When is an investigation not an investigation

I scanned an amusing, to my way of thinking, interview in MedScape Today News recently with the misleading heading ADHD Diagnosis a Detective’s Job. The subheading is also very curious, An Expert Interview With Julie Dopheide, PharmD, BCPP. Her credentials are sticking way out there, aren’t they? You don’t see many interviews billing themselves as amateur interviews anyway. This interview apparently grew out of a discussion at the American Pharmacists Association Annual Meeting and Exposition, held March 25 to 28 in Seattle, Washington. Druggists have conventions, do they?

You need to do a little detective work and figure out all the possible causes of inattention, impulsivity, and hyperactivity.

Translation: you need an over-educated, minister evangelist of the DSM (i.e. a shrink), to give your child a psychiatric label, and make a cripple for life of that child. Over-bearing parents have a tendency to do that kind of thing. Your regular gumshoe, if he was astute enough, might be able to see through the whole business.

There really are underlying brain changes that have been uncovered. There are changes in dopamine receptor density in unmedicated patients with ADHD, compared with controls. Other studies have found a delay in cortical thickening. These children don’t develop their executive functioning and decision-making capabilities until later, and that predisposes them to inattention, impulsivity, and hyperactivity.

A growing brain is a growing brain. It’s important to remember that you are dealing with children here and not with adults. If the child’s executive functioning and decision-making capabilities aren’t fully developed yet, maybe that is because the child is a child and not an adult. Labeling less mature children with ADHD is a practice that is not in the best interest of the child. Inattention, impulsivity and hyperactivity are all characteristics of childhood, and such traits aren’t the symptoms of disease.

There are both short-term and long-term effects of these medications. Parents are often really worried about their child becoming a drug addict or developing a problem with drugs if they are given a drug that has abuse potential. But a large trial showed that ADHD itself is associated with a larger rate of substance abuse and delinquency, and there’s no evidence that giving a stimulant makes them more likely to get into drug or alcohol abuse. Clinicians and family members have to be more vigilant for abuse with ADHD patients generally, because they may be self-medicating with an addictive drug.

Apples and oranges…Is it the drug or is it the label? When you’ve got a kid on a wrong track sometimes you just need to change tracks. Labeling leads to further labeling, troubles lead to more serious troubles, and apparently taking prescription drugs leads to further drug taking.

Read this interview a little further, between the lines, of course, and you will see concretely in terms of changes in physical health why there are better things to do with children than to label them with ADHD, and put them on powerful growth retarding chemical compounds.

Unfortunately, desperate and sometimes over-burdened parents don’t always tend to be so astute as your typical private dick.

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