Update #2: The Behavioral Drug Continuum

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What can I say, articles on what I am calling the Behavioral Drug Continuum (which I blogged about in my post of 04.15.14) are coming fast and furious. Here’s one by Allen Frances, professor emeritus at Duke University. Professor Frances was chairman of the DSM-IV task force. His article is entitled:

My Prediction: The ADHD Fad Is About to Fade

Consider this quote from Frances’ article:

Teachers may also encourage the excessive diagnosis of ADHD, particularly when working in school systems that are chaotic (with classes that are too large, and insufficient gym periods for letting kids blow off steam).

In the next quote Frances talks about the connection between big pharma and the ADHD diagnosis. As talked about in Gary Goldberg’s book The Book of Woe: The DSM and the Unmaking of Psychiatry, Frances led the charge to uncover the connection between big pharma and ADHD research.

The drug companies will not give up their $10-billion-a-year stimulant cash cow without a fierce fight. They have the motive and the means to massively and misleadingly market ADHD and will try to expand its customer base by making it as ubiquitous in adults as it already is in kids. And Pharma is one of the most powerful lobbies in Washington: It has successfully bullied our government to allow direct-to-consumer drug advertising that is banned in almost all other countries.

One last quote. Frances makes the same point Russell Barkley makes in his book Executive Functions: using behavioral drugs to treat attention disorders is not very effective. As Barkley points out, behavioral drugs do control behavior, but they do very little as far as developing Executive Functioning. EF skills—planning, delaying gratification, empathy, perspective taking, mental time travel, etc.—are what allow the individual to appropriately channel attention. It’s sad that behavioral drugs keep us from the very skills that could save us from attention disorders.

Studies show that stimulants are much less effective than we originally thought in improving long-term school performance.