Wednesday, May 1, 2013

Academic Steroids: Part Whatever

Attention Deficit Drugs Face New Campus Rules:

Fresno State is one of dozens of colleges tightening the rules on the diagnosis of A.D.H.D. and the subsequent prescription of amphetamine-based medications like Vyvanse and Adderall. Some schools are reconsidering how their student health offices handle A.D.H.D., and even if they should at all.
Various studies have estimated that as many as 35 percent of college students illicitly take these stimulants to provide jolts of focus and drive during finals and other periods of heavy stress. Many do not know that it is a federal crime to possess the pills without a prescription and that abuse can lead to anxiety, depression and, occasionally, psychosis.
Although few experts dispute that stimulant medications can be safe and successful treatments for many people with a proper A.D.H.D. diagnosis, the growing concern about overuse has led some universities, as one student health director put it, “to get out of the A.D.H.D. business.”
The most surprising thing about this is the percentage...we're talking over a third of college students amping up in some capacity with prescription amphetamines come finals time. And while limiting access to the drugs via campus health centers is a good start, this is more of a legal affairs issue than it is a campus health issue.
Changes like these, all in the name of protecting the health of students both with and without attention deficits, involve legal considerations as well. Harvard is being sued for medical malpractice by the father of a student who in 2007 received an A.D.H.D. diagnosis and Adderall prescription after one meeting with a clinical nurse specialist.
You knew this had to involve law suits in some capacity. Decisions like these have less to do with the welfare and best interests of the students, and everything to do with covering the colleges collective back sides from litigation.

But asking students to take the equivalent of virginity pledges when it comes to abusing stimulants ("I am making a commitment to myself, my family, and my Creator, that I will abstain from amphetamines of any kind before graduation") is going to do little to stop the push back from the pro-A.D.H.D. crowd.
Still, many student health departments regard A.D.H.D., a neurological disorder that causes severe inattention and impulsiveness, as similar to any other medical condition. Eleven percent of American children ages 4 to 17 — and 15 percent of high school students — have received the diagnosis, according to a survey by the Centers for Disease Control and Prevention.
New college policies about A.D.H.D. tend not to apply to other medical or psychiatric conditions — suggesting discrimination, said Ruth Hughes, the chief executive of the advocacy group Children and Adults With Attention-Deficit/Hyperactivity Disorder. Such rules create “a culture of fear and stigma,” she said, adding that if students must sign a contract to obtain stimulants, they should have to do so for the painkillers that are also controlled substances and are known to be abused.
Which is absurd given that painkillers are not academic steroids and are not used to cheat (er, perform better) on tests, papers, and so forth. Talk about a straw man. 

And are we really going to hear the cries of "discrimination" from these people? That's like saying athletes suspected of using PED's are being "discriminated" against, or that wanting to cut down on cheating and abuse is just a "culture of fear and stigma."

I'm also bothered by the phrase "A.D.H.D, a neurological disorder..." It's a behavioral diagnosis (label) with no grounding whatsoever in neurology, biology or anything that meets the scientific method. In fact, new evidence suggests that the behavior so labeled as attention deficit may actually be nothing more than sleep disorders.
For some people — especially children — sleep deprivation does not necessarily cause lethargy; instead they become hyperactive and unfocused. Researchers and reporters are increasingly seeing connections between dysfunctional sleep and what looks like A.D.H.D., but those links are taking a long time to be understood by parents and doctors.
A number of studies have shown that a huge proportion of children with an A.D.H.D. diagnosis also have sleep-disordered breathing like apnea or snoring, restless leg syndrome or non-restorative sleep, in which delta sleep is frequently interrupted.
I had forgotten about "restless leg syndrome," better known as The Rockettes Disease. But seriously...
One study, published in 2004 in the journal Sleep, looked at 34 children with A.D.H.D. Every one of them showed a deficit of delta sleep, compared with only a handful of the 32 control subjects.
There has been less research into sleep and A.D.H.D. outside of childhood. But a team from Massachusetts General Hospital found, in one of the only studies of its kind, that sleep dysfunction in adults with A.D.H.D. closely mimics the sleep dysfunction in children with A.D.H.D.
Thakkar also notes the correlation between the rise in sleep disorders and the explosion of A.D.H.D in the 1990's...right around the time the internets exploded as well.

And to illustrate the very subjectiveness of the diagnosis that I and others have been railing about for years, this:
As it happens, “moves about excessively during sleep” was once listed as a symptom of attention-deficit disorder in the Diagnostic and Statistical Manual of Mental Disorders. That version of the manual, published in 1980, was the first to name the disorder. When the term A.D.H.D., reflecting the addition of hyperactivity, appeared in 1987, the diagnostic criteria no longer included trouble sleeping. The authors said there was not enough evidence to support keeping it in.
"The authors"...I love that, like the DSM is a work of fiction (cough).

One would also assume that the removal of the sleep criteria was based solely on money. There simply isn't as much money to be made in sleep disorders as there is in the ever-expanding criteria for A.D.H.D.

At the end of the day, colleges and universities are fighting a losing battle here. As the first article notes, students are more likely to bring their prescriptions with them to campus. And lacking that, why bother with the health center when you can score Adderall via the underground, black market (Biff's fraternity brother knows a dude who knows a dude who...)? It's everywhere.

This is a classic case of the fish rotting from the head down. Until we recognize the power of the psychiatric-industrial complex and Big Pharma to keep imposing its biomedical view of madness on every single social behavior, we're doomed. 

And like mold, its spread is harder to stop the longer we wait.

Cross posted to: The Cranky Sociologists

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