Author: Michael Janofsky
DENVER -- A resolution recently
passed by the Colorado Board of Education to discourage
teachers from recommending behavioral drugs like Ritalin and
Luvox has intensified a national debate over the growing use
of prescription drugs for children.
The resolution, the first of
its kind in the country, carries no legal weight. But it urges
teachers and other school personnel to use discipline and
instruction to overcome problem behavior in the classroom,
rather than to encourage parents to put their children on
drugs that are commonly prescribed for attention deficit and
Proponents of the resolution,
which passed by a 6-to-1 vote on Nov. 11, said they were
motivated, in part, by evidence that they said suggested that
dozens of violent crimes, including the massacre last spring
at Columbine High School in Littleton, Colo., had been
committed by young people taking psychotropic drugs.
One of the teenage shooters at
Columbine, Eric Harris, had been taking Luvox, an
anti-depressant, although there is no evidence that the drug
had anything to do with the shootings or that a teacher
recommended the use of the medication.
Patti Johnson, the school board
member who organized a hearing on the issue and proposed the
resolution here, conceded that only a small number of teachers
in Colorado had ever insisted on a child taking prescription
drugs as a precondition to returning to class. But the
resolution, she said, was largely intended for them.
No other states are considering
a measure similar to the one in Colorado, where an unusual set
of circumstances played a role in the passage of the
resolution: an elected and fairly conservative school board
responding, in part, to the outcry from one of the nation's
worst school shootings. But the
resolution reflected broader issues, as well, as parents,
mental health professionals and school officials debate the
use of behavioral drugs by more than 2.5 million children in
the United States.
Experts in mental health issues
point out that children who take the drugs do so because they
were having difficulties to begin with. They acknowledge that
impulsive or violent behavior is a side effect in a small
percentage of people taking the drugs.
Arguing that a majority of the
children who use the drugs are benefiting from them, these
experts contend that the Colorado resolution is irresponsible
and perhaps even dangerous in that it could lead school
personnel to ignore signs of serious mental disorders in
children and that it would discourage communication between
teachers and parents.
"I hope what happened in
Colorado is the exception and not the rule," said Michael
M. Faenza, president of the National Mental Health
Association, a consortium of advocacy groups for the mentally
ill, conceding that he fears other states and school districts
might replicate Colorado's efforts.
"Holding up psychotropic
medicines as the possible cause of violent behavior is
absurd," Faenza said. "There's a wealth of
information to show that they have helped dramatically."
The use of Ritalin and other
psychotropic drugs has steadily increased among
schoolchildren, according to Children and Adults with
Attention Deficit/Hyperactivity Disorder, a national nonprofit
organization known as CHADD, in Landover, Md.
In Colorado, increased usage
has turned a new focus onto the role that teachers and
administrators play in the lives of students. It has also
pitted experts who say use of the drugs is growing because
they are beneficial against those who contend parents and
teachers are too quick to seek out prescription medicine as
the simplest way to treat children with behavioral problems.
Ms. Johnson said in the five
years that she has been on the board she has received
"numerous complaints" from parents who claimed a
teacher had insisted that their child go on Ritalin or another
drug before returning to class.
Ms. Johnson recounted the case
of one girl who was showing signs of attention deficit
disorder through mood swings and napping in class. She said
the girl was later diagnosed with hypoglycemia and needed to
change her diet. According to the girl's parents, Ms. Johnson
said, the teacher told them, "You need to get her a
prescription for Ritalin."
As a result of the complaints,
she said, a resolution was written to remove school personnel
from any medical decisions. She said the board, which is
comprised of six Republicans and one Democrat, passed the
resolution along party lines with minimal debate.
The lone Democrat, Gully
Stanford, did not return a telephone call, seeking comment.
"The resolution does not
stop teachers from communicating with parents," Ms.
Johnson said in an interview. "What it does do is stop
teachers from giving parents an ultimatum: 'Put you kid on a
drug or we're not going to teach them.' That can't happen any
more. It's wrong."
Brenda Welburn, executive
director of the National Association of State Boards of
Education, said Colorado is one of only seven states that
elect a board of education. Those boards, she said, tend to be
Ms. Welburn added, however,
"I agree that too often the first answer for children
with some behavior problem is to reach for medication. Some of
the numbers we are seeing for medication of children are
Julie Underwood, general
counsel of the National School Boards Association, said she
knew of no other school board examining the question. Ms.
Underwood added that while many are concerned about
overmedication, "We would be reluctant to support such a
resolution because there are children who may need such
services, who may benefit from the medication."
Dr. Stephen M. Stahl, a
professor of psychiatry at the University of California in San
Diego, said that because of the complexities of mental
disorders and the rapidly changing personalities of children
as they grow older, both sides of the psychotropic debate may
"There's no blood test for
this," Dr. Stahl said. "It's not objective. If a kid
is acting out in class and a stimulant like Ritalin calms him
down, it would be immoral not to give him the medicine."
"But the problem
comes," he added, "when the stimulants don't work
and parents give them anyway as an excuse to avoid tough
decisions or talking with teachers and doctors to learn what's
Another problem complicating
the issue, Dr. Stahl said, is the location of the school.
Typically, he said, in poor areas, mental disorders are
underdiagnosed, and often in more affluent school districts,
children are overdiagnosed, sometimes making a bad situation
Besides complaints from parents
about insistent teachers, Ms. Johnson said she was also
motivated to propose the resolution by the violent crimes
involving young people, in which investigators said the
perpetrators were using psychotropic drugs.
Accounts of those incidents
also persuaded a Colorado state lawmaker, Penn Pfiffner of
Lakeland, to hold a separate hearing on the prescription drugs
issue, which, by coincidence, came two days before the school
board voted on Ms. Johnson's measure.
Dr. Peter R. Breggin, director
of the International Center for the Study of Psychiatry and
Psychology, a nonprofit research organization in Bethesda,
Md., testified at both hearings and said doctors have become
too eager to prescribe psychotropic drugs at the expense of
conversations among parents, teachers and children to learn
why children are acting in antisocial ways.
"It's a tremendous mistake
to subdue the behavior of children instead of tending to their
needs," Dr. Breggin said in an interview.
"We're drugging them into
submission rather than identifying and meeting the genuine
needs of the family, the school and the community," Dr.
Breggin said. "It's wrong in principle."
Citing Harris and other young
killers who were found to be taking Ritalin and other drugs,
Dr. Breggin said he was convinced there was a direct link
between the drugs and violent acts.
Cohen of CHADD and others said
the resolution might inhibit teachers from applying common
sense and experience in the case of a troublesome child by
merely telling parents something is wrong without offering a
full range of possible solutions.
"If a child has hearing or
vision problems that the teacher identifies, we would expect
the teacher to talk to the parents," said Jeanne Mueller
Rohner, executive director of the Mental Health Association of
Colorado, which opposed the resolution. "It should be the
same thing for mental health."
Opponents of the measure also
said they were uncomfortable with the ardent support offered
the measure by the Church of Scientology through an affiliate
organization, the Citizens Commission on Human Rights.
The president of its American
branch, Bruce Wiseman, who described the commission as a
"psychiatric watchdog group," testified at both
hearings and urged rejection of Ritalin and other drugs as a
solution to troublesome behavior.
But Ms. Johnson, as well as
Pfiffner, said the organization's support was not a critical
factor in any of their actions.
But in the end, said Andrea
Giunta, president of the largest teachers' union in Denver, it
might not matter.
By the time most children are
diagnosed with an attention deficit or hyperactive disorder,
Ms. Giunta said they have been observed and analyzed by a team
of experts, including teachers, nurses, counselors and school
"A teacher shouldn't
recommend a specific course of action," Ms. Giunta said.
"But what she can do is say, this has been my experience
with other children when they have displayed this kind of
behavior. What you do is up to you."