Tag Archives: stimulants

Driving Under the Influence of Stimulants

On April 22, I published a post on this general topic.  In that article I pointed out that the notion of stimulant prescription drugs improving the driving of people who “have ADHD” was gaining traction.

Since than I have come across two articles on this subject from Australia.  (Thanks to Nanu Grewal for the links.)  Both articles appeared in the Sunshine Coast Daily, and you can see them here and here.

Apparently in 2009, four people, including five-year-old twin girls, died in a two-car accident.  The driver of one of the cars had been prescribed dexamphetamine for the treatment of ADHD by a local psychiatrist, and was found to have had six times the prescribed dosage of dexamphetamine in his system at the time of the crash.

In the first article, dated October 2011, two years after the accident, it was noted that the psychiatrist’s prescribing practices were under investigation.  But the general manager of the psychiatric hospital where the psychiatrist practiced is quoted as saying that none of the allegations had been substantiated.

“Not one shred of evidence against anyone has been unearthed.”

The article also quotes Michael Cleary, Queensland acting chief health officer, as saying

“An analysis of available medical evidence has found that under-medicating is potentially more dangerous than prescribing higher doses, particularly when expert physicians consider a higher dose is appropriate”

So if an “expert physician” (presumably a psychiatrist) says that it’s OK to drive stoked to the gills on speed, then it’s OK!

The second article is dated July 2013, four years after the fatal accident.  Here it is reported that the prescribing psychiatrist whose practices had

“…been the subject of complaints by colleagues and nurses for many years, has had severe restrictions placed on his right to practice.”

 It is also reported that two nurses who were fired after

“…repeatedly raising concerns” about the psychiatrist were planning to sue for reinstatement.

What’s noteworthy about all of this is that, firstly, it took four year and persistent pressure from the dead girls’ father before some kind of action was taken against this psychiatrist.  Secondly, there had evidently been multiple complaints about this psychiatrist, but they were ignored by the hospital

. . . . . . . . . 

The idea of prescribing stimulant drugs to people who drive motor vehicles has always seemed problematic to me.  I worked for five years in the chemical dependency treatment area, and I have heard more horror stories about driving under the influence of stimulants than I care to remember.  Today the notion is gaining credence that stimulant drugs improve driving performance in people who “have ADHD.”  All of the research that supports this notion was industry sponsored , and most was conducted in simulators and under artificial conditions.

In real-life driving, it has to be recognized that stimulants are addictive drugs.  School children sell them to their classmates for recreational use.  Adults buy them illegally on the street.  People who receive them on prescription sometimes save them up for a weekend binge.  How many traffic accidents today are stimulant-induced?  How much of the frenetic, aggressive driving that we see on our highways stems from the use of these products?

There is a movement in most western countries today to combat drunk driving, and this is having considerable success.  In this context, psychiatry’s contention that people who “have ADHD” drive better under the influence of stimulants has to be seen as a major step backwards.

Is there truly no limit to what psychiatry will do to sell drugs and enhance their own perceived importance?

The Sandcastle Continues to Crumble: ADHD Does Not Exist

BOOK PREVIEW

Richard C. Saul, MD
ADHD Does Not Exist:  The Truth About Attention Deficit and Hyperactivity Disorder
Publication date:  February 18, 2014

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Those of us on this side of the psychiatry debate have been saying for decades that the condition known as ADHD is not an illness, but is rather an arbitrarily delineated cluster of vaguely defined problems that children have acquired in various ways.  We have also pointed out that psychiatry’s labeling of this condition as an illness is simply another instance of their inexorable turf expansion, and that their widespread drugging of the individuals so labeled is destructive and disempowering.

And, also for decades, psychiatry has been marginalizing us as unscientific mental illness deniers, who seek to put the clock back and deprive people suffering from this “illness” of the vital “treatment” that they so desperately need.

In recent years, we have seen some fracturing in psychiatry’s defenses.   Individual psychiatrists have been dissenting – sometimes very forcibly – against psychiatry’s philosophy that every problem is an illness and for every illness there’s a pill.

And now their voices are joined by Richard C. Saul, MD, an experienced and highly regarded neurologist who practices in the Chicago area.  He has written a book, ADHD Does Not Exist:  The Truth About Attention Deficit and Hyperactivity Disorder, which is due out next month.  The book is sure to present a formidable challenge to the orthodoxy and practices of organized psychiatry, with regards to this particular “diagnosis,” that has seen an almost four-fold increase in prevalence from 1987 to the present day.

Kyle Smith, a journalist who writes for the New York Post, has written a promotional article on the book for the Post (January 4).  Here are some quotes from the article:

“After a long career treating patients complaining of such problems as short attention spans and an inability to focus, Saul is convinced that ADHD is a collection of symptoms…”

“Treating ADHD as a disease is a huge mistake, according to Saul. Imagine walking into a doctor’s office with severe abdominal pains and simply being prescribed painkillers. Then you walk away, pain-free. Later you die of appendicitis.”

“Adderall and Ritalin are stimulants, though, and the more you take them the more you develop a tolerance for them, which can lead to a dangerous addiction spiral.”

“The explosion in ADHD diagnoses and related prescriptions of stimulants is not without substantial costs. Potentially addictive drugs are not to be given out like Skittles.”

“‘I know of far too many colleagues,’ Saul writes, ‘who are willing to write a prescription for a stimulant with only a cursory examination of the patient, such as the ‘two-minute checklist,’ for ADHD.'”

“Two minutes to jot down a prescription may lead to years of consequences: short-term side effects of stimulants include loss of sleep, increased anxiety, irritability and mood problems. Over the long term, use of these drugs can lead to unhealthy weight loss, poor concentration and memory, even reduced life expectancy or self-destructive behaviors not excluding suicide.”

Dr. Saul’s debunking of ADHD as a disease entity should come as no surprise.  There was never a shred of evidence or valid reason for considering it an illness in the first place.  It became an illness the same way other psychiatric conditions became illnesses – by APA fiat:  Let there be illness, said the APA, and illness appeared everywhere.

It will be interesting to see how the APA leadership spin this.  I imagine that today they’re just reaching for the acetaminophen, but we can be sure that their ever-resourceful Office of Communications and Public Affairs will be all over it soon, and that our esteemed Dr. Lieberman’s fluent pen will be generating persuasive prose to reassure us that psychiatric diagnoses reflect real illnesses, and that there are vast unmet needs in this area.

The DSM’s so-called nosology is like a sandcastle on the foreshore.  The tide of scrutiny, particularly from survivors, is rising, and as the APA’s cherished edifice crumbles, organized psychiatry’s hold on reality becomes increasingly tenuous.