So many people are popping Ritalin pills in Idaho that the state ranks No. 1 in the nation for per capita consumption of the drug.
“I wonder why the kids in Idaho have these problems that the kids in L.A. or New York or Miami don’t have,” asked Gary Domeny, chief investigator for the Idaho Board of Pharmacy. “Is it something in the air?”
No study has pinpointed the reason why Idahoans are more likely to use the easiest method to treat children with Attention Deficit Disorder (ADD).
People typically blame Idaho’s high number of children per family, rural setting and lack of resources.
In 1988, the Idaho Board of Medicine concluded the state’s penchant for big families was the reason it ranked fifth nationally in Ritalin consumption at that time.
Out of every 100 Idahoans, 22 are school-aged, the group that uses the most Ritalin. In auditing thousands of patient visits, the board found “children are being carefully and appropriately treated” for ADD.
Since then, the doses of Ritalin flowing into the state has become a swift-running, ever-rising current. Idaho attained the No. 1 ranking in 1991.
Yet, even after considering the state’s large child population, Idaho still gobbles up Ritalin tablets like they’re potatoes.
Utah has the highest percentage of children and used to be the top Ritalin consumer. But for the last several years, consumption remained flat there.
“Stories in the press led practitioners to switch to other drugs,” such as Dexedrine, said Steve Davis, chief investigator for Utah’s pharmacy board. Utah ranks high in its consumption of other stimulants, he said.
Lack of money combined with Idaho’s rural nature may offer another explanation.
Class sizes in Idaho are some of the largest in the nation, and the state spends less per student than 45 states.
School psychologists and behavior specialists say they often are overwhelmed, and few schools have nurses.
Teachers complain they are worn down by a few difficult students, and cannot spend as much time teaching.
These pressures may lead educators to assume a difficult child has ADD, increasing the number of referrals to doctors for medication.
“What worries me, as funds for education have decreased, there’s not as much money for schools to do a thorough investigation,” said Mark Stein, an ADD expert with the University of Chicago.
Centralization of special services in a few urban pockets also contributes to a reliance on medication over other forms of therapy, suggested Laurie Wilson, psychology professor at the University of Idaho.
“It’s not that they’re bad kids, but they need specific treatment and that may not be available in rural areas,” she said.
Lack of resources does not explain why wealthier communities, such as Sun Valley, tend to use more Ritalin than their poorer cousins.
That kind of statistic leads critics to call Ritalin a chemical restraint, used to control bad behavior that’s dressed up as a neurobiological disorder.
, DataTimes ILLUSTRATION: Graphic: When it comes to Ritalin, Idaho is No. 1
MEMO: This sidebar appeared with the story: FOR MORE INFORMATION “Attention Deficit Hyperactivity Disorders Handbook.” A Washington task force wrote these guidelines for diagnosis and treatment. Includes tips for teachers. Published March 1994. Free. Order from state superintendent’s office, Old Capitol Building, P.O. Box 47200, Olympia, Wash. 98504-7200. Or call 1-360-753-6733. “Education of Children with Attention Deficit Disorder.” This kit from the U.S. Department of Education includes two videotapes and tips for parents and teachers. Costs $55, including shipping. Order from the Council for Exceptional Children, 1920 Association Drive, Reston, Va. 22091. Or call 1-800-232-7323. A catalog of books, audio tapes and videotapes is available from the ADD WareHouse. Call 1-800-233-9273. CHADD (Children and Adults with Attention Deficit Disorders) publishes fact sheets, a newsletter and a magazine with the latest research and news about ADD. Sponsors annual conferences. Individual membership costs $35. Call 1-305-587-3700. National Attention Deficit Disorder Association provides a list of resources. Write NADDA at 42 Way to the River, West Newbury, Mass., 01985. Or call 1-800-487-2282. Children First! holds dissenting views from the mainstream concerning ADD and its treatment. Membership to Children First! is $25. For more information, write the Center for the Study of Psychiatry, 4628 Chestnut St., Bethesda, Md., 20814.