Pubdate: Thu, 25 Nov 1999
Source: New York Times (NY)
Copyright: 1999 The New York Times Company
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 hyperactive disorders.

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

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

"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 more pragmatic.

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 staggering."

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 be right.

"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 going on."

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 worse.

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

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

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."
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