Report Title:

Psychiatric Drugs; No Recommendation by DOH for Students

Description:

Prohibits DOH personnel from requiring, suggesting, or implying that a student take psychiatric drugs as a condition of attending school.

THE SENATE

S.B. NO.

999

TWENTY-SECOND LEGISLATURE, 2003

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to psychiatric drugs for children.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that in 1988 -- just one year after "attention deficit hyperactivity disorder" (ADHD) was added to the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders -- that diagnosis had been given to five hundred thousand American children. By 1997, the figure had reached 4,400,000 children. Today, at least six million American children are currently diagnosed with some form of psychiatric disorder requiring medication. Currently, American schools spend a combined of $1,000,000,000 a year on psychologists who work full-time to diagnose students.

Among the symptoms indicative of attention deficit hyperactivity disorder are descriptions such as "has difficulty playing quietly," "often talks excessively," "often loses things," "is easily distracted," "has difficulty awaiting turns in games," "blurts out answers to questions," and "has difficulty following instructions."

Attention deficit hyperactivity disorder -- a set of descriptive symptoms -- is notoriously subjective to diagnose and yet children are routinely labeled as having attention deficit hyperactivity disorder and are just routinely given heavy psychiatric drugs to control their behavior. In schools throughout the nation, children who are having problems with their academic work, their peers, their teachers, or their families are being labeled as suffering from disorders that carry labels like "oppositional defiant disorder," "conduct disorder," or "ADHD." These children may be placed in special classes, dismissed from school, or given medication. Under the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders (DSM-IV), certain "learning disorders" are also considered mental disorders including:

· Mathematics Disorder

· Reading Disorder

· Disorder of Written Expression

Several other countries also have high rates of similar diagnoses. For example, stimulant drug prescriptions given to British children have increased from 23,500 in 1993 to 126,000 in 1998. In fact, the administration of psychiatric drugs to control attention deficit hyperactivity disorder diagnosed in children has grown so much that the United Nations International Narcotics Control Board has been prompted to ask authorities to investigate this child-drugging phenomenon.

However, compared to the very large numbers of American children diagnosed with either attention deficit hyperactivity disorder or "attention deficit disorder" (ADD), this diagnosis is not nearly as prevalent, if they exist at all, in children of comparable ages in certain countries such as Japan and China. Those countries certainly do not widely administer psychiatric drugs to children. Attention deficit hyperactivity disorder remains a predominantly American phenomenon and according to the International Narcotics Board, the United States remains the main consumer of methylpenidate, the active ingredient in Ritalin, a psychiatric stimulant drug routinely given to school-age children, accounting for more than eighty per cent of global consumption of the drug.

Attention deficit hyperactivity disorder is frequently claimed to be a "brain-based disease" and that a chemical imbalance in the brain is responsible for the symptoms attributed to attention deficit hyperactivity disorder. Yet, there is no scientific evidence to prove this. In fact, in 1998, a U.S. National Institutes of Health Conference of the world's leading attention deficit hyperactivity disorder experts concluded that there is no data confirming attention deficit hyperactivity disorder as a brain dysfunction. The U.S. Drug Enforcement Agency has stated that it "has not made a determination of whether ADHD is a disease or a syndrome...We are also unaware that ADHD has been validated as a biologic/organic syndrome or disease."

Furthermore, it is well established that psychiatric drugs may induce long-lasting biochemical and structural changes in the brain. For example, it was found in 1998 that the brains of attention deficit hyperactivity disorder subjects were, on average, ten per cent atrophic (smaller) compared to normal control subjects. It is now thought that this abnormality is likely iatrogenic, that is, caused by the stimulant therapy itself, and not by attention deficit hyperactivity disorder.

The main stimulant used for attention deficit hyperactivity disorder is an amphetamine-like drug, which purportedly acts as a tranquilizer in children. According to the Citizens Commission on Human Rights, it is more potent than cocaine, numerous health risks attend its use, and it can lead to later drug abuse. The childhood use of mind-altering drugs is a major contributing factor to later cocaine dependence.

In addition, studies have found that children who take amphetamine-type or other prescribed, mind-altering drugs do not perform better academically. In fact, children who take these drugs fail just as many courses and drop out of school just as often as children who did not take the drugs.

Our nation's military has begun to worry that the widespread use of Ritalin and other stimulant drugs prescribed for the millions of children under age eighteen may render them ineligible for military service. An Army Times article dated December 8, 1997 reported that Air Force medical standards state that "any individual prescribed Ritalin after age 12 must be medically disqualified" from entering the service. The other military branches have similar prohibitions against admitting current or former patients who have taken Ritalin. In fact, the article reports that attention deficit disorder is itself a disqualifier for military service.

The legislature further finds that it is not surprising that, in technologically-oriented western cultures where the scientific method is a hallowed tradition, society has resorted to objectifying certain complex childhood behaviors that are troubling, but perhaps temporary, by conveniently categorizing and labeling them as a medical disorder for which there is a simple pharmacological solution. On the contrary, it is well-known that as children naturally progress through the various stages of physical, social, emotional, and psychological maturation, and in the process of learning and internalizing appropriate individual and societal norms, their behavior may at times be erratic and may appear extreme to adults. By succumbing to the seductive promise of a clean and convenient and, above all, a scientific cure, society and educators have acquiesced to the drugging of children identified and defined as having a bona fide mental disorder, our consciences eased somewhat by the cachet of scientific legitimacy lent to a clinically simple drug solution. Subscribing to the "ADHD" doctrine not only allows educators, parents, and society to absolve themselves and the child from moral culpability for the consequences of the behaviors, but also excuses everyone from searching for genuine solutions to a complex problem in which physical, social, emotional, psychological, and maturational factors all play an intricate part.

On the other hand, parents who do wish to assume responsibility to help their children are often threatened with the removal of their children from school unless their children receive some form of psychiatric medication to modify their behavior.

However, various jurisdictions in America and around the world have proposed using alternative means to address behavioral, attention, and learning difficulties such as in Sweden, where it was proposed that all health and medical personnel be educated on alternative, natural methods of treating children who display hyperactive behavior. In Colorado, the State Board of Education called for teachers to use academic rather than drug solutions. In Connecticut, a law enacted in 2001 prohibits school personnel from recommending the use of psychiatric drugs for any child, especially as a condition for the child to remain in class.

Although it is undeniable that certain children have difficulty paying attention, have difficulty learning, and display hyperactive behavior, the all too ready diagnosis of a mental disorder, accompanied by the use of powerful psychiatric drugs, is inappropriate for such a great number of children.

The purpose of this Act is to protect our children from indiscriminate overuse and abuse of psychiatric stimulant drugs as a means of controlling the behavior of children in the schools by prohibiting department of health personnel from recommending the use of psychiatric stimulant drugs for children in Hawaii's schools.

SECTION 2. Section 321-242, Hawaii Revised Statutes, is amended to read as follows:

"321-242 Department of health; implementation[.]; policy on use of psychiatric drugs. (a) The department of health shall implement this program with the present health services now provided to those schools under the pilot project established under Act 130, Session Laws of Hawaii 1970, to each public school, and shall further provide the necessary number of health aides in order to service each public school. The department of health may provide health related screening services at each public school.

(b) School health aides may assist the student by administering oral and topical medication, and in emergency situations, other premeasured medication; provided that:

(1) If the student receiving the medication is a minor, a parent or guardian requests and authorizes such administration of medication;

(2) The medication has been prescribed by a licensed physician, as defined in [[]section[]] 334-1 or by a practitioner with prescriptive authority;

(3) The administration of [such] the medication is with the approval of the department of health; and

(4) The administration of the medication is necessary for the health of the student and for the student's attendance at school.

(c) Notwithstanding subsection (b)(3) and (4), the department of health shall adopt and implement a policy prohibiting any department of health personnel from requiring, suggesting, or implying that a student take psychiatric drugs as a condition of attending school. This subsection shall not prohibit department of health personnel from recommending that a child be evaluated by an appropriate medical practitioner, or prohibit department of health personnel from consulting with a practitioner, with the consent of the parents or guardian of a child."

SECTION 3. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 4. This Act shall take effect upon its approval.

INTRODUCED BY:

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