`Zombie drug' doses soaring

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The Independent Online
THE HEALTH service is spending millions of pounds on a drug for disruptive children which critics fear is creating classrooms of sedated "zombies".

The number of prescriptions for Ritalin, an amphetamine-type drug that calms hyperactive children, has risen from 2,000 in 1991 to 92,000 last year. MPs, backed by paediatricians, have called for an inquiry by the Health Secretary into why this is so, and whether prolonged use can have damaging effects on learning and behaviour.

The drug, available since 1957, is being prescribed to teenagers and children as young as five years old. The NHS bill for Ritalin was pounds 1,636,000 last year and is expected to rise beyond pounds 2m in 1998.

Doctors say it is used more widely in towns and areas with social deprivation, low incomes and high crime rates.

Families with children on Ritalin may also qualify for disability living allowance of up to pounds 34 a week. Special needs teachers, who work with difficult children, say that some parents regard this as an incentive to push for the drug.

"My experience of a few children taking Ritalin is it is successful [but] if they take too large a dose they can become sleepy," added one special needs teacher. "I have heard one teacher describing them as too quiet and passive and unresponsive - zombified."

Ritalin, whose chemical name is methyl phenidate, is designed to calm down children with Attention Deficit Disorder. It works on the part of the brain that controls anti-social behaviour, and increases their ability to pay attention.

But doctors fear that naughty children with no medical problems may be also being dosed to keep them under control, such as those whose behaviour could be stemming from abuse or neglect.

They also fear that disruptive children are being given the drug as an alternative to exclusion from school and costly counselling courses.

"A lot of paediatricians feel very unhappy about this. They are very reluctant to prescribe mind-altering drugs," said Dr Harvey Marcovitch, of the Royal College of Paediatrics and Child Health. "Many of us are very sceptical about the causes of hyperactivity. Some people say it is a product of learning and relationships and watching too much TV."

Doctors say that a shortage of child psychologists, health visitors and social workers has led to a breakdown in the support for problem children.

They are worried that children are being drugged because of lack of help for short-term behavioural difficulties, and that some GPs are not seeking the proper professional advice before prescribing.

"Serious emotional disturbance is extremely common in children. All the surveys show this and it is often short-lived," said Dr Duncan Keeley of the Royal College of General Practitioners. "There has been a disappearance of social services targeted at needy children. Poverty among children has increased, family breakdown rates are up, and so all the circumstances likely to lead to behavioural disorder in children."

Around 7,000 children are believed to be taking Ritalin every day, although exact statistics are unavailable.

Primary school teachers are being asked to assess the progress of children on the drug and administer it every few hours. Yet teachers' unions object to this.

"Our advice to teachers is completely clear," said a spokeswoman for the NUT. "They shouldn't be involved in giving drugs to children unless they are properly trained."

The long-term effects of Ritalin are unknown, although the side effects for children diagnosed by child psychiatrists as having Attention Deficit Disorder are minor.

Angela Smith MP, who has been contacted by concerned constituents about the drug, is today writing to Frank Dobson asking for an enquiry into the steep rise in prescriptions.

"I am sure when doctors are doing this they are acting in the best interest of the child," said the Labour MP for Basildon. "But when we see such an alarming increase around the country we ought to be finding out what the root cause of the problem is, and not just treating the symptoms."