November 25, 1999
Behavioral Drugs Focus of Debate in Colorado
By MICHAEL JANOFSKY
ENVER -- A
resolution recently passed by the Colorado Board of Education to
discourage teachers from recommending behavioral drugs like Ritalin
and Luvox has intensified a national debate over the growing use of
prescription drugs for children.
The resolution, the first of its kind in the country, carries no
legal weight. But it urges teachers and other school personnel to use
discipline and instruction to overcome problem behavior in the
classroom, rather than to encourage parents to put their children on
drugs that are commonly prescribed for attention deficit and
Proponents of the resolution, which passed by a 6-to-1 vote on Nov.
11, said they were motivated, in part, by evidence that they said
suggested that dozens of violent crimes, including the massacre last
spring at Columbine High School in Littleton, Colo., had been
committed by young people taking psychotropic drugs.
One of the teenage shooters at Columbine, Eric Harris, had been
taking Luvox, an anti-depressant, although there is no evidence that
the drug had anything to do with the shootings or that a teacher
recommended the use of the medication.
Patti Johnson, the school board member who organized a hearing on
the issue and proposed the resolution here, conceded that only a small
number of teachers in Colorado had ever insisted on a child taking
prescription drugs as a precondition to returning to class. But the
resolution, she said, was largely intended for them.
No other states are considering a measure similar to the one in
Colorado, where an unusual set of circumstances played a role in the
passage of the resolution: an elected and fairly conservative school
board responding, in part, to the outcry from one of the nation's
worst school shootings. But the resolution reflected broader issues,
as well, as parents, mental health professionals and school officials
debate the use of behavioral drugs by more than 2.5 million children
in the United States.
Experts in mental health issues point out that children who take
the drugs do so because they were having difficulties to begin with.
They acknowledge that impulsive or violent behavior is a side effect
in a small percentage of people taking the drugs.
Arguing that a majority of the children who use the drugs are
benefiting from them, these experts contend that the Colorado
resolution is irresponsible and perhaps even dangerous in that it
could lead school personnel to ignore signs of serious mental
disorders in children and that it would discourage communication
between teachers and parents.
"I hope what happened in Colorado is the exception and not the
rule," said Michael M. Faenza, president of the National Mental Health
Association, a consortium of advocacy groups for the mentally ill,
conceding that he fears other states and school districts might
replicate Colorado's efforts
"Holding up psychotropic medicines as the possible cause of violent
behavior is absurd," Faenza said. "There's a wealth of information to
show that they have helped dramatically."
The use of Ritalin and other psychotropic drugs has steadily
increased among schoolchildren, according to Children and Adults with
Attention Deficit/Hyperactivity Disorder, a national nonprofit
organization known as CHADD, in Landover, Md.
In Colorado, increased usage has turned a new focus onto the role
that teachers and administrators play in the lives of students. It has
also pitted experts who say use of the drugs is growing because they
are beneficial against those who contend parents and teachers are too
quick to seek out prescription medicine as the simplest way to treat
children with behavioral problems.
Ms. Johnson said in the five years that she has been on the board
she has received "numerous complaints" from parents who claimed a
teacher had insisted that their child go on Ritalin or another drug
before returning to class.
Ms. Johnson recounted the case of one girl who was showing signs of
attention deficit disorder through mood swings and napping in class.
She said the girl was later diagnosed with hypoglycemia and needed to
change her diet. According to the girl's parents, Ms. Johnson said,
the teacher told them, "You need to get her a prescription for
As a result of the complaints, she said, a resolution was written
to remove school personnel from any medical decisions. She said the
board, which is comprised of six Republicans and one Democrat, passed
the resolution along party lines with minimal debate.
The lone Democrat, Gully Stanford, did not return a telephone call,
"The resolution does not stop teachers from communicating with
parents," Ms. Johnson said in an interview. "What it does do is stop
teachers from giving parents an ultimatum: 'Put you kid on a drug or
we're not going to teach them.' That can't happen any more. It's
Brenda Welburn, executive director of the National Association of
State Boards of Education, said Colorado is one of only seven states
that elect a board of education. Those boards, she said, tend to be
Ms. Welburn added, however, "I agree that too often the first
answer for children with some behavior problem is to reach for
medication. Some of the numbers we are seeing for medication of
children are staggering."
Julie Underwood, general counsel of the National School Boards
Association, said she knew of no other school board examining the
question. Ms. Underwood added that while many are concerned about
overmedication, "We would be reluctant to support such a resolution
because there are children who may need such services, who may benefit
from the medication."
Dr. Stephen M. Stahl, a professor of psychiatry at the University
of California in San Diego, said that because of the complexities of
mental disorders and the rapidly changing personalities of children as
they grow older, both sides of the psychotropic debate may be right.
"There's no blood test for this," Dr. Stahl said. "It's not
objective. If a kid is acting out in class and a stimulant like
Ritalin calms him down, it would be immoral not to give him the
"But the problem comes," he added, "when the stimulants don't work
and parents give them anyway as an excuse to avoid tough decisions or
talking with teachers and doctors to learn what's going on."
Another problem complicating the issue, Dr. Stahl said, is the
location of the school. Typically, he said, in poor areas, mental
disorders are underdiagnosed, and often in more affluent school
districts, children are overdiagnosed, sometimes making a bad
Besides complaints from parents about insistent teachers, Ms.
Johnson said she was also motivated to propose the resolution by the
violent crimes involving young people, in which investigators said the
perpetrators were using psychotropic drugs.
Accounts of those incidents also persuaded a Colorado state
lawmaker, Penn Pfiffner of Lakeland, to hold a separate hearing on the
prescription drugs issue, which, by coincidence, came two days before
the school board voted on Ms. Johnson's measure.
Dr. Peter R. Breggin, director of the International Center for the
Study of Psychiatry and Psychology, a nonprofit research organization
in Bethesda, Md., testified at both hearings and said doctors have
become too eager to prescribe psychotropic drugs at the expense of
conversations among parents, teachers and children to learn why
children are acting in antisocial ways.
"It's a tremendous mistake to subdue the behavior of children
instead of tending to their needs," Dr. Breggin said in an interview.
"We're drugging them into submission rather than identifying and
meeting the genuine needs of the family, the school and the
community," Dr. Breggin said. "It's wrong in principle."
Citing Harris and other young killers who were found to be taking
Ritalin and other drugs, Dr. Breggin said he was convinced there was a
direct link between the drugs and violent acts.
Cohen of CHADD and others said the resolution might inhibit
teachers from applying common sense and experience in the case of a
troublesome child by merely telling parents something is wrong without
offering a full range of possible solutions.
"If a child has hearing or vision problems that the teacher
identifies, we would expect the teacher to talk to the parents," said
Jeanne Mueller Rohner, executive director of the Mental Health
Association of Colorado, which opposed the resolution. "It should be
the same thing for mental health."
Opponents of the measure also said they were uncomfortable with the
ardent support offered the measure by the Church of Scientology
through an affiliate organization, the Citizens Commission on Human
The president of its American branch, Bruce Wiseman, who described
the commission as a "psychiatric watchdog group," testified at both
hearings and urged rejection of Ritalin and other drugs as a solution
to troublesome behavior.
But Ms. Johnson, as well as Pfiffner, said the organization's
support was not a critical factor in any of their actions.
But in the end, said Andrea Giunta, president of the largest
teachers' union in Denver, it might not matter.
By the time most children are diagnosed with an attention deficit
or hyperactive disorder, Ms. Giunta said they have been observed and
analyzed by a team of experts, including teachers, nurses, counselors
and school psychologists.
"A teacher shouldn't recommend a specific course of action," Ms.
Giunta said. "But what she can do is say, this has been my experience
with other children when they have displayed this kind of behavior.
What you do is up to you."