In a recent piece for City Journal, Lee Siegel notes the “emotional blunting” he has encountered among friends taking antidepressants, and wonders whether “the widespread use of drugs that can abolish our ability to empathize with what another person is feeling risks creating a collective hell.” A question well worth asking. A related one: How many of your neighbors need to rely on mind-altering medicine to get through the day before you start to wonder whether it’s modern life, and not they, who is mad?
I ask because I am concerned about one worrisome outcome in particular: the inevitable rise of conformity in a psychiatrically medicated population. There is no shortage of cultural observers lamenting the groupthink among our youth. Aghast at story after story of campus conformity, they blame our propaganda-driven curriculum or teachers with agendas for squashing individual thinking. But even the most ideological teachers, supported by the most radical lesson plans, would be unable to rule their academic fiefdoms without the prescriptions pumped out by my fellow physicians. When not paying attention to one’s teacher becomes a treatable medical condition, the only possible future classroom is one in which total obedience is the norm.
Medicine bothers with attentiveness for one simple reason: We have a drug for it. If Ritalin did not exist, neither would ADHD; the treatment conjures the disease. After the accidental discovery that amphetamines—widely used to help soldiers stay alert in the trenches—also helped children sit still in class, drugmakers sensed a new market for their “pep pills” and started pushing the use of stimulants in school decades before the medical community figured out a plausible diagnosis to justify the treatment. As one infamous ad campaign put it, “Whatever the terms used to identify the affliction . . . Ritalin helps ‘the problem child’ become lovable again.”
What makes a child “problematic” is in the eye of the beholder. Considering the beholder in question was usually a put-upon teacher, you can guess what followed. Ritalin entered the market in 1956; by 1970, a bombshell Washington Post story revealed that, in one school district, thousands of mostly black students—up to 10 percent of the elementary school population—were being pharmaceutically de-problematized. Per reporter Robert Maynard, the school was partnering with doctors to “drug black children into quiet submission.”
Even after the attention deficit disorder diagnosis became official in 1980, few could explain what precisely the illness was. When the National Institutes of Health finally convened an expert panel on the matter in 1998, the takeaway was, in the memorable words of one participant: “The diagnosis is a mess.” Nonetheless, the everyday experience of parents, doctors, teachers, and students showed that cocaine-like drugs rather unsurprisingly gave children cocaine-like levels of focus—in other words, the drugs “work.” Indeed they do, as any Wall Street trader who lived through the eighties could tell you. Yet, for all the debate over the ethics of daily amphetamine use on individual children over the years, few have raised an equally important concern: the repercussions of the mass drugging of our student population.
Looking back, the Washington Post’s alarm over a possible 10 percent rate of scholastic speed use is positively quaint. Hardly a day goes by that a student isn’t sent to me to be evaluated for ADHD. Kindergartners are sent for incomplete worksheets and fidgeting in their seats. Teenaged mechanical prodigies are sent for daydreaming during social studies. My fellow doctors, for their part, shrink from false humility when called upon to assess appropriate amounts of attention per curricular initiative. In parts of America, certain school-aged cohorts are flirting with a 40 percent rate of being on ADHD medication. Since students with ADHD routinely have accommodations ensuring seats at the front of the class, this means that your typical teacher glances up from her lecture slides to see cherubic faces watching with dull-eyed, pharma-engineered obedience. Aside from the impact on the drugged children themselves, what kind of message does that send their unmedicated classmates? To harken back to an earlier era of medical hubris, I would venture the effect would be not unlike seeing the class clown wheeled back from detention with a lobotomy scar on his forehead and drool dribbling down his chin.
We are engaged in a massive national experiment, making all schoolchildren fit one behavioral mold; the results speak for themselves. Reading and math scores have not risen, but mindless acceptance of orthodoxy certainly has. The dream of certain educational reformers for centuries, it is only in the past couple decades that factory education has become reality, thanks to the power of Big Pharma. When students of the past did not fit, there was not that much even the most authoritarian teacher could do about it. Today, however, the choice is starker: Conform or be drugged. We used to make dystopian movies about it; now we make our children live it.
The medicine is the message. The nature of your discourse depends upon the popularity of your prescriptions. Once we have obedience in a tablet—a drug that makes students sit still and attend to whatever faddish nonsense their teacher may be spouting—society can be independent no longer. By making pharmaceuticals an integral part of the modern educational project, it is not simply the stimulant-taking students who become docile and obedient, but the unmedicated ones as well.
Adrian Gaty is a pediatrician based in Austin, Texas.
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