The following editorial was published September 2th, 2015 in Ynet, one of the most widely read online publications in Israel.
ADHD: Should I give my child drugs?
In recent years, consumption of Ritalin (which is the most commonly administered drug patients with ADHD in Israel) among children and adolescents diagnosed with ADHD has increased significantly. Some attribute this phenomenon to increased acceptance of medicinal drug use, changes in modern lifestyles, and the proliferation of imposing technologies and other stimuli.
Do Doctors Rush to Prescribe Drugs? Most professionals working in the field of ADHD agree that rising pharmaceutical consumption of Ritalin and other drugs is a function of increased awareness that the disorder. Moreover, there is greater consensus that ADHD is treatable and that improvements are being made towards successfully diagnosing the disorder. The steep increase in consumption of drugs for ADHD is raising public suspicions that there is over diagnosis of the disorder and that both doctors and parents are too quick to diagnose. In reality, the situation is very different. Doctors in Israel do not rush to recommend prescription drug therapy for younger patients, while the majority of doctors recommend parental coaching as a first step. Most parents are afraid and hesitate to give their child medication, while those who do decide to do so tend to turn to medication only after trying many other strategies to no avail.
Regarding Criticism of Parents There is a great deal of controversy and disagreement in the debate around drugs for ADHD and pharmaceutical treatment. On the one hand, the decision to give a child a long drug treatment is by no means trivial or simple, both because of the expected side effects and also because of the stigma created by slanderous media campaigns against the drug. Additionally, parents who chose to give their child drugs combating ADHD with a very heavy heart are perceived as parents who are have failed in setting limits for or investing in their children. It’s a shame that the very parents who invest great effort in trying to improve the quality of life for their child face harsh criticism that causes them to feel guilty and frustrated, further impairing their ability to maintain their very correct path of child-rearing. Criticism of these parents stems from both an expansion of uncontrolled drug use and a lack of understanding of the essence of ADHD, as well as the impact it has on both the quality of family life and the emotional state of the child.
Dealing with Exhaustion On the other hand, the interests of the child might be negatively affected by the decision not to administer drug therapy. The price that children with ADHD pay for not undergoing treatment is reflected in their lack of self-esteem and damage to their sense of self-worth. This is an injury that will drag into their adult lives and create a cycle of frustration. According to studies done by the Israel Anti-Drug Authority (IADA), children with ADHD who have been prescribed drug therapy are less prone to drug addiction than children with ADHD who were not treated. Furthermore, children with ADHD who undergo drug therapy have the same rate of addiction as those children who do not suffer from ADHD. An important point to remember is that parenting a child with ADHD is very challenging. These parents are required to maintain their focus and energy when confronting the relentless and exhausting realities of raising a child with ADHD, both inside and outside of the school. A common mistake is to consider only the academic implications of ADHD, which focus on the child’s need for concentration and self-restraint. In recent years, there is increased consensus that impairments to concentration and attention affect all areas of one’s life through the compromising of one’s Executive Functions such as planning, organization, and self-control.
Every Decision Comes With a Price The decision of whether or not to administer drugs for ADHD to a child is the responsibility of the parents! Like any decision, this decision has its advantages and disadvantages. Make sure to make your decision based on what is right for your child and his/her life, not based upon the considerations of others. Below are a few tips that will help you decide whether or not to administer drug therapy to your child:
Knowledge is power – Base your decision on as many credible, qualified and reliable information sources regarding ADHD and its treatment as possible, while also selecting a doctor that is qualified in these matters.
The doctor is the authority – A recommendation for drug therapy is a medical one and must come from a doctor! Diagnosis of ADHD is clinical and can only be done by a neurologist, psychiatrist or developmental pediatrician who specialized in ADHD. Only a specialist can determine with certainty whether your child suffers from this disorder and prescribe medication.
What about side effect? – Are you concerned about possible side effects? Consult your doctor regarding changing the dosage or type of medicine to reduce the side effects or prevent them altogether. You should also know that there are newer drugs today with much milder side effects. This is one of the main reasons why you should seek a specialist in ADHD, allowing you to consult continuously after the diagnosis has been made.
For the good of the child above all else – Medications for ADHD are meant to improve the quality of life of the child and to mitigate the frustrations associated with the difficulties that arise from the disorder. There are children for which drug therapy is not a fit and whose quality of life is impaired in such a way that does not justify the administration of drugs. These children tend to suffer from anxiety and nervous tics, which do not subside over time.
Not only for the parents – Make sure to read all of the recommendations in a medical diagnosis. They usually include recommendations for teachers, as well as recommendations for parental guidance or coaching. The recommendations are based on studies conducted on the subject that found that the most effective treatment is a combination of drug therapy and training (improving executive functions). This includes creating an adapted environment through cooperation with the educational staff, which in turn reduces the emotional challenges and injury caused to the child’s self-esteem and social situation.