When drugs mask our society's failings

In this age of hyper-parenting, too many children are under too much pressure.

Psychiatry has always been a mysterious and much-derided science, criticised by psychologists for being too focused on medication, looked down upon by other doctors for being too "wishy-washy", and often accused of being an arm of law and order rather than health and medicine.

The latest figures showing a five-fold increase in the past three years in the prescribing rates of dexamphetamine, the drug often used to treat attention deficit hyperactivity disorder (ADHD), suggest the profession is trying hard to rid itself of the wishy-washy tag.

But while a host of reasons are given for the syndrome, from dodgy doctors to too much television, the role of desperate parents seeking a "product" to aid their parenting endeavours and, at times, absolve them of some responsibility, is less questioned.

The one million scripts for dexamphetamine filled over the past three years are mainly written for low-income families. ADHD is still a "disease" of poverty in Australia. The vast majority of referrals come from schoolteachers who are no longer able to cope with unruly children. This is understandable. Teachers have so much on their plates that they cannot focus all their energies on one child. And no more needs to be said about the level of resources in Australia's public schools.

There is always some controversy about the diagnosis of ADHD, and there has been no clear link found between it and a biological or genetic abnormality. Diagnostic criteria include such hazy markers as "not able to listen" and "difficulty concentrating during the interview, shown by fidgeting". This decision is always difficult to make in the setting of an hour-long interview.

The doctor, when discussing the problem child with desperate, pleading parents, would like to prescribe better resources in schools to deal with children struggling with learning disabilities, more money to help families on the verge of separation, greater help for victims of child abuse, and better support for those suffering from drug and alcohol addiction. Unfortunately, a doctor cannot prescribe such a remedy. But he can prescribe a drug. And children who use this particular drug often show considerable improvement. The parents are, of course, much happier and the child often engages better with school and family. The side effects are not usually marked.

Nonetheless, it is fairly obvious that ADHD is the "medicalisation" of a social problem. Most sufferers are raised in families of conflict and or poverty, or have parents with a drug problem. While it is unfortunate that we must resort to a drug to treat such a far-reaching issue, the alternative appears to be too difficult and too expensive.

Compared with the massive social spending required to even put a dent in the inexorable march towards family and social breakdown, the $5 million taken from the Pharmaceutical Benefits Scheme (PBS) to fund the prescriptions for dexamphetamine is a drop in the ocean.

Furthermore, it is hard for parents to take responsibility for difficult children. Parents will jump at the chance to claim credit if a child succeeds, but they will also happily point to external causes of the same child's failures. We live in an age of hyper-parenting, where a child is the ultimate validation of an adult's ego and the little time they have to spend with them must be "quality time". There is little room for deviance, boredom or unplanned curiosity in the modern child's routine, especially when the parents return home from long hours at work.

In the meantime, medications and video games are increasingly becoming the nannies, grandmothers and babysitters of our children.

With the drug dexamphetamine, psychiatry is once again playing its role in law and order, offering a type of chemical restraint for our difficult children. But it is wrong to blame the doctor or the television when there is such a massive parental demand for the treatment.

It is a consumer response to social degradation.