Abuse and diversion

Keeping Medications Secret – A Way to Curb Abuse?

A recent article in USA Today about the challenges of dealing with ADHD at college suggested students keep their conditions - and their prescriptions - secret from their peers.

The reason? Abuse of stimulant medications like Adderall and Ritalin is rampant on college campuses, where the medications are used as "study drugs" and also to provide a boost of energy during long nights of drinking and partying.

As a result, students with such prescriptions can find themselves under intense pressure to share or sell their pills.

But when students keep their meds a secret from peers, does anyone actually benefit?

Continue Reading

Antidepressants

Waiting Until You’re “Old Enough” for Antidepressants

What's it like to suffer from severe depression for as long as you can remember - and to be too scared to ask for help until age 18?

Today I’m featuring the story of Allie, a 21-year-old college senior in Wisconsin who was ultimately diagnosed with bipolar disorder. Allie kept her unhappiness a secret and didn't begin taking medication when she was old enough to ask for it without her parents finding out.

Allie's story is interesting, because it shows how kids can suffer from severe depression from a very young age. It also shows how in a culture where psychiatric drugs seem ubiquitous kids can come to focus on medication as a source of salvation.

Continue Reading

ADHD drugs

A Hierarchy of Medications?

People who take psychiatric medications long-term are no strangers to stigma, or the threat of it. We perennially face, for example, the question of whether it's worth risking others' judgment and the potential negative repercussions of disclosing our conditions -- and the fact that we take medication for them.

But you can commit to taking medications long-term and still perpetuate or further the stigma associated with meds. And I don't just mean that in the sense of keeping your medication regimen secret. Most of us do so in another way altogether that we're largely unaware of.

The fact is, most people have some kind of internal barometer when it comes to medications - which ones they are willing to take, and which ones they're not.
Continue Reading

ADHD drugs

Medicating Class Cut-Ups But Overlooking the Rest

This weekend a mother published a New York Times column about how her son came to be diagnosed with ADHD and became a member of the ballooning "Ritalin Generation."

"Just a little medication," the teacher told the boy's mother, "could really turn things around" for the boy, who was having trouble focusing on class worksheets and lining up quietly for transitions between classes.

When the mother firmly responded that she and her husband weren't going to medicate their son, the teacher backtracked, sounding mock-horrified.

She wasn't explicitly suggesting medication, she said. The law prohibited such a thing. She just didn't want him to fall through the cracks - and thus was was merely suggesting the boy's parents have him evaluated by a psychologist.

The boy was evaluated, and sure enough, he ended up on Ritalin for a short-time, though he quit it on his own a year later, matured out of his former inattentiveness, and eventually ended up a well-adjusted, school-loving honor-roll student - and medication-free.

Such stories are commonly invoked as cautionary tales about the alleged over-diagnosis of ADHD and other behavior disorders and over-prescribing of drugs like Ritalin to keep children's behavior in check. Teachers recommending meds for disruptive students often feature prominently. In fact, the debate over school involvement in medicating disruptive children showed up as early as the early 1970s.
Continue Reading

ADHD drugs

The Hidden Costs of Medication

Psychiatric medications have a lot of potential hidden costs.

We don't know, for example, how taking them from a young age affects long-term brain and psychological development in kids. They have myriad of side effects, some serious, like diabetes, high cholesterol, neurological impairment and birth defects when taken in pregnancy. They carry stigma, both from others and self-imposed.

But I'm not talking metaphorically about costs here. I'm talking straight-up financial outlays. Taking psychiatric medications can really add up, even for those who have health insurance, and even when they can take generic instead of brand-name drugs.

One big reason is the so-called "medication merry-go-round."
Continue Reading

Abuse and diversion

Taking Meds, Being Judged

With all the attention on the misuse of psychiatric drugs, I think it's worth taking a look at how the increased scrutiny affects people who have a diagnosis and a legitimate prescription.

I don't mean to suggest that just because someone has been diagnosed and a doctor has seen fit to prescribe her medication that she necessarily needs the meds - or even that she "should" be on them. Plenty of people have unjustified diagnoses and unneeded prescriptions.

But for those who do benefit from treatment, you've got to wonder how all the media attention affects their experience.

Continue Reading

Antidepressants

How Psych Drug Studies Shortchange Kids

For years, researchers and health policy experts have been charging that psychiatric medications aren't adequately tested in children - and a new study gives some powerful ammunition to that critique.

The study, from Pediatrics, looked at clinical drug trials between 2006 and 2011, involving five conditions that cause the greatest "disease burden" for children, as measured by a rating that counts the total years of healthy life lost to disability.

In high-income countries like the United States, three of the five conditions with the highest disease burden among kids were psychiatric disorders: depression, bipolar disorder and schizophrenia.

But of the drug studies to treat those conditions, disproportionately few involved children.

The lack of trials is troubling because children and adults don't necessarily respond to medication in the same way. With psychiatric drugs, that's a potential problem both for physical reasons - and for psychological and developmental ones.
Continue Reading

Antidepressants

Could Meds Make It Harder To Take the Heat?

New York, like much of the country, was mired in a massive heat wave for much of this week. Everyone was complaining that they could hardly stand to go outside - the heat index was 100 degrees. Once high temperatures set in, I began feeling particularly faint and achy, like I was getting sick.
At first, I figured I was about to get a migraine, since I often feel like this before a particularly bad one. But no big headache arrived. Then I figured I was getting the flu. But I didn't have other symptoms, like a sore throat or an upset stomach.

And then, I read an article online from the Philadelphia Inquirer about how heat and certain medications affect how well the body can regulate its own temperature, making people who take them more susceptible to extreme heat.

I knew that people who take lithium as a mood stabilizer have to be careful in the heat. The drug has has a narrow therapeutic range and can reach toxic levels in your system if you get dehydrated, something that's much more likely to happen in hot weather.

But it was news to me that other psychiatric drugs, including the antidepressants I take, could alter the body's ability to regulate its temperature.
Continue Reading

ADHD drugs

Do Meds Reduce the Risk of Being Bullied – or Increase It?

In a recent post, I explored the question of whether meds can help reduce bullying behavior in kids with psychiatric conditions, since they are more likely to bully peers than kids without such problems.

But research shows that kids with psychiatric problems are also more likely to be bullied - and that those who are bullied are at elevated risk of suffering from psychiatric disorders later on.

In my own research for my book on young adults who grew up taking psychiatric meds, I was struck that almost everyone I interviewed reported having been bullied during childhood or adolescence (some also reported bullying other kids).

So how does taking psychiatric meds affect the likelihood of kids being bullied? Do the drugs enhance kids' self-esteem and behavior so that they're less likely to be picked on? Or do kids get teased because they take meds?
Continue Reading