Drugs - First Option or Last Resort for ADHD?

The above is the question being asked in a July 12, 2008 article on the Australian news website News.com.au. The article starts off by reporting that the Australian Federal Government has officially endorsed drugs, such as Ritalin, as the "first-line treatment" for children with ADHD.  The article also reports that the Australian government's recommendations say that, "Parents have also been warned to ignore alternative treatments, such as diet and exercise, which the guidelines claim have 'limited or no benefit' in treating ADHD".

This endorsement brought harsh criticism from many groups including the Australian Childhood Foundation, an advocacy group and charity that provides programs for children and parents. Their stated goal is to strengthen community responsibility for promoting the well-being and protection of all children throughout Australia. 

Dr Joe Tucci, CEO of the Australian Childhood Foundation noted in the article that it was dangerous to believe medication was the only answer, and commented, "It should be the last resort rather than the first. I think these guidelines will make over-prescription worse. The premise of prescribing medication as the first intervention ignores the causes of ADHD."

The recommendations for drugs first was due to a set of draft guidelines compiled by the Royal Australasian College of Physicians.  The guidelines do warn against giving toddlers Ritalin or longer lasting drugs such as Concerta.

Dr. Jeanne Ohm, a chiropractor and president of the International Chiropractic Pediatric Association also weighed in on the argument by stating: "Today, parents are becoming more informed about health care choices for their families and are no longer interested in using potentially harmful drugs as treatment. More and more parents are recognizing that making improvements in their families' lifestyle is a safer and more effective way of restoring health and well-being. Nutrition, exercise, emotional behavior modifications are safer modes of care that work with the body's ability to be well.

Dr, Ohm continued by adding, "Chiropractic care is another form of care gaining popularity with families because it works to reduce nerve system stress and enhance normal body function. In one large study evaluating more than 10,000 visits, parents reported chiropractic care for their children to be gentle, safe and effective. The preliminary results showed improved sleep, more pleasant behavior and an increase in immune system function in their children. I encourage parents to make informed health care choices for their children and to determine health care choices that support their children's natural, inherent ability for well-being."

Dr. Tucci argued that the research being done is only on drugs and is funded by drug companies, "The research has been mainly conducted by drug companies who have millions invested." He noted that no other research on other means of treatment is being conducted due to lack of funding, "Research into the other treatments isn't backed."

In an ironic admission, the chair of the ADHD guidelines working group, Associate Professor David Forbes agreed that not enough research had been done into alternative therapies.  However, he defended the working groups recommendations by saying, "No one is saying kids go on medication and stay on it," he said. "There wasn't the evidence to support a positive reaction (for diet and exercise)."

The article points out that the reality may be far different as children are being kept on these drugs for long periods.  Leanne Komaromi, a mother interviewed for the article summed up the reaction of many to the Australian Governments recommendations by saying, "Parents should look at alternatives rather than accepting the first thing the doctor says," she said. "My doctor would have kept Dominic on medication till kingdom come."