02/15/2001 – RISKING KIDS' HEALTH FOR SAKE OF SCIENCE – AT WHAT COST?

http://www.nypost.com/commentary/23654.htm

RISKING KIDS’ HEALTH FOR SAKE OF SCIENCE

Monday,February 12,2001

By DOUGLAS MONTERO

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AT WHAT COST?
Columbia’s Dr. Laurence Greenhill heads the Ritalin study.
– NYP: Rick Dembow

TWO city research institutions will extend their tentacles into our
communities today, looking for hundreds of kids, some as young as 3, to use
as guinea pigs.

The experiments, to determine the safety and efficacy of Ritalin in
preschoolers, have advocates up in arms – they think researchers are playing
fast and loose with the brains of children.

“Where’s the limit?” asked Dr. Ellen Isaacs, a member of the Coalition
Against the Violence Initiative, a grass-roots group in the Washington
Heights section of Manhattan. “Are they going to give it to kids in the
womb?”

The rationale of the nationwide experiment on the preschoolers seems noble –
Ritalin is already prescribed by doctors like lollipops without any sound
medical evidence to show that it’s safe for a child’s developing brain.

About 2 million kids nationwide, nearly a quarter-million of them between
ages 2 and 4, take Ritalin and other psychiatric drugs, according to a March
2000 report by the Journal of the American Medical Association.

The report inspired then-First Lady Hillary Clinton, who was a candidate for
the U.S. Senate at the time, to prod the White House to look at ways to stop
the alarming trend, and that translates into experiments. Some thought
Clinton’s motives were political, others applauded her.

The National Institute of Mental Health subsequently gave $6 million to a
consortium of six institutions, led by Dr. Laurence Greenhill of Columbia
University, to conduct the Ritalin study. New York University also is part
of the group.

Two-thirds of the more than 300 kids in the nationwide study called
Preschool ADHD Treatment Study (PATS) will be under 6 years old.

They are looking for kids with symptoms of Attention Deficit Hyperactivity
Disorder who have never been medicated.

Members of the coalition two weeks ago protested outside Columbia
Presbyterian Medical Center, which is affiliated with Columbia University,
handing out leaflets alerting parents, schools and community groups.

The coalition is worried researchers will offer money for subjects or give
parents false hopes that their children will be cured. They also worry that
the unknown, long-term side effects of the drugs might harm kids.

Advocates are also wondering how researchers are going to properly diagnose
the preschoolers – some of who can’t express themselves thoroughly.

“Obviously, if it’s the researchers doing the diagnosis, it is in their
interest to diagnose kids with ADHD because they need them for the study,”
said Leonard H. Glantz, a law professor at Boston University and author of a
book on the ethics of researching on children.

“Unlike doctors, researchers don’t have the best interest of the patient in
mind.”

Greenhill said the five-stage, 40-week study has been reviewed and
re-reviewed by five ethics panels “to make sure the rights of the children
and their families’ rights are protected.”

Researchers will seek kids by advertising, by referrals from local doctors
and by sending flyers to private schools – since they are prohibited from
recruiting at public schools, Greenhill said.

The children will be diagnosed by a special group of researchers composed of
up of six institutions, including Johns Hopkins, University of California at
Los Angeles, University of California at Irvine, and Duke, said Greenhill,
who insisted the parents will only be given money to get and from the
hospital.

Greenhill is seeking more than 60 kids whose parents will first receive
training to see if their child’s behavior improves. The second stage
involves low-dose medication that’s later upgraded, Greenhill said.

The fourth stage includes a placebo experiment, where some kids get a sugar
pill. Advocates say children will suffer from withdrawal symptoms because
Ritalin is addictive.

Parents have to sign consent forms for each stage, including the last, which
includes a gradual tapering off or continuation of the drug.

Informed of the study she inspired, Clinton spokeswoman Karen Dunn said,
“Hillary Clinton is very concerned about the increased use of Ritalin in
young children and has strongly supported efforts to determine whether it is
being used appropriately and effectively.”

That sounds politically and morally correct, but the folks in Washington,
D.C., aren’t going to be around to see what becomes of these kids who donate
their brains to science.

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