From school to work, we are socialized to respect authority and follow directions. From a young age, children are given medications to help them pay attention and be productive. But for whose benefit is this productivity? This coveted value of the capitalist system is prized by bosses in the workplace and reproduced by parents at home.
Stimulants such as Adderall, Focalin, Ritalin, and Concerta can help solve the problem of inattentiveness. When done thoughtfully, medications can be used as a helpful tool. But on a societal level, too often we have used medications as a way to dull undesirable qualities of diagnosis.
Parents and teachers both express on a consistent basis that they are concerned with student behavior in school. But anyone who has been through grade school can attest to how the words “boring”, “prison”, or “busywork” often are used to describe what school feels like.
It is unclear to me which is the chicken and the egg. Have there really been more diagnoses of ADHD, for which stimulants should be prescribed? Or does the way we educate our children breed behavior and attention issues, to which stimulants mask a larger problem?
In 1990, when mass testing was first identified as a viable policy option, it was reported that stimulant use for school-age children grew almost 6 times, from 600,000 to 3.5 million. In 2009, as the No Child Left Behind (NCLB) law was well under way, about 1 in 12 children were diagnosed with ADHD, and over half of them took stimulants as a form of treatment.
Companies who design and produce standardized tests have also profited from government mandated testing. Standardized testing policies routinely break up community learning environments, tying high test scores to school funding, teacher salaries, and more.
It is true. Disregarding cultural and wealth gaps, students given stimulants perform better on tests, a 2009 government-funded study found. This smells like another quick fix to education and mainstream disability, as opposed to actually looking at system-level factors for poor test scores.
The reckless distribution and overmarketing of medication for ADHD mirrors in an interesting way the opioid epidemic. This capitalist society, saturated with oppression and despair, is a breeding ground for mental health conditions. But because of the constraints of the health care system, doctors are quick to prescribe medications for an issue brought up by a patient, or parent, instead of really listening to them and figuring out long-term solutions. This is evident in the short duration of doctor’s visits, which neglects important psychosocial determinants of health, and can be even more costly because of referrals and tests.
On an individual level, people regardless of age can benefit from prescription drugs to help them regulate all sorts of biological and chemical processes. But by overprescribing medications, the creative aspects of ADHD can be dulled. When you zoom out, mass medicating starts to look similar to social control.
Are people with ADHD literally on a different wavelength? According to a 2016 Japanese study, the answer is yes. People with ADHD respond well in situations that confuse others, such as a crisis. It is no wonder that many EMTs and emergency personnel could have ADHD! There is a relationship between this notion and the “inattentiveness” and fidgety phenotype that most people associate with the condition at baseline. Some people with ADHD also report feeling more able to adapt to COVID conditions. This correlates with the idea that people with ADHD are also more adept at functioning during crises in general, because their brains are always spinning at quicker rates.
In the before-times, as they are called, neurodiverse folks have had to cope with an ableist world with certain rules and expectations. Now that the rules have changed, people have had to find new solutions and methods of interacting. It is this type of out-of-the-box creativity that people with ADHD excel at. Why would we want to inhibit that with overmedication?
All drugs, prescription or otherwise, have side effects. As social workers, it is incredibly important that we listen to our clients talk about their relationship with drugs, including how they feel when they’re medicated, and what their reasons are for using. As I state in my previous article, “It’s About the Relationship”, our clients know themselves best. Only they can say how different dosages or medications affect them. Drugs are only one part of the bigger picture.
Of course, there must be Macro changes in addition to Micro considerations. While clinicians work with individuals and groups, healthcare and education policy must both reorient themselves for the future, by learning lessons from the past. Project-based learning (PBL) in schools can take the place of standardized testing for assessment, which reduces the effect of language barriers and inattentiveness. While we should still be thinking about preventative health, we should envision what future healthcare practice looks like by incorporating racial and environmental justice, and public health measures into care.
Medications specifically, and drugs generally, can serve as a way to medically intervene in a short amount of time in a potentially evidence-based way. But one question to ask is who controls the narrative on what is an licit/illicit drug, and who has the power to legalize substances. They serve as a tool to either get ahead in a competitive world, or to explore an alternate reality. But we must get to the [square] root of the problem: Capitalism breeds drug abuse. With Adderall, have you had it all?