Wednesday, October 17, 2012

Doping is Cool in School

bike doping

recent article in the New York Times brought up the subject of performance-enhancing drugs, but not in the way we usually think of them, which is for sports. No, this article highlighted a not-so-secret use of stimulant drugs: prescribing them for children who do not have ADD/ADHD, but who are struggling in school. The article was fairly non-judgmental and focused mainly on one doctor in rural Georgia who sees a lot of underprivileged kids, who, in his words need the drugs because they are "mismatched with their environment." For support and contrast, the article included other doctors, as well as educators, from across the country to weigh in on this surprisingly (to me) common use of stimulant drugs.

This particular doctor's rationale for prescribing ADD drugs to kids who don't have ADD is that he feels these drugs can help to make up for deficits elsewhere in the system, such as a lack of funding for tutors or aids that could address the kids' issues through more labor-intensive behavioral strategies. Another doctor was quoted as saying:

“We as a society have been unwilling to invest in very effective nonpharmaceutical interventions for these children and their families,” said Dr. Ramesh Raghavan, a child mental-health services researcher at Washington University in St. Louis and an expert in prescription drug use among low-income children. “We are effectively forcing local community psychiatrists to use the only tool at their disposal, which is psychotropic medications.”

That article was thought-provoking in and of itself. But when you combine that news with the United States Anti Doping Agency's indictment of the Lance Armstrong doping situation that emerged at roughly the same time, well, you have sort of schizophrenic situation. Apparently doping is good in some situations, and bad in others. After all, here are two different uses of performance-enhancing drugs. One is an example of professional athletes using drugs to make up for limitations of the human body. The other example is of students using drugs to make up for limitations in their school systems.

Is there a difference?

According to the doctors, educators and some parents, there is. After all, Lance Armstrong's team was stripped of all their medals and banned from their sport because they used performance-enhancing drugs. Conversely, struggling kids without ADD are being encouraged to use performance-enhancing drugs in order to compensate for shortcomings not in themselves, but in their academic settings. Performance-enhancing drugs, mind you, that are categorized by the Drug Enforcement Administration as Schedule II Controlled Substances because they are particularly addictive. From the NYT:
"The superintendent of one major school district in California, who spoke on the condition of anonymity, noted that diagnosis rates of ADHD have risen as sharply as school funding has declined. "It's scary to think that this is what we've come to how not funding public education to meet the needs of all kids has led to this," said the superintendent, referring to the use of stimulants in children without classic ADHD."
Doping kids appears, at least in the short term, to enable struggling kids who don't have ADD/ADHD to keep up with the baseline of what they need to learn. But I can't get over what it says about us as a society - that we would choose to medicate kids who don't really need those strong medications* rather than fund our schools to the extent that those students could get the appropriate support to help them learn. Support that could supply them with behavioral modification and cognitive tools that could serve them throughout their lives. And, here's a nasty truth: Even while these marginalized kids are maintaining, kids at the top of the heap are using the same drugs illegally to vault into the stratosphere of GPAs and test scores. So the drugs still are not leveling the playing field.

If we, as a society, decide that it is OK to dope some kids, how do we decide? The doctor in the article says he does not prescribe stimulants to students who make As and Bs, so he draws his lines along grades. I have not heard or read how team physicians make the distinction as to whom to dope, but I imagine it is the higher performers who have a real chance at breaking records that use performance-enhancing drugs. So if we should try to create guidelines as to when and for whom it is appropriate to dope based on that reasoning, the resulting guidelines might look like this:
  • High-performing academic kids [without a diagnosis of ADD] from well-funded schools should receive drug testing, and those who are found using stimulants should be stripped of their academic awards, college scholarships, and acceptances into elite professionals schools.
  • Lower-performing cyclists who have not benefited from optimal training opportunities would be able to use performance-enhancing drugs in order to make up for the deficits in their training systems.
Of course, those "guidelines" are tongue in cheek and I don't expect them to really happen (but after thinking about it, the first bullet might be worth considering). I only pose them to prove a point about our society's inconsistency when it comes to drugs.

However, what should not get lost are the needs of students who could benefit from "extras" that some schools can provide, but that many, increasingly, cannot. If we can't come up with the money and support to address their learning in the optimal way, then what are we going to do? It seems, at least to a handful of doctors, that we'll medicate those kids until they graduate from high school, then we'll let them figure it out for themselves.


Image courtesy of Wikimedia Commons.

* You don't have to read too far into the comments after the NYT article to read lots of testimonies from people whose lives were changed for the better once they began using medications. So, clearly, if a student has ADD/ADHD, medications are an option that should be considered.

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