Medicate THIS

We medicate for everything now, and for a lot of things that don’t truly require medication. For instance, now there’s a drug for people who feel that their eyelashes aren’t lush enough. That should be a good indication that we’ve gone off the deep end. And doctors are so quick on the trigger to write prescriptions that they barely consider non-pharmaceutical options anymore.

The medical treatment of children AD(H)D is a perfect case in point. We’re medicating kids by the millions now and the number continues to increase. More kids diagnosed, more kids prescribed medication, more AD(H)D drugs available.

Concerta, in case anyone is wondering, contains the same active drug as Ritalin: methylphenidate. Methylphenidate is a pretty old-school drug—it’s been used since 1944. Ritalin has been available since 1948, and Concerta is the new kid on the block, coming to market in 2000.

Methylphenidate is technically a stimulant; it works on the brain in a similar manner to cocaine, by increasing dopamine levels in the brain. Dopamine, as you may know, is “the feel-good chemical” that makes you feel eleventeen different kinds of awesome. It’s what causes the cocaine high and the feeling you get when you eat chocolate.

But dopamine can also help quiet the “noise” in the brain and allow a person to focus more easily. That’s how methylphenidate works in the treatment of AD(H)D. There is some clinical evidence that people with AD(H)D have lower-than-normal levels dopamine receptors in their brains—meaning that their systems can’t process dopamine as well as people with the normal amount of dopamine receptors. Picture your brain as having a bunch of little sponges designed to absorb all the dopamine that flows by. If your brain doesn’t have enough little sponges, you’re not going to be able to get all of it. So basically, methylphenidate helps to sop up all that juicy, delicious dopamine even without sponges, so that your brain can function more like the brains of people who have the usual number of little sponges. More dopamine = more calming effect on the brain = more focus and less hyperactivity.

[NOTE: This is a really, really simplified description of how it works. Also, I'm not an official scientist so I've played fast and loose with a lot of the technical nitty gritty here.]

Now for the flip side. Methylphenidate can also cause horrendous side effects, especially in children. If you’ve ever seen an ad for Concerta, you’ve seen the black box warning. Black box warnings are mandated for all drugs that pose a severe safety risk. Most cancer drugs, for instance, have black box warnings; among other things, they can increase your risk of serious infection, cause permanent heart problems, or just kill you outright. A lot of antidepressants have black box warnings now because they can increase the risk of suicidal thinking and behavior.

Concerta’s black box warning pertains to the risk of addiction. But that’s not the only serious problem with Concerta and other drugs used to treat AD(H)D. They can cause tremendous stress on the cardiovascular and nervous systems. Unbearable for a child to experience, unbearable for a parent to watch.

There are, of course, children who are really are hyperactive, to the extent that their quality of life really suffers. For them and their families, medication can be a godsend. But what about kids whose situation isn’t so extreme? Or for that matter, what about anyone with a chronic condition, who might be well managed without medication? Don’t we owe it to ourselves to see what we can do without immediately introducing a stream of drugs into our system? You wouldn’t use a Howitzer to swat a fly, so why go directly to meds when holistic treatments could work just as well but without all the collateral damage?

Don’t get me wrong, I’m not against the use of pharmaceuticals. In the interest of full disclosure, I’m in the pharmaceutical industry. I’ve worked with Big Pharma for years. I know that drugs can work wonders for people who really need them. They can save lives, make people functional, take away pain, and all kinds of other crucial stuff.

But no drug–whether it’s prescription or over the counter–is completely benign. All drugs can cause side effects, and you can’t always predict how they’ll affect you. So it’s imperative to do your homework and always weigh the benefits against the potential side effects. And consider non-pharmaceutical therapies as well.