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A response to the New York Times Article: Ritalin Gone Wrong

Alan Sroufe’s article “Ritalin gone Wrong” had some very important points around treatment decision-making for ADHD. Unfortunately, because it was presented in a somewhat negative way, the feeling of alarm and fear were the resounding take-home messages. In contrast, Ned Hallowell’s response demonstrated a much more empowering message of where medication fits in with treatment and is definitely worth a read.

Of course, Springboard Clinic strongly supports that “we must rely less heavily on drugs”: full stop. Many patients arrive at our door step with the experience of having tried multiple medications for their ADHD symptoms, and describe feeling frustrated that the medications did not do more for their well-being. Very few of these have been involved in a multi-faceted treatment program. The medication can kick start change, can motivate confidence to push through skills development, and can help focus on executive function tasks that require more effort by the pre-frontal cortex. Medication can help them focus, but they still require the necessary knowledge, skill development and confidence to truly achieve their potentials.

We say to patients and clients: if you find the right medication, it will help you only 30%. It will be a key piece in helping you develop strategies and build skills but it should never be used as a “quick fix.” There are many who describe a more dramatic, positive experience with medication, saying that a “fog has been lifted” and they can finally think clearly. Some benefit in the short-term and others long-term. But never does it take away ADHD or act as a comprehensive solution.

A few excerpts from Dr. Ned Hallowell’s response are worth noting:

“No clinician worth his or her salt believes that all problems can be cured with drugs. But neither does a responsible clinician deny the good that medications can do. When people ask me, ‘Do you believe in Ritalin?’ I reply that Ritalin is not a religious principle. Ritalin like all medications, can be useful when used properly and dangerous when used improperly. Why is it so difficult for so many people to hold to that middle ground?”

“Used properly, Ritalin is safe, safer than aspirin. As to its long-term use, apply common sense. Use it as long as it is helpful and causes no side effects. That may be for a day, or may be for many years”.

“But that is not to say,” as Dr. Sroufe does, “that Ritalin has ‘gone wrong’.” We may go wrong in how we use it, when we over-prescribe it, or when we use it as a substitute for love, guidance and the human connection. But as long as we use it properly, it remains one of our most valuable – and tested—medications. Going all the way back to the first use of stimulants to treat what we now call ADHD in 1937, stimulants have serves us well as one too—not the tool—for helping children and adults learn how to strengthen the brakes of their race car brains and become the champions they can be”

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