Ritalin on Trial

While some Houston parents fight what they charge is "a river of Ritalin" running through the schools, one father has gone to court to try to prove that, for his son, Ritalin use is Ritalin abuse.

By the time Keene got his case into court, other parents around Houston had also begun to question what one calls the "flood" of Ritalin that's gone through area schools. And other parents have watched their children struggle with weight loss, headaches and depression induced when their children come down from the drug.

Sandy Martin, a mother of three boys in Fort Bend County, was one who reluctantly put a son on Ritalin, but then took him off of it when, she says, he began showing signs of Tourette's syndrome, which is characterized by tics and loss of hand control. One day a couple of years ago, she compared notes with three fellow real-estate salespeople who were riding together to a sales conference. All of them, it turned out, had children taking Ritalin. What, Martin wondered, were the odds of that, when only 5 percent of the children in the entire U.S. are thought to have ADHD or ADD (the disorder minus the hyperactivity)?

No one knows exactly how many children are taking Ritalin and its generic equivalent, methylphenidate, but the Drug Enforcement Administration estimates it's somewhere in the range of 1.5 to 2.5 million kids. While the number of children taking methylphenidate is not known precisely, the amount manufactured is. Over the last five years, production of the drug has increased sixfold, from 1,700 kilograms in 1990 to 10,400 kilograms in 1995. Of the world's total supply of this amphetamine, American children consume by far the vast majority. Much of this increase in the use of Ritalin has been driven by a spate of self-help books and articles that created widespread public awareness of attention deficit disorders. And schoolteachers and counselors are increasingly urging parents to evaluate their children for the disorder.

Julie Williams, a mother of two boys in suburban Fort Bend County, was living in Europe when this upsurge of Ritalin use began. Williams says she must have been one of the few mothers at Austin Parkway School in suburban Sugar Land who hadn't heard of the "disorder of the '90s." But she soon learned a great deal when teachers suggested she have her son evaluated for ADD. The school gave her an inch-thick packet of articles on the disorder that explained how parents can better manage their children. On the top of the packet was a list of 11 physicians and several clinics and associations for referral.

Williams and her husband decided to use a local pediatrician, and on their visit, she and her son spent an hour and a half with a nurse-practitioner filling out questionnaires. When it was over, Williams was told her son had at least eight of the characteristics that qualified him for a diagnosis of ADD. The physician came in during the last ten minutes, looked over the nurse-practitioner's notes, and signed a recommendation for Ritalin, Williams says. Still, even though, as she says, "a lot of parents come in and beg for Ritalin," Williams hesitated.

"[The nurse-practitioner] knew I was resistant," says Williams. But the nurse countered her fears, telling Williams the drug wasn't addictive and suggesting she give it a 30-day trial. Then the nurse added a capper: "She said, 'If he had diabetes, you wouldn't withhold insulin, would you?' " Williams recalls. She put her son on it.

But Williams still had reservations. She began to be concerned that the Ritalin was masking her son's true problems, not helping him with them. She started to suspect that while her son was getting Ritalin, he wasn't getting the help he needed in school for his learning disabilities.

"In my heart I didn't think I had an ADD child," she says. "I couldn't forget my child had reading, writing and spelling problems. How was a pill going to affect that?"

Finally, a few weeks into the third grade and a year after he had been put on Ritalin, her son James came home with tears running down his face and a heartbreaking message: "I want someone to teach me to read."

Williams suspected dyslexia, and when she went to the Fort Bend Independent School District for help, the system that had given her an inch-thick file on attention deficit disorders reluctantly handed over to her its information on dyslexia. It amounted to only a few sheets. Ultimately, Williams successfully got her son's reading problems diagnosed.

Since her son's reading instruction has been changed, Williams reports, he's much happier in school. His morning stomachaches have gone away, for Williams has quit giving him his morning dose of Ritalin. She's kept quiet about that, though, out of fear that the school might suddenly report conduct problems if administrators there knew that his disciplinary medicine had disappeared, and that what has really calmed him down and focused his attention is learning to read.

In the course of her fight, Williams found that only a handful of Fort Bend students had been tested for dyslexia. So last March she filed a complaint with the federal Office for Civil Rights. That, Williams says, got the district's attention. Now the Fort Bend schools are starting to address the problem of dyslexia, and may be less quick to judge children who have it as being candidates for Ritalin. But, she adds, she has had to raise holy hell to get some action.

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