When Colorado's education board last week urged schools to rely more on effective classroom discipline - and less on medication - for unruly kids, the move catapulted the state to the forefront of an intense debate over the use of behavioral drugs for school-age children.
The statement was prompted by news that student gunmen in several mass school shootings were taking psychiatric drugs - and it marks the first time a government body has officially registered concern about the growing prevalence of such prescriptions among America's youths.
Not surprising, the decision by the Colorado Board of Education has sent shock waves through the medical community. To many, the move seems a desperate attempt to explain the recent rash of school violence, based more in hysteria than common sense.
To board members and their supporters, however, the one-page document represents a shift in attitude toward drugs such as Ritalin, Prozac, and Luvox - and a new unwillingness to put schools in the position of influencing parents to medicate hard-to-control kids.
They also acknowledge that the recent spate of school shootings influenced the decision. One of the Columbine High School gunmen had been taking Luvox, and student shooters in Springfield, Ore., Jonesboro, Ark., Pearl, Miss., Paducah, Ky., and Conyers, Ga., were reported to have been on that or other drugs.
"People are on pins and needles about this," says William Moloney, state commissioner of education. "We don't know if there's a link to school violence. But we're taking the radical step of saying that maybe someone might want to look at this."
Such medications have become a part of daily life for an estimated 6 million American schoolchildren. Most often, the drugs are administered when a child is diagnosed with Attention Deficit Hyperactivity Disorder. The American Medical Association considers ADHD a legitimate disorder that can be treated effectively with medication.
But critics assert that ADHD is at best overdiagnosed and, at worst, nonexistent. The primary treatment for ADHD, Ritalin, has been administered to America's youths for 50 years, but its use has tripled in the past five years.
Meanwhile, a recent study at the Michigan State University in East Lansing revealed that both Ritalin and Prozac were being prescribed to toddlers between the ages of 1 and 3. And a study in New York found that minority boys are 11 times more likely to be on medication than is the general student body.
Against this backdrop, many parents complain schools pressure them to medicate their children for disruptive behavior, and some are applauding Colorado's resolution, a nonbinding measure with no legal effect.
"Educators see Ritalin as something that's going to make their lives easier, rather than making modifications in their classroom," says one Colorado parent, who requested anonymity. "The problem is that the drug robs these kids of their personality. They become these quiet little robots."
Putting less pressure on parents to choose drugs was a key rationale in Colorado's decision. "Our intent is to give parents the authority, with their medical doctor, to make decisions and not be pressured by any school official to put their child on [Ritalin]," says Patti Johnson, an education board member.
But many in the mental-health community believe schools and teachers have a responsibility to alert parents to problems.
"Teachers are often the first to see these problems," says Jeanne Mueller Rohner of the Mental Health Association of Colorado. Just as teachers should alert parents if a child is having a vision problem, they should be urged to mention potential mental-health problems, she says."This will be detrimental to the children of Colorado. We need more mental-health care, not less," says Ms. Rohner, who expects the association to petition the board to rescind its resolution.
Meanwhile, Colorado lawmakers are also scrutinizing the issue. Last week, in a hearing organized by state Rep. Penn Pfiffner, they heard testimony from national crusaders such as psychiatrist Peter Breggin, author of "Toxic Psychiatry." He testified that drugs like Luvox and Ritalin produce violent behavior in some 4 percent of users.
"If we're going to spend the next six months discussing ways to prevent violence - like installing metal detectors in schools - and we overlook what might be an underlying cause, then we have been irresponsible," says Mr. Pfiffner, a Republican.
One concern, say critics of the Colorado resolution, is that people will hold the drug responsible to the child's actions. "If you have serious psychiatric problems, you already are at risk for this type of behavior," says Matthew Cohen, president of Children and Adults with Attention Deficit-Hyperactivity Disorder in Landover, Md. "The medication doesn't produce the violence. The more accurate thing to say is that the medication was insufficient to prevent it."
Ritalin and other such medications continue to have supporters on the front lines of dealing with youths.
"I've seen the results [of Ritalin] with thousands of kids," says Edith Feldman, a child psychologist employed by the Board of Cooperative Education Services in Nassau County, N.Y. "They're able to focus, to learn, to get along with others, and they feel better about themselves."
(c) Copyright 1999. The Christian Science Publishing Society