By CCHR International
The Mental Health Industry Watchdog
August 22, 2017

The U.S. Centers for Disease Control and Prevention (CDC) published statistics this month about the increasing drug overdose deaths of teens aged 15 to 19, including ADHD drugs  (psychostimulants) and Anti-anxiety drugs (benzodiazepines). Although death rates for drug overdoses were highest for opioids, death rates involving psychostimulants with abuse potential quadrupled from 0.1 in 1999 to 0.4 in 2015. The rate of drug overdose deaths involving benzodiazepines increased six-fold from 0.1 in 2000 to 0.6 in 2015. In response to the CDC report, the mental health watchdog CCHR International is alerting parents about the risks of prescription psychostimulants and benzodiazepines which have rates of overdoses that were 33 percent and 100 percent higher than cocaine in 2015.

The psychostimulant, methylphenidate, is a Schedule II drug which means the U.S. Drug Enforcement Administration (DEA) classifies it as having a high potential for abuse. It is prescribed largely to treat  those diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) in children and adolescents, a disorder with an insurance billing code that has come under increasing criticism for labeling normal childhood behavior as a mental illness. The DEA warns that methylphenidate produces many of the same effects as cocaine. Psychotic episodes and severe psychological addiction have all been associated with methylphenidate abuse.[2]

The agency also correlates that the increased use of the drug to treat ADHD parallels an increase in its abuse among adolescents and young adults who crush these tablets and snort the powder to get high. The CDC reported that the percent of children given an ADHD diagnosis increased from 7.8 percent in 2003 to 11 percent in 2011-12.[3] More recent estimates are as high as 15 percent, with children routinely prescribed stimulants.[4]

In 2014, CCHR obtained statistics from IMS Health’s Vector One National Database that showed more than 1.78 million adolescents aged 13 to 17 were taking psychostimulants and 650,273 were taking anti-anxiety prescription drugs[5], many of which are from the benzodiazepine class.

In 2015, the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) also reported that:

• Of the 17.2 million users of prescription stimulants, 1.8 million were youths aged 12 to 17 (7.3 percent of youths), 4.9 million were young adults aged 18 to 25 (14.1 percent of young adults). Additionally, 3.5 million people aged 12 or older used methylphenidate products in the past year. This number represented 1.3 percent of the population aged 12 or older.

• Of the 39.3 million past year users of tranquilizers (mostly benzodiazepines), 1.1 million were youths aged 12 to 17 (4.3 percent of youths) and 4.2 million were young adults aged 18 to 25 (12.1 percent of young adults).

• Of the 18.6 million users of prescription sedatives, 600,000 were youths aged 12 to 17 (2.4 percent of youths), 1.3 million were young adults aged 18 to 25 (3.8 percent of young adults).[6]

Factoring in younger-aged children and teens, in 1990, 600,000 American children were on stimulants. By 2013, this had reached 3.5 million, an increase of 483 percent.[7]

CCHR says that helping to generate this epidemic of child and adolescent drugging have been aggressive marketing of stimulants, the sales of which more than doubled to $10.5 billion in 2012 from $4 billion in 2007, according to IMS Health. Between 2012 and 2015, sales jumped again to $11.2 billion — a 180% increase since 2007.[8] Sales are expected to reach $17.5 billion in the year 2020.[9] CCHR wants to see parents better informed of the facts, soon launching its Fight for Kids campaign.

Other psychotropic drugs parents should be aware of are benzodiazepines (a type of sedative hypnotic). Prescriptions for these have more than tripled and fatal overdoses have more than quadrupled in the past 20 years, researchers also found in 2016. “Overdoses rose at a faster rate than prescriptions, suggesting that people were using benzodiazepines in a riskier way over time,” said lead author Dr. Marcus Bachhuber, assistant professor of medicine at Albert Einstein College of Medicine in New York.[10]

Dependence on benzodiazepines can also develop after only a few weeks of taking them. Most addicts consider it harder to withdraw from benzodiazepines than from heroin or narcotic painkillers.[11]

The increasing prescription of the psychoactive prescription drugs may be contributing to unintentional overdoses or inducing suicidal behavior, CCHR says. The CDC report says that of all drug overdose deaths among adolescents aged 15-19 in 2015, 13.5% were suicide. There were almost 22% of drug overdose deaths among female adolescents that were suicides compared to 8.7% males.[12]

Suicidal thoughts are among a battery of known side effects of methylphenidate type stimulants.[13] There are at least two drug regulatory agency warnings linking methylphenidate to suicide risk or attempts.[14]

Psychostimulants can be bought and sold among students who have no idea what they were messing with, said Alan Schwartz, a New York Times reporter and author of ADHD Nation: Children, Doctors, Big Pharma and the Making of an American Epidemic.[15] He found that kids “were either faking ADHD to their doctors or buying the pills from someone who had been diagnosed.”[16]

In 2013, Partnership for Drug-Free Kids released the findings of a survey that found nine percent of teens (about 1.9 million) reported having misused or abused two the most prominent ADHD stimulants. More than a quarter of teens (27 percent) mistakenly believed that misusing and abusing prescription drugs was safer than using street drugs.[17]

Schwartz said he “asked the ADHD and child-psychiatry establishment” about ADHD and stimulant prescription concerns “and they denied it was happening….They denied that teenagers were buying and selling pills….They basically denied that anything about their world was malfunctioning at all. In the end, they doth protest too much. I wrote about 10 front-page stories for The New York Times on the subject from 2012-2014.”[18]

Making things worse, he added, were pharmaceutical companies who produced advertisements “ultimately to parents themselves that misrepresented what their product was, what it treated, and what it did. Disgustingly so. ADHD drugs do not give a child ‘grades that match his intelligence,'” which is what one stimulant drug ad told parents in People magazine. “Another ad had a mother telling her kid that, thanks to the ADHD drugs, ‘I’m proud of you.’ It’s sick. But there are really no repercussions for companies that do this,” Schwartz reported. “Every ADHD drug has received a formal reprimand from the FDA for false and misleading advertising. Every one,” Schwartz said.[19]

Subjective Diagnosis Creates Drug Epidemic

CCHR says that the criteria for diagnosing ADHD are so subjective and arbitrary that any child could be diagnosed with the label. This is one reason kids can easily “fake” the symptoms to doctors. In its Fight for Kids campaign, CCHR plans to increase educational information for parents and teachers about how the symptoms of ADHD are almost identical to those attributed to gifted children.[20]

Dr. Robert Berezin, who taught psychiatry at Harvard Medical School for 30 years said, “What is called ADHD in general is merely one part of the constellation of temperaments that make up the human condition.” He added:

• “Somewhere along the line we have lost the understanding that kids come in all shapes and sizes. Some kids are active, some are quiet; some kids are dreamers, others are daring; some kids are dramatic, others are observers; some impulsive, others reserved; some leaders, others followers; some athletic, others thinkers. Where did we ever get the notion that kids should all be one way?[21]

• In his last interview before his death, Leon Eisenberg, the “scientific father of ADHD” and a leader in child psychiatry for more than 40 years, admitted that “ADHD is a prime example of a fictitious disease.”[22]

• Dr. Keith Conners conducted the first formal trials on the use of methylphenidate in noisy and difficult to control children, subsidized by the drug’s manufacturer. Findings from these trials spurred research into the then so-called Minimal Brain Dysfunction or Hyperkinetic Reaction of Childhood (later replaced with ADHD). Conners became a champion of the diagnosis and drugs prescribed to treat it. Yet today he calls ADHD misdiagnoses “a national disaster of dangerous proportions.”[23]

Psychiatric Drug Side Effects Online Database Can Help Prevent Children and Adolescents Being Put at Risk

In addition to overdoses from psychotropic prescription drugs and adverse side effects, CCHR encourages parents to research the drugs before agreeing to have their child administered them. They produced an online, easily searchable psychiatric drug side effects database to help.

• Since 2013, there have been more than 19,000 reports of complications from ADHD drugs, most of which are stimulants made to the U.S. Food and Drug Administration (FDA), according to a Milwaukee Journal Sentinel/MedPage Today analysis.

• In emergency departments around the country, the number of cases involving two common ADHD drugs nearly quadrupled over seven years. In 2004, the drugs played a role in 10,800 cases of emergency department visits. By 2011, the figure for those two drugs jumped to 42,000.[24]

CCHR says that parents are up against a “quick fix” culture, with heavy psychiatric marketing that children’s natural exuberance, creativity, independence and even teenage angst is abnormal requiring a mind-altering drug. The fact that these drugs become illicit street drugs and can lead to high rates of overdose and hospital emergency visits is evidence of their serious risks. Dr. Berezin commented that, “One thing is for sure: There is no brain condition that generates some disease called ADHD, and none has ever been demonstrated. And no child should be given amphetamines.”[25] That should be extended to all psychotropic drugs, CCHR says.

As a nonprofit, public benefit organization, CCHR has been responsible for helping obtain over 180 laws enacted, including the 2004 Federal Child Medication Safety Amendment that prohibits schools from forcing children to take psychotropic drugs as a requisite for their education. Click here to support the “Fight for Kids” campaign.

References:

[1] Sally C. Curtin, M.A., Betzaida Tejada-Vera, M.S., and Margaret Warner, Ph.D., “Drug Overdose Deaths Among Adolescents Aged 15–19 in the United States: 1999–2015,” Centers for Disease Control and Prevention, NCHS Data Brief No. 282, Aug. 2017; https://www.cdc.gov/nchs/products/databriefs/db282.htm; https://www.cdc.gov/nchs/data/databriefs/db282.pdf

[2] “Drugs of Abuse,” U.S. Department of Justice, Drug Enforcement Administration, p. 35, https://www.naabt.org/documents/Drugs%20of%20abuse%20DEA.pdf

[3] https://www.cdc.gov/ncbddd/adhd/data.html

[4] Sylvia Booth Hubbard, “ADHD ‘Epidemic’ Called False Crisis That Has Led to Overprescribing of Drugs,” Newsmax, 19 Oct. 2016, http://www.newsmax.com/Health/Headline/ADHD-epidemic-crisis-overprescribing/2016/10/19/id/754299

[5] IMS, Vector One: National (VONA) and Total Patient Tracker (TPT) Database, Year 2013, Extracted April 2014; https://www.cchrint.org/psychiatric-drugs/children-on-psychiatric-drugs

[6] Arthur Hughes, et al., “Prescription Drug Use and Misuse in the United States: Results from the 2015 National Survey on Drug Use and Health,” SAMHSA NSDUH Data Review, Sept. 2016, https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR2-2015/NSDUH-FFR2-2015.htm.

[7] “Generation Adderall,” The New York Times, 12 Oct. 2016, https://www.nytimes.com/2016/10/16/magazine/generation-adderall-addiction.html?mcubz=0

[8] “Medicines Use and Spending in the U.S., A Review of 2016 and Outlook to 2021,” QuintilesIMS Institute, May 2017, http://www.imshealth.com/en/thought-leadership/quintilesims-institute/reports/medicines-use-and-spending-in-the-us-review-of-2016-outlook-to-2021; “Top Therapeutic Classes by U.S. Spending,” IMS National Sales Perspectives™, 23 Feb 2012, http://www.imshealth.com/files/web/Corporate/News/Top-Line%20Market%20Data/Top_Therapy_Classes_by_Sales.pdf.

[9] Luke Whelan, “Sales of ADHD Meds Are Skyrocketing. Here’s Why,” Mother Jones, 24 Feb. 2015, http://www.motherjones.com/environment/2015/02/hyperactive-growth-adhd-medication-sales

[10] “Benzodiazepine prescriptions, overdose deaths on the rise in U.S.,” Reuters, 26 Feb. 2016, http://www.reuters.com/article/us-health-rxdrugs-benzodiazepine-overdos-idUSKCN0VZ2TU

[11] Jonathan Brett and Bridin Murnion, “Management of benzodiazepine misuse and dependence,” Australian Prescriber, 1 Oct. 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657308; http://www.drugaddictiontreatment.com/types-of-addiction/prescription-drug-addiction/ambien-addiction

[12] Sally C. Curtin, M.A., Betzaida Tejada-Vera, M.S., and Margaret Warner, Ph.D., “Drug Overdose Deaths Among Adolescents Aged 15–19 in the United States: 1999–2015,” Centers for Disease Control and Prevention, NCHS Data Brief No. 282, Aug. 2017; https://www.cdc.gov/nchs/products/databriefs/db282.htm; https://www.cdc.gov/nchs/data/databriefs/db282.pdf

[13] http://www.dailymail.co.uk/health/article-2141044/ADHD-Ritalin-prescriptions-soaring-experts-warn-effects.html

[14] https://www.cchrint.org/psychiatric-drugs/stimulantsideeffects/ritalinsideeffects

[15] Gareth Cook, “Big Pharma’s Manufactured Epidemic: The Misdiagnosis of ADHD,” Scientific American, 11 Oct. 2016, https://www.scientificamerican.com/article/big-pharma-s-manufactured-epidemic-the-misdiagnosis-of-adhd

[16] Sylvia Booth Hubbard, “ADHD ‘Epidemic’ Called False Crisis That Has Led to Overprescribing of Drugs,” Newsmax, 19 Oct. 2016, http://www.newsmax.com/Health/Headline/ADHD-epidemic-crisis-overprescribing/2016/10/19/id/754299

[17] https://drugfree.org/newsroom/news-item/national-study-teen-misuse-and-abuse-of-prescription-drugs-up-33-percent-since-2008-stimulants-contributing-to-sustained-rx-epidemic

[18] Gareth Cook, “Big Pharma’s Manufactured Epidemic: The Misdiagnosis of ADHD,” Scientific American, 11 Oct. 2016, https://www.scientificamerican.com/article/big-pharma-s-manufactured-epidemic-the-misdiagnosis-of-adhd

[19] Gareth Cook, “Big Pharma’s Manufactured Epidemic: The Misdiagnosis of ADHD,” Scientific American, 11 Oct. 2016, https://www.scientificamerican.com/article/big-pharma-s-manufactured-epidemic-the-misdiagnosis-of-adhd

[20] Behaviors Associated with Giftedness: Poor attention, boredom, daydreaming in specific situations; low tolerance for persistence on tasks that seem irrelevant; judgment lags behind development of intellect; intensity may lead to power struggles with authorities; high activity level; may need less sleep; questions rules, customs, and traditions; http://www.prnewswire.com/news-releases/watchdog-group-alerts-parents-and-teachers-about-gifted-children-being-mislabeled-adhd-and-given-stimulant-drugs-300501824.html

[21] Robert Berezin M.D., “No, There is No Such Thing as ADHD: Different temperaments make some kids more active,” Psychology Today, 17 Mar. 2015, https://www.psychologytoday.com/blog/the-theater-the-brain/201503/no-there-is-no-such-thing-adhd

[22] http://www.wnd.com/2013/05/father-of-adhd-calls-himself-a-liar/#SAe7LssguLIzLtry.99

[23] Gareth Cook, “Big Pharma’s Manufactured Epidemic: The Misdiagnosis of ADHD,” Scientific American, 11 Oct. 2016, https://www.scientificamerican.com/article/big-pharma-s-manufactured-epidemic-the-misdiagnosis-of-adhd

[24] “New heroin? ADHD drug abuse similar to opioids,” APP (Part of USA Today network), 12 Sept. 2016, http://www.app.com/story/news/2016/09/12/new-heroin-abuse-adhd-drugs-similar-opioids/90272344

[24] Robert Berezin M.D., “No, There is No Such Thing as ADHD: Different temperaments make some kids more active,” Psychology Today, 17 Mar. 2015, https://www.psychologytoday.com/blog/the-theater-the-brain/201503/no-there-is-no-such-thing-adhd