 and 40 percent of all mentally ill Americans will be jailed or incarcerated at some point in
their lives.
In Chicago, Tom Dart is a 52-year-old sheriff of Cook County. Dart supervises about
6,900 sworn officers in the Cook County Sheriff’s Department. His jurisdiction encompasses
the roughly 5.3 million people living in and around Chicago. As sheriff, Dart is also
responsible for Cook County Jail, the largest single-site jail in the United States.
92
 ‘This is typically what I see everyday,’ said Elli Petacque-Montgomery, a
psychologist and the deputy director of mental health policy for the sheriff’s department. She
showed me a medical intake form filled with blue pen scribbles. Small boxes listed possible
illnesses: bipolar disorder, ADHD, schizophrenia, and so on. The forms are designed to
help jail officials identify which inmates have mental illnesses as early as possible. Details
from four new inmates could fit on a single sheet. She showed me a completed one. “Of
those four,” she said, pointing to the descriptors, “I have three mentally ill people.”
The overwhelming majority had been arrested for “crimes of survival” such as retail
theft (to find food or supplies) or breaking and entering (to find a place to sleep). A
pervasive misconception is that violence and mental illness are closely linked. Dart and
other jail officials repeatedly emphasized to me that the men I met were nonviolent, as were
the vast majority of those they encountered overall. One of them, Pierre, had been charged
with retail theft. Though he had no history of violence, the judge remanded him to the
county’s custody on a $100,000 bond. “I can’t make a $100,000 bond,” Pierre told us
pleadingly. “I couldn’t either,” Dart replied.91

Three of the largest mental health providers in the nation are the following jails: Cook

County in Illinois, Los Angeles County in California and Rikers Island in New York.92

Incompetence

The consequences of antipsychotics are revealed in the February 2011 issue of the Archives of

General Psychiatry, Antipsychotics and the Shrinking Brain written by Donald C. Goff, MD.

Ho and colleagues published an article that examined the relationship between long-term
antipsychotic treatment and brain volume in first-episode schizophrenia patients. That paper
triggered considerable media attention. Because it was widely interpreted as showing that
antipsychotics damage the brain, it may have caused many people—both patients and family
members—to reconsider whether to take their prescribed medication.
If we were to draw conclusions from this study alone, it would appear that gray matter
loss can’t be altered by reducing antipsychotic exposure or by switching antipsychotic
class—it just happens. The one possible benefit of a low-dose antipsychotic, the preservation
of white matter, is of unclear clinical significance, as is the possible increase in parietal white
matter with second-generation agents. However, the story gets more complicated as we look
earlier in the course of treatment.
Back in 2007, Ho and colleagues published a report based on roughly half their current
sample. In this analysis, they discovered that antipsychotic dose was related to the rate
of loss of frontal gray matter, but only in medication-naive patients. Frontal gray matter
loss, in turn, corresponded with cognitive decline.
A study in monkeys conducted by David Lewis’ group prompted concern about antipsychotic
neurotoxicity several years ago. Monkeys treated with haloperidol and olanzapine for 17 to 27
months lost roughly 10% of their total brain volume, both gray and white matter, compared with
sham-treated controls, with greatest volume loss in frontal and parietal cortex. Further
examination revealed a reduction in the number of glial cells. Other studies suggest that
antipsychotic effects on brain volume may occur rapidly. For example, Vernon and

93
 colleagues found a significant loss of frontal cortical volume after only 8 weeks in rats
given haloperidol or olanzapine.
Evidence of the rapidity at which antipsychotics can affect brain volume in humans was
recently provided by Tost and associates. These investigators found a significant,
reversible decrease in striatal volume in healthy subjects within 2 hours after they were
treated intravenously with haloperidol. Loss of striatal volume powerfully predicted
neurological adverse effects.
Taken together, these studies suggest that antipsychotics may contribute to early gray matter
loss and, later in the course of treatment, to white matter loss. These effects may be dose-
related and probably are not prevented by the use of second-generation agents. This argues
for minimizing antipsychotic exposure both acutely and long-term.93

Jamycheal Mitchell was described as a hyperactive youth who was labeled with ADHD at age

ten when he could not sit still at school. After taking ADHD drugs, he began hearing voices and was

diagnosed with bipolar disorder and schizophrenia, according to his family. His family stated

everything went downhill for him after the ADHD diagnosis. He would lapse into manic states and

would not sleep for days at a time. He would hear voices and have delusions (all side effects of ADHD

drugs).

Jamycheal happened to live in southeast Virginia, where one out of three boys is diagnosed

with ADHD. As discussed above, many of these children are then likely to be misdiagnosed with

bipolar and schizophrenia disorder due to the side effects of ADHD drugs. A series of tragic events

led Jamycheal down a one-way path of no return. For the unforgivable inability to sit still in school and

stay focused, an ADHD diagnosis may have condemned him to mental incompetence, psychosis and

death. Jamycheal’s childhood began as an altar boy at the local Catholic Church where he attended

three times a week. His life ended after months of detention all alone in a jail cell where he was

arrested for a minor theft of food. He was suffering psychosis from the damage of antipsychotic

drugs.

Dr. Alana Hollings concluded he was incompetent to stand trial. She suggested changing his

psychotropic medications to alleviate the delusions. He was placed in solitary confinement, known as

“the hole” awaiting transfer to a mental hospital.94

94
 Alanna Durkin Richer, Associated Press and reporter Ben Finley from Portsmouth, Virginia

covered this horrific story of Jamycheal Mitchell’s death while in jail.

1 year after jail death, questions remain

Jamycheal Mitchell loved making people laugh and was known for his smile. Beneath his
friendly persona, however, was a young man with [ADHD], bipolar disorder and schizophrenia
who dropped out of high school and couldn’t hold a steady job. Despite those troubles, the 24-
year-old appeared to have a positive outlook. ‘Every time we had family events, Jamycheal
was the center of attention,’ his cousin Jenobia Meads said. Then, last year, a small
transgression — the theft of $5 in junk food from a convenience store — ended with Mitchell’s
death in jail.
He was accused in April 2015 of stealing a Mountain Dew, a Snickers bar and a Zebra Cake
from a 7-Eleven in Portsmouth — a small city along Virginia’s Elizabeth River where most
residents, like Mitchell, are black. Critics say his arrest effectively became a death sentence,
and they blame failures in Virginia’s mental health and criminal justice systems. Mitchell was
ordered to a state mental hospital after his arrest. Instead, he spent months behind bars before
being found dead in his jail cell last August. He died of heart failure accompanied by severe
weight loss, a medical examiner said.
A year later, questions remain about how Mitchell deteriorated in plain sight of jail and health
officials, frustrating advocates who say they fear that thousands of mentally ill people behind
bars in Virginia remain at risk. ‘We haven’t really been given many great answers as far as any
reassurances that people with mental illnesses aren’t going to die anymore,’ said Mira Signer,
executive director of National Alliance on Mental Illness in Virginia.
Mitchell’s family filed a lawsuit accusing jail officials of physically abusing Mitchell and
withholding food. Mitchell was treated like a ‘circus animal,’ a fellow inmate said in the lawsuit,
which claims jail officials kicked, punched, and mocked Mitchell, and sprayed him with mace.
Hampton Roads Regional Jail has pushed back fiercely against the claims, denying that
employees mistreated Mitchell and arguing that officers routinely checked on him and provided
three meals daily. Jail officials initially said video footage captured outside Mitchell’s cell had
been recorded over, but they changed course in court documents last month. Officials now say
video exists but have declined to release it.
The jail has blamed contractor NaphCare, which provided health care there at the time. Jail
officials say the company never warned of Mitchell’s deteriorating physical health. When asked
to comment, NaphCare referred to an earlier statement calling allegations of ‘indifference and
neglect’ against its staff ‘false and unfounded.’ In June, Virginia State Police announced a
criminal investigation into the matter. Advocacy groups also want the US Department of Justice
to launch a civil rights investigation; the local FBI office says it’s prepared to look into the case
if state police find evidence to do so.
‘How did somebody not say, ‘We have got to get help for this young man?’ said G. Douglas
Bevelacqua, a former official in the Virginia inspector general’s office, which investigated
Mitchell’s case. A whistleblower complaint accused the agency of inadequately completing the
work, but the governor’s office dismissed the allegation. ‘Until we understand how this
happened to Mr. Mitchell, it has a greater likelihood of being repeated someplace.’
Mitchell spent several years in a behavioral health group home as a teen and was hospitalized
at times at state institutions, court documents state. On April 22, 2015, he was charged with
95
 larceny and trespassing after the 7-Eleven clerk caught him stealing. Police had previously
banned him from the store, which Mitchell incorrectly believed his father owned, his family’s
lawsuit says. A judge set Mitchell’s bond at $3,000 but then revoked bail altogether, according
to the lawsuit. Psychological records described Mitchell as manic and psychotic, and not
mentally competent to assist in his defense. The judge ordered Mitchell to a state mental
hospital for treatment so the judicial process could move forward. But the hospital didn’t
receive the order until two months later, a state investigation found. The paperwork ended up in
a hospital employee’s desk drawer, and Mitchell was never put on a waiting list for a bed, the
investigative report said.
The employee who mishandled the order, according to the report, was overwhelmed, due in
part to an increase in mental-hospital admissions. She was ‘astonished and distraught,’ the
report says, and has since retired. Advocates and policymakers hope Mitchell’s death will be a
catalyst for reform, such as increased funding for community-based services and jail-diversion
programs. In 2015, more than 7,000 people in Virginia jails had some form of mental illness,
according to state figures. But the problems laid bare by Mitchell’s death have long been
known to policymakers, and change has been incremental, critics say.
The state lags behind much of the country in general-fund spending on behavioral health care
and continues to invest heavily in expensive state mental hospitals, while other states have
moved toward community-based care, said Michael Schaefer, of the Virginia Department of
Behavioral Health. Some remain skeptical that real change is on the horizon.
‘The traditional pattern is for people to be outraged at incomprehensible treatment for a period
of time and then people return to their lives,’ Bevelacqua said. ‘The system has just such
tremendous inertia that it just rolls over everyone and continues to rumble along, delivering
services that are frequently not in the interest of the people being served but the bureaucracies
that are serving.’95
Current, former OSIG workers cite possible conflicts of interest by Sarah Leiner and K. Burnell

Evans of the Richmond Times-Dispatch summarized. 10/27/2016

Three whistleblowers in the Office of the State Inspector General described on

Wednesday potential conflicts of interest between their bosses and the state's mental health
system, which the office is in charge of investigating. Cathy Hill, Ann White and William
Thomas, the whistleblowers, also said key information about overworked employees at the
mental hospital where Jamycheal Mitchell was supposed to be
transferred was intentionally removed from reports. The three spoke Wednesday by phone
with a work group of the Joint Subcommittee Studying Mental Health Services in the 21st
Century. Hill is a longtime member of the Virginia inspector general's staff and plans to retire
Jan. 1. White and Thomas were independent contractors who retired recently after several
years of service at the office.
The three said that Priscilla Smith, director of behavioral health at the Office of the State
Inspector General, intentionally removed information from a report and an administrative letter
that would have brought to light a "crisis" at Eastern State Hospital before Mitchell died. They
believe Smith removed the information because she worked at Eastern State immediately
before she joined the Office of the State Inspector General and still has friends there. Smith
was not available for comment..
White, Hill and Thomas also criticized the inspector general's office for its philosophical
shift toward conducting reviews by phone and mail rather than in person.
96
Conclusion
The ADHD label is a danger to children. The reality is that not all children are capable of obtaining high

levels of academic excellence. Contrary to popular belief, tutoring and behavioral resources do not naturally

follow on the heels of this diagnosis. As a consequence, the default response is to look to medications for

help. Pushing ADHD drugs on children, however, is not the answer. Children suffer greatly by being placed

on such drugs.

The long term effects of ADHD drugs are much worse than originally imagined. Children placed on

ADHD drugs are far more likely to later be misdiagnosed with bipolar disorder and schizophrenia due to some

side effects of the drugs. Other side effects include frontal lobe shrinkage, depression, anxiety, insomnia,

stunted growth, auditory hallucinations, cancer, cardiac issues, tics, violence and even death. The list of side

effects even includes Tardive Dyskinesia, a potentially irreversible neurological disorder resulting in involuntary

and uncontrollable movements, slurred speech, tremors, anxiety, inability to sit still, inner restlessness, distress

and paranoia. Furthermore, ADHD drugs are gateway drugs to other serious drugs such as heroin. They have

also proven to cause addiction. Finally, after children have taken ADHD drugs they are often then placed on

several other medications to deal with the side effects. It is no wonder that sixty percent of Americans are on 5

prescription medications or more, most including antipsychotics.

As the adult population increasingly relies upon prescription medications, it stands to reason that

children will continue to be pushed in the same direction. After all, if it is good enough for the adults, it is good

enough for the children. Children's brains, however, are not fully developed and the chemical insult introduced

by medications is more damaging to them. ADHD has become a catch-all diagnosis for any problems that

children may have. Labeling them with ADHD is an excuse for failing to provide children with what they really

need. Since the beginning of time many boys and some girls have had short attention spans, becoming easily

distracted and bored. It is adults' responsibility to guide children through these periods, not chemically

lobotomize them into submission.

None of the everyday common childhood behaviors children display constitute ADHD or any other

learning disability. While laws have been enacted to stop the push to medicate children, it is still common
97
practice in schools to demand that they undergo testing and take the drugs. This is even true after the child's

doctor has ruled out any form of ADHD. It is important to note that affirmatively ruling in ADHD requires a skill

set pediatricians do not possess; they are neither trained nor qualified to do so.

Medicaid officials in Arkansas, Vermont, Illinois, Washington, Georgia and Missouri decided many

years ago that health care costs in general were rising at an unsustainable rate. They decided to take a look at

the “episodes of care” that affected the largest number of people and showed the most room for cost reduction.

One of the first conditions they tackled was ADHD. Dr. Susanna Visser, the CDC’s top ADHD researcher,

states the gold standard would be to require doctors to first attempt management of ADHD in children by using

proven psychotherapy treatments involving parents and teachers.96

When parents question teachers or administrators or complain about academic outcomes, the

response far too often involves deflection with the suggestion that the child has attention problems. Often it is

the environment that causes problems, with teachers expected to handle large classrooms of children who are

given inadequate breaks. Other times the teachers are illequipped, either by their training or their

constitutions, to handle children who exhibit the traits of children. The child then becomes the focus. Indeed,

the very definition of ADHD describes the normal child. As if the diagnosis is not bad enough, interest groups

that have sprung up for the purported purposes of helping ADHD sufferers appear to be nothing more than

front groups for the pharmaceutical companies. Many people now question the apparent conflict of interest

inherent in CHADD's relationships with those pharmaceutical companies. Some go so far as to accuse

CHADD of lobbying for a change to the DSM definition of ADHD so that it essentially describes the average

child, thus opening up a whole new market to the pharmaceutical companies.

Is the nation prepared to sentence these children to a life where they are wrongly labeled with mental

illness and thus deprived of the opportunity to enter many professions for which they are best suited, but no

longer qualify for admission? These children often gravitate toward professions like the military due to their

physical stamina and athletic ability. As more and more children, mainly boys, are denied access to those

careers in which they would flourish, the policies and practices driving this undesirable change must be

98
reevaluated. Medicating away children's natural energy and placing undue restrictions on their physical needs

is inhumane. For those children who struggle more than most, society must provide other avenues of help for

them such as physical outlets or tutoring. Reducing unhealthy academic pressure and adhering to more

humane schedules would benefit all children.

Children are being robbed of their childhood by the intolerant mentality that requires them to sit all day

and spend a majority of their remaining time completing homework at night, on weekends and during their

academic "breaks". Forcing them on to drugs so they can make the grade is not only morally wrong, it is short-

sighted. Society loses their talents when they are young and bears the responsibility of caring for them when

the long-term effects of the drugs become clear. A return to sanity with regard to children's school work and

schedules would have the added benefit of strengthening families. After all, today's scholastic pressures leave

little opportunity for family time. This has damaged the stability of families and the fabric of this country.

Furthermore, with regard to where some of these children end up and what should be done to prevent

it, journalist Robert Whitaker spoke recently at the Society for Ethical Psychology and Psychiatry’s conference

in Los Angeles and had this to say:

The United States imprisons its citizens at a higher rate than any other country in the
world (according to a 2013 study). We make up five percent of the world’s population and yet
our citizens make up 25% of the total world population of prisoners. So the problem we are
talking about here is not just the ‘imprisoning’ of the ‘mentally ill,’ but a problem of a society that
imprisons people at a grotesque rate. [Many for nuisance crimes].

In addition, any inquiry into this problem should look at these two questions. Many of
our prisons [and Juvenile Detention Centers] today are run in a very harsh manner. Inmates
[and juveniles] are isolated for long periods of time. Such treatment could turn the most sane
person mad. In addition, those who run prisons know that if inmates are diagnosed as severely
mentally ill, that makes it possible to put them on antipsychotics, which will make the inmates
easier to manage. The advocates for forced treatment in outpatient settings argue that forced
drug treatment would prevent the mentally ill from ending up in prison, and thus their legislation,
which in fact curbs the civil rights of citizens in profound ways, comes cloaked in the rhetorical
garb of ‘humanism’. Indeed, an argument can be made that the growing imprisonment of the
‘mentally ill’ is yet another example of how our drug-based paradigm of care has failed us. The
use of psychiatric medications in our society has exploded over the past 25 years; there is great
societal pressure put on people diagnosed with schizophrenia or bipolar disorder to take their
medications; and yet we now have this problem of hundreds of thousands of ‘mentally ill’ in
prisons and jails.

99
 Any effort to remake mental health care in this country needs to include a focus on what
can be done to help the multitudes of poor people and disenfranchised people who show up in
distressed emotional states in emergency rooms and homeless shelters, and the eventual
routing of many such people to jails and prisons. But, in my opinion, if we want to find a
solution, we should focus on providing housing, social support and jobs that help people lead
meaningful lives. In short, forced drug treatment isn’t an answer to the ‘prison’ problem;
creating a more just and supportive society is. I also think we could borrow a page from the
Quakers in the early 1800s. They built moral therapy asylums for the ‘mad’, with the idea that
such refuges — where people could be near nature and were to be treated in a kind, humanistic
way — could, with time, help many people get well. Such places would surely be a good
alternative to jails and prisons, where inmates today may be isolated for 23 hours each day. [72
hours or longer in Juvenile Detention Centers without documentation].

We have the subtle coercion that occurs in schools, when teachers and
administrators urge certain parents to get their children treated for ADHD. We have the
dramatic expansion of the prescribing of antipsychotics in situations that basically lack
consent: to foster children, to prison inmates; to ‘mental’ patients in hospitals; and to
older adults in nursing homes [and VA facilities]. (Emphasis added). Finally, we have the
passage of state outpatient commitment laws that, in essence, force people to take
antipsychotic medications.

Indeed, ever since the popularization of the ADHD diagnosis and the arrival of the
atypical antipsychotics, psychiatric coercion has been on the march in our society, so much so
that it hangs like a cloud over our society today. Such coercion is a marker for a fearful, less-
free society, and thus if we want to list important battles to be fought today, I would argue that
the fight against this expansion of ‘psychiatric coercion’ should be at the top of the list.

Robert Whitaker is an American journalist and author, writing primarily about medicine, science,
and history. Whitaker was a medical writer at the Albany Times Union newspaper in Albany,
New York from 1989 to 1994. In 1992, he was a Knight Science Journalism fellow at MIT.
Following that, he became director of publications at Harvard Medical School. In 1994, he co-
founded a publishing company, CenterWatch, that covered the pharmaceutical clinical trials
industry. CenterWatch was acquired by Medical Economics, a division of The Thomson
Corporation, in 1998.

100
Answers

What can be done to combat this problem? The answers are several.

First, raise awareness. Parents must be told of the long term side effects of ADHD drugs. The

government must educate and support parents so they can make the informed decision to remove their

children from these drugs. Parents should also be informed of their rights to resist institutional pressure to

medicate their children. Stop all advertising and articles financed by pharmaceutical companies.

Second, stop the use of the previously-banned black label drugs because of their high risk of side

effects. Just as in many other states like Arkansas, Illinois, Missouri and Vermont the goal is to eliminate

unnecessary medications for children who were improperly diagnosed for ADHD. They should no longer be

available for use in children. What right does the system have to expect parents to risk damage to their

children's brains? These children are left to deal with the ramifications of brain damage long after they have

been chemically forced to sit still and pay attention.

Third, change expectations. Children cannot maintain the level of attentiveness and focus that is

demanded of them in today’s schools. Testing and homework have become overwhelming to the child and

family. Laws must be enacted requiring elementary schools to give all children at least thirty minutes of

unstructured free time and thirty minutes for lunch. Middle schools and high schools should be allotted at least

45 minutes for lunch breaks. According to the Virginia Department of Education, the provision of special

education services increases in middle school and dramatically in high school. This coincides with

the elimination of recess or break time and increase in homework for these age groups. This is

particularly difficult for boys, which is not surprising because they need more physical outlets. Limits must be

placed on the amount of homework. Simply following the current guidelines of ten minutes per grade would be

a great place to start. This limit is meant to include all class assignments, projects and study time required for

tests and quizzes. Far too often it is misinterpreted to mean ten minutes of homework per grade plus project

and study time. Give back study halls so children can get a head start on their homework or receive necessary

101
tutoring. The practice of removing children from their other classes to receive tutoring causes them to fall

behind in those classes, thus compounding the problem.

Fourth, reclassify ADHD and all other learning disabilities so they are no longer a mental illness, a label

that can wreck a child’s life. A child who behaves like a child and struggles with a workload that would

overwhelm an adult is not mentally ill--he/she is a normal child.

Fifth, impose penalties upon doctors and agencies that use their position to prescribe or recommend

black label psychostimulant drugs for anyone under the age of 22 for mere academic success or for use as a

chemical restraint. These are not over-the-counter drugs; they can only find their way into children’s systems

with the complicity of licensed physicians. Furthermore, measures such as the Massachusetts’ Physician Gift

Ban Law should be enforced. This law prohibits the industry from treating doctors to trips and other types of

entertainment. Such measures, however, should go even further to ban all gifts or meals.

Sixth, make schools (including private schools that receive public funding) aware that federal and local

funding will be denied for violating the remedial laws discussed here. If schools are allowed to continue

skirting the rules, they will find ways to abuse the system and gain further funding.

Seventh, track statistics regarding the number of children in each Virginia school (public and private)

who are labeled with ADHD or other categories such as "specific learning disabilities, other health impairment,

multiple disabilities and emotional disturbances." This should include such psychiatric diagnoses as

mathematics disorder, disorder of written expression and conduct disorder, etc. The funding that each school

receives as a result of such labeling should also be tracked. Recess/breaks, lunch times and homework

guidelines should also be monitored.

For those afflicted with the most severe side effects of the psychotropic drugs, society owes it to them to

provide a safety net. We should provide housing like the Faison Center located in Richmond, Virginia. The

mission there is to give autistic individuals the best chance to improve their life’s journey. It is a hand up, not a

hand out, connecting individuals with support groups to gain life skills, employment and the possibility of

transitioning out of supervised housing.

102
Notes
1
http://www.cdc.gov/ncbddd/adhd/data.html
2
http://www.nytimes.com/2013/12/15/health/the-selling-of-attention-deficit-disorder.html?pagewanted=all&_r=0
3
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918118/
4
https://www.thebalance.com/new-asthma-and-add-adhd-policy-3353970
5
https://toxnet.nlm.nih.gov/cgi-bin/sis/search2/r?dbs+hsdb:@term+@rn+@rel+113-45-1
6
https://draxe.com/brainwashed-by-psychotropic-drugs/
7
www.save.org and http://www.cdc.gov/mmwr/pdf/wk/mm6408.pdf.
8
www.teenhelp.com
9
http://www.cdc.gov/vitalsigns/adhd/index.html
10
http://.foxnews.com/health/2012/03/06/adhd-over-diagnosed-in-youngest-kids-in-class.html
11
http:joanlipuscek.com/child-therapy-news/youngest-children-in-class-at-greater-risk-for-adhd
12
www.today.com/helath/thats-nuts-100-000toddlers-get-drugs-adhd-2D79684452
13
University of Michagan: T.E. Robinson and B. Kolb, “Structural Plasticity Associated with Exposure to Drugs
of Abuse,” Neuropharmacology, volume 47, Supplement 1, pp. 33-46, 2004.

Medical University of South Carolina: P.W. Kalivas, N. Volkow, and J. Seamans, “Unmanageable Motivation in
Addiction: A pathology in prefrontal-accumbens glutamate transmission,” Neuron, volume 45, pp. 647-650,
2005.

University of Pittsburgh: S.P. Onn and A. A. Grace, “Amphetamine Withdrawal Alters Bistable States and
Cellular Coupling in Rat Prefrontal Cortex and Nucleus Accumbens Neurons Recorded in Vivo.” Journal of
Neuroscience, volume 20, pp. 2332-2345, 2000.

Brown University: Y. Li and J.A. Kauer, “Repeated Exposure to Amphetamine Disrupts Dopaminergic
Modulation of Excitatory Snaptic Plasticity and Neurotransmission in Nucleus Accumbens,” Synapse, volume
51, pp. 1-10, 2004.

Sweden: R. Diaz-Heijtz, B. Kolb, and H. Forssberg. “Can a Therapeutic Dose of Amphetamine during Pre-
Adolescence Modify the Pattern of Synaptic Organization in the Brain?” European Journal of Neuroscience,
volume 18, pp. 3394-3399, 2003.

Italy: G. Di Chiara, V. Bassareo, S. Fenu, M.A. De Luca, and associates, “Dopamine and Drug Addiction: The
nucleus accumbens shell connection,” Neuropharmacology, volume 47 supplement 1, pp. 227-241, 2004.

103
Netherlands:Louk J. Vanderschuren, E. Donne Schmidt, T. J. De Vries, and associates, “A single Exposure to
Amphetamine Is Sufficient to Induce Longterm Behavioral, Neuroendocrine, and Neurochemical Sensitization
in Rats,” Journal of Neuroscience, volume 19, pp. 9579-9586, 1999.
14
http://healthtools.aarp.org/goldcontent/amphetamine-salts-oral-tablet?brand=Adderall
15
https://draxe.com/brainwashed-by-psychotropic-drugs/
16
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278148/
17
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2637252/
18
Psyched Out: How Psychiatry Sells Mental Illness and Pushes Pills That Kill. [E-Reader Version] Kelly
O'Meara, 2006. Print.
19
https://www.psychologytoday.com/blog/saving-normal/201603/keith-connors-father-adhd-regrets-
its-current-misuse
20
https://www.socialworkhelper.com/2013/05/20/interview-with-dr-allen-frances/

Brown, BJ. Personal interviews 2017

21
http://www.theatlantic.com/health/archive/2014/04/1-in-68-children-now-has-a-diagnosis-of-autism-spectrum-
disorder-why/360482/
22
Childish | Definition of Childish by Merriam-Webster
23
Art and Laraine Bennett, The Temperament God Gave Your Kids (Huntington, IN, Our Sunday Visitor
Publishing Division, 2012) p.13
24
Jerome Kagan and Nancy Snidman, The Long Shadow of Temperament (Cambridge: The Belknap Press of
Harvard University, 2004), pp. 13ff.
25
http://www.theatlantic.com/health/archive/2014/04/1-in-68-children-now-has-a-diagnosis-of-autism-spectrum-
disorder-why/360482/
26
https://www.madinamerica.com/2014/12/debate-allen-frances-robert-whitaker/
27
https://ewds.strath.ac.uk/historymedicine/View/Resource/tabid/6225/articleType/ArticleView/articleId/1007/Dr-
Matthew-Smith-on-ADHD-and-Ritalin.aspx
28
https://www.cchrint.org/issues/psycho-pharmaceutical-front-groups/chadd/
29
https://www.washingtonpost.com/news/answer-sheet/wp/2015/11/24/how-twisted-early-childhood-education-
has-become-from-a-child-development-expert
30
Brown, BJ. Personal interviews. September 2013-2015.
31
Brown, BJ. Personal interviews. September 2013-2015.
104
32
http://www.theatlantic.com/sexes/archive/2013/06/stop-penalizing-boys-for-not-being-able-to-sit-still-at-
school/276976/
33
http://hechingered.org/content/a-day-in-the-life-of-chinese-students_3826/
34
http://m.psychologytoday.com/blog/the-squeaky-wheel/201110/how-much-homework-is-too-much
35
https://www.washingtonpost.com/posteverything/wp/2016/08/11/schools-that-accept-no-excuses-from-
students-are-not-helping-them/?utm_term=.7d40eac86eb9
36
http://theweek.com/articles/457373/rise-youth-suicide-china
37
http://www.nytimes.com/2012/06/10/education/seeking-academic-edge-teenagers-abuse-
stimulants.html?pagewanted=2&ref=general&src=me&pagewanted=all
38
http://www.virginiarules.com/virginia-rules/child-labor-laws
39
http://www.takepart.com/feature/2015/01/19/ritalin-recess-adhd
40
http://www.centerforpubliceducation.org/Main-Menu/Organizing-a-school/Time-out-Is-recess-in-
danger#sthash.tUWvHgo3.dpuf
41
https://www.drugabuse.gov/news-events/news-releases/2016/07/athletic-teens-less-likely-to-transition-
prescription-pain-relievers-to-heroin
42
http://www.alfiekohn.org/article/rethinking-homework/
43
https://www.washingtonpost.com/opinions/give-kids-a-break-on-homework-over-spring-
break/2014/04/15/fbdaa690-c3fd-11e3-9ee7-02c1e10a03f0_story.html
44
http://articles.mercola.com/sites/articles/archive/2014/05/01/antidepressants-adhd-drugs.aspx#_edn7
45
http://usmilitary.about.com/od/joiningthemilitary/a/asthma.htm
46
http://wvtf.org/post/virginia-sets-minimum-exercise-time-elementary-children#stream/0
47
http://www.educationnews.org/parenting/study-adhd-drugs-dont-improve-academic-performance-in-kids/
48
https://www.psychologytoday.com/blog/teen-girls-crash-course/201211/stressed-out-teen-girls-
cutting-cope
49
http://www.drugfreeworld.org/drugfacts/ritalin.html
50
Brown, BJ. Personal interviews. September 2015.
51
http://www.drugs.com/comments/methylphenidate/ritalin.html
52
http://www.drugs.com/comments/methylphenidate/ritalin.html
105
53
https://www.thestar.com/news/canada/2012/09/26/adhd_drugs_suspected_of_hurting_canadian_k
ids.html
54
http://observer.com/2014/08/ex-governor-paterson-blames-heroin-crisis-on-childhood-medication/
55
http://www.cnn.com/2014/02/02/us/heroin-use-rising/index.html
56
http://www.hhs.gov/opioids/about-the-epidemic/index.html
57
http://www.learnoutloud.com/Free-Audio-Video/Education-and-Professional/Medical/Biology-of-Mood/15404
58
http://www.buffalo.edu/news/releases/2001/11/5433.html#sthash.xo7ZNzhe.dpuf
59
https://www.sott.net/article/266334-Honey-they-shrunk-my-brain-Study-confirms-antipsychotics-decrease-
brain-tissue
60
http://www.pbs.org/newshour/updates/americans-spend-much-pharmaceuticals/
61
http://www.worldatlas.com/articles/countries-with-the-highest-rates-of-deaths-from-dementia.html
62
https://www.theguardian.com/books/2016/sep/25/blitzed-norman-ohler-adolf-hitler-nazi-drug-abuse-interview
63
The DAWN Report: Emergency Department Visits Involving Attention ...
64
https://www.washingtonpost.com/news/to-your-health/wp/2015/11/03/more-americans-than-ever-are-taking-
prescription-drugs/
65
https://www.madinamerica.com/2014/12/debate-allen-frances-robert-whitaker/
66
Every Mass Shooting Shares One Thing In Common & It’s NOT Weapons April 1, 2013 by Dan Roberts
67
http:www.thenewamerican.com/usnews/crime/item/14655-prescription-for-murder
68
http://www.spiegel.de/international/the-nazi-death-machine-hitler-s-drugged-soldiers-a-354606.html

https://www.theguardian.com/books/2016/sep/25/blitzed-norman-ohler-adolf-hitler-nazi-drug-abuse-interview
69
http://www.pharmoutsourcing.com/1315-News/124167-Aenova-Acquires-Temmler/
70
http://www.spiegel.de/international/germany/crystal-meth-origins-link-back-to-nazi-germany-and-world-war-ii-
a-901755.html
71
https://www.theguardian.com/books/2016/sep/25/blitzed-norman-ohler-adolf-hitler-nazi-drug-abuse-interview
72
https://www.wsj.com/articles/SB976832374667325423
73
http://www.timesofisrael.com/hitler-was-meth-addict-records-claim/

106
74
www.pharmoutsourcing.com/1315-News/124167-Aenova-Acquires-Temmler/
75
http://injurypreventionbeta.bmj.com/content/early/2016/11/11/injuryprev-2016-042162
76
http://www.thenewamerican.com/usnews/crime/item/14655-prescription-for-murder
77
O'Meara, Kelly. Psyched Out: How Psychiatry Sells Mental Illness and Pushes Pills That Kill
78
http://www.nytimes.com/2013/12/15/health/the-selling-of-attention-deficit-
disorder.html?pagewanted=all&_r=0

Brown, BJ. Personal interviews 2017

79
www.justice.gov/opa/jj-pc-docs.html.
80
https://www.justice.gov/opa/pr/ShirePharmaceuticalspharmaceuticals-pharmaceuticals-llc-pay-
565-million-resolve-false-claims-act-allegations-relating-drug
81
http://educationvotes.nea.org/2016/09/01/justice-dept-sues-ga-segregating-students-disabilities/
82
http://touch.latimes.com/#section/-1/article/p2p-79435656/
83
http://www2.ed.gov/policy/elsec/leg/esea02/pg2.html
84
http://rense.com/general4/addd.htm
85
http://www.sharpermindcenters.com/dea.htm
86
http://www.spiegel.de/international/world/child-psychologist-jerome-kagan-on-overprescibing-drugs-to-
children-a-847500.html
87
http://archives.republicans.edlabor.house.gov/archive/hearings/106th/oi/ritalin92900/baughman.htm
88
http://webspecial.mercurynews.com/druggedkids/?page=pt3
89
http://ahrp.org/americas-overmedicated-children-vera-sherav/
90
http://www.alternet.org/culture/social-death-penalty-why-being-ostracized-hurts-even-more-bullying
90
http://www.cbsnews.com/news/sex-abuse-high-at-youth-detention-centers/
90
https://www.ncjrs.gov/html/ojjdp/jjjnl_2000_4/sui.html
91
http://www.theatlantic.com/politics/archive/2015/06/americas-largest-mental-hospital-is-a-jail/395012/
92
http://newsone.com/2744141/prisons-mental-health-providers/
93
http://www.psychiatrictimes.com/articles/antipsychotics-and-shrinking-brain

107
94
http://www.roanoke.com/news/virginia/man-who-died-in-portsmouth-jail-was-troubled-loved-
by/article_c0af5a07-cc97-52ad-bb08-7dafdb269ba7.html
95
http://valawyersweekly.com/2016/08/10/1-year-after-jail-death-questions-remain/
96
http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2014/10/08/medicaid-adhd-treatment-
under-scrutiny

APPENDIX A
20 U.S.C. ' 1412 (25)
(25) Prohibition on mandatory medication
(A) In general
The State educational agency shall prohibit State and local educational agency personnel from requiring a
child to obtain a prescription for a substance covered by the Controlled Substances Act (21 U.S.C. 801 et seq.)
as a condition of attending school, receiving an evaluation under subsection (a) or (c) of section 1414 of this
title, or receiving services under this chapter.
(B) Rule of construction
Nothing in subparagraph (A) shall be construed to create a Federal prohibition against teachers and other
school personnel consulting or sharing classroom-based observations with parents or guardians regarding a
student's academic and functional performance, or behavior in the classroom or school, or regarding the need
for evaluation for special education or related services under paragraph (3).

APPENDIX B
20 U.S.C.A. ' 1232h (b)
(b) Limits on survey, analysis, or evaluations
No student shall be required, as part of any applicable program, to submit to a survey, analysis, or evaluation
that reveals information concerning—
(1) political affiliations or beliefs of the student or the student's parent;
(2) mental or psychological problems of the student or the student's family;
(3) sex behavior or attitudes;
(4) illegal, anti-social, self-incriminating, or demeaning behavior;
(5) critical appraisals of other individuals with whom respondents have close family relationships;
(6) legally recognized privileged or analogous relationships, such as those of lawyers, physicians, and
ministers;
(7) religious practices, affiliations, or beliefs of the student or student's parent; or
(8) income (other than that required by law to determine eligibility for participation in a program or for receiving
financial assistance under such program),
without the prior consent of the student (if the student is an adult or emancipated minor), or in the case of an
unemancipated minor, without the prior written consent of the parent.

108