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By Ami Albernaz
Given rising concerns over the number of children on Ritalin and
other psychotropic drugs, state legislatures throughout the country
have been debating measures that would curb recommendations of such
drugs in schools.
While controversy has swirled around student use of Ritalin (methylphenidate)
over the past decade, the issue has received more attention in the
past few years. Stimulants counteracting Attention Deficit Disorder
are now directly marketed to parents. Such drugs received an additional
boost when the American Academy of Pediatrics endorsed their use,
provided clear goals and monitoring. Such moves added to concerns
that drugs are being suggested too quickly.
"There's concern about the unusually high number of children on
psychotropic medications," said Andrew Gersten, Ph.D., a psychologist
on the New Hampshire Psychological Association's legislative committee
and a school consultant. New Hampshire is one of two New England
states where bills concerning psychotropic drugs in schools were
recently presented. Of five such laws proposed in the Granite State,
three were killed and two are still being studied.
Perhaps nowhere in the country is the debate so relevant as in
New England. The region leads the country in consumption of Ritalin
and its generics: New Hampshire rates first, followed by Vermont,
Massachusetts, Rhode Island and Maine.
That New England states dispense more Ritalin per capita than anywhere
else is a cause for alarm among some practitioners, including J.
David Egner, M.S., a child psychologist and former special education
director in Rutland, Vt. Speaking of his own state, he says, "Vermont
is rural; there's no inner-city ghetto problem. There are incredibly
small classrooms. But options of alternatives (to Ritalin) aren't
discussed."
A bill that was defeated in the Vermont legislature last year would
have required schools to tell parents that their children need not
use Ritalin even when it is advised by an outside doctor or therapist.
Egner supported the bill, and still believes that a harder line
needs to be taken on Ritalin and similar drugs. He says he has known
parents who have been pressured by school officials to start their
children on Ritalin or a similar drug. Meanwhile, he adds, Ritalin
has become the most prevalent street drug in Rutland.
Connecticut is the one New England state to have a so-called anti-Ritalin
law. In 2001, the legislature ruled that schools could recommend
therapists, and not drugs, to students. Supporters say that such
a law clarifies the boundaries involved in suggesting medications.
"The purpose of the bill is to ensure that the person who is prescribing
medication is the best qualified," says Michael Schwarzchild, Ph.D.,
director of the Center for Child and Adolescent Behavior in Brookfield,
Conn. While the Connecticut bill met little opposition, it was regarded
by some, including the state's Board of Education, as redundant,
because an outside professional would be needed to prescribe medication
in any case.
Nationwide, Texas, Virginia and Minnesota are among states to have
also passed "anti-Ritalin" laws.
That such laws have not been passed in other New England states
is perhaps a reflection of other preoccupations, such as severe
budget crises or the belief that Ritalin is, for the most part,
safe. In New Hampshire, the measures struck down this year included
the creation of a committee to study psychotropic use in schools;
another would have prohibited any government agency employee from
recommending psychotropic drugs to children.
The measures still under study, meanwhile, include a parental bill
of rights concerning school disciplinary actions and psychotropic
drugs in schools and one that would establish legal guidelines for
when parents refuse to put their children on psychotropic medications.
Balancing the attempts to curb psychotropic drugs in schools is
a defense of the drugs, which for many children, seem to have worked
well.
Kirsten Singleton, executive director of the New Hampshire Psychological
Association, says that had the Ritalin debate gone further in New
Hampshire, the association would have sought to "educate the legislature,
and give them a balanced view."
Meanwhile, even in states where no laws curbing recommendations
of psychotropic drugs have been passed, some school systems have
advised personnel to avoid suggesting medication directly and to
instead advise seeing an outside professional. This course of action
is sensible, Gersten says.
"It's appropriate for school personnel to suggest a physician
to see if medications would be helpful," he says. "It's no different
from recommending another specialist such as a neurologist."
The battle over Ritalin and similar drugs in schools will likely
continue. A recent demonstration in Concord, N.H. by a Massachusetts-based
civil rights group called for the outright ban of such drugs. While
a ban appears unlikely, firmer guidelines of how psychotropic drugs
will be recommended and handled in schools - or at least debates
on what the guidelines should be - are anticipated.
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