The Case Against Diagnosis and Treatment of ADHD

THE CASE AGAINST DIAGNOSIS AND TREATMENT OF ADHD AND RELATED DISORDERS AND THEIR TREATMENT WITH STIMULANTS

(Presentation to the Parliamentary Assembly", default", Council of Europe, November 23, 2001)

by Fred A. Baughman Jr., MD—Neurologist/Pediatric Neurologist

El Cajon, California, USA 

First, I must explain that I am a neurologist, not a psychiatrist.  It is essential that the reader know this, because neurologists, not psychiatrists, are medically and legally responsible for the diagnosis and treatment of actual abnormalities/diseases of the brain.  Psychiatrists, on the other hand are responsible only for the emotional and behavioral problems of physically/medically normal children/persons.  Actual abnormalities/diseases, are ruled out by non-psychiatric physicians before they refer them to psychiatrists or to other ‘mental health’ practitioners. 

Throughout the eighties and nineties, I witnessed the exploding ADHD epidemic. Just as it was my duty to my every patient to diagnose actual disease when it was present, it was equally my duty to make clear to them that they had no disease, when that was the case—when no abnormality could be found.  That was the case with every child and adult referred with a diagnosis of ADHD.  Moreover, it was my duty to know the scientific literature concerning every real, neurological disease, and every purported neurological disease as well.  Neither could I find validation of ADHD in the medical/scientific literature.  Finally,I am a neurologist who has discovered and reported real neurological   and genetic diseases [1-13].   By contrast, in 40 years of pseudo-scientific research, ‘biological psychiatry,’ has yet to validate a single psychiatric condition/diagnosis as an abnormality/disease, or as anything ‘neurological,’ ‘biological,’ & 8216;chemically-imbalanced’ or ‘genetic.’ Out of deference to the almighty, psychiatric-pharmaceutical cartel, other neurologists and neurological associations neglect to speak of these false representations of emotional and behavioral patterns as “brain diseases” due to “chemical imbalances of the brain.”

Announcing the November, 1998, National Institutes of Health (NIH), ADHD-Consensus Conference, Planning Committee Chairman, Peter Jensen [14] , of the  National Institute of Mental Health (NIMH), also a member of the Professional Advisory Board of Children and Adults with Attention Deficit Disorders (CHADD),  wrote: 

“…AD/HD has been surrounded by long-standing controversy.  This controversy surrounds the actual diagnosis of AD/HD—that is, whether the diagnosis simply ‘pathologizes’  (labels abnormal/diseased) normal child behavior and whether it is a function of large (school) classes, to busy parents, or the machinations of a medical/pharmaceutical cabal.” 

Here, Jensen defines the essence of the controversy--not Ritalin or amphetamines and the   risks they bear—all drugs bear risks-- but whether or not ADHD is a bona fide disease. 

In testimony at 1970 Congressional Hearings on whether or not to fund research into pharmacological (drug) treatment for school problems, Dr. John D. Griffith [15], Assistant Professor of Psychiatry, Vanderbilt University School of Medicine, posited:

“I would like to point out that every drug, however innocuous, has some degree of toxicity.  A drug, therefore, is a type of poison and its poisonous qualities must be carefully weighed against its therapeutic usefulness.  A problem, now being considered in most of the Capitols of the Free World, is whether the benefits derived from Amphetamines outweigh their toxicity.  It is the consensus of the World Scientific Literature that the Amphetamines are of very little benefit to mankind.  They are, however, quite toxic.” 

Nor is the essence of the controversy whether or not ADHD is ‘misdiagnosed’ or ‘over-diagnosed.’  If it doesn’t exist (as a physical abnormality/disease)—and it does not—it is, as I [16] testified at the National Institutes of Health, November, 16-18, 1998, Consensus Conference on ADHD, a ‘total, 100% fraud.’  

I am against the treatment of ADHD and of all psychiatric conditions with Schedule II, stimulants because none are actual diseases having confirmatory, demonstrable/diagnosable, objective, abnormalities.  For simplicity’s sake, I urge all non-physicians to remember that the abnormality is the disease; no abnormality, no disease. 

[slide #1: no abnormality = no disease = normal; whole body/brain  abnormality (diabetes); focal body abnormality (stomach cancer); focal brain abnormality (stroke, cancer); psychiatric conditions (all) = no abnormality = no disease = medically/physically normal.]

The first duty of all physicians, with the notable exception of psychiatrists, is to determine whether a disease/abnormality is present, or not present.  A third to a half of all persons who visit their physician have complaints/symptoms (subjective), but no abnormality/disease (objective).  It is from this group, in whom abnormality/disease has been ruled out/excluded, that patients in need of psychiatric/mental health referral are found.  

The fundamental issue before us, and before all countries of the developed world is whether or not ADHD is a bona fide, diagnosable disease or not.  If not, if the children are normal, as I know them to be, they are not medical patients and no medical treatment is necessary, or justified.  Rather, their unmet needs lie, as in generations-past, with their parents, teachers, and with their communities.  In my generation, fortunately, psychiatry and psychology had not yet invaded the schools, and literacy-, achievement-, and graduation- rates were infinitely higher than they are today.

Debate of the issue of whether or not ADHD and other psychiatric conditions/diagnoses are abnormalities/diseases, as psychiatry claims, is well-framed in the presentation of Jan Buitelaar and Ad Bergsma [17] to the Pompidou Group, December 8-10, 1999.  I will refer to and comment upon the main point they make

Buitelaar and Bergsma, page 19, paragraph 2:

“From the standpoint of child psychiatry, ADHD is a categorical (absolute, unequivocal) diagnosis that may be conferred following a systematic evaluation and eventually using validated behavior checklists and interview procedures.  ADHD is associated with functional and morphological abnormalities of the brain and is predominantly due to genetic factors.”

The diagnostic tools of psychiatry: behavior checklists, structured interviews, achievement and aptitude tests, never seek or demonstrate actual physical abnormalities/diseases.  And yet, having proven no such things, they claim: ‘ADHD is associated with functional and morphological abnormalities of the brain and that it is due, predominantly, to genetic factors.’

Swanson, a psychologist, presenting for he and Castellanos [18], spoke at the ADHD Consensus Conference (1998) on the subject of “Biological Bases of ADHD: Neuroanatomy, Genetics, and Pathophysiology.” In fact there is no one or several biological bases of ADHD—not anatomic, not genetic, and not physiologic.  Nor are there today.  Did Swanson intend to deceive? 

As a speaker at the American Society of Adolescent Psychiatry, March 6-8, 1998, Swanson [19] reported that the MRI (brain scan) research of Castellanos, et al [20] and Filipek, et al [21] showed brain atrophy in children with ADHD, but not in controls.

From a floor microphone, I  pointed out that 93% of the subjects in the Castellanos [20] study had been on chronic stimulant therapy, and inquired as to the stimulant status of those in the Filipek [21] study, which I had not yet read.   Swanson  acknowledged that the ADHD subjects in the Filipek study, as well, had been on chronic stimulant therapy--an acknowledgment not heard in his lecture or seen in his review of the same research in a  February, 1998, Lancet article [22]. Instead of confirmation of brain atrophy due to ADHD, i.e., an ADHD phenotype—we had strong, replicated, evidence that it was the stimulant therapy (methylphenidate/amphetamine) that was the cause of the brain atrophy.   Swanson [19] lamented:

“I would like to have an objective diagnosis for the disorder (ADHD).  Right now psychiatric diagnosis is completely subjective…We would like to have biological tests--a dream of psychiatry for many years.”

Saying “psychiatric diagnosis is completely subjective,” when--absent an objective abnormality, there is no disease--is a confession, from Swanson--a leading ADHD researcher-- that there is no such thing as a psychiatric/psychological disease. 

Buitelaar and Bergsma, page 19, paragraph 2:

“From a different standpoint—one that has been popularized in the media—ADHD is viewed as a stigmatizing and harmful label attached to children who are difficult to handle.”

Finding no abnormality in the “ADHD child” the pseudo-medical label is nothing but “stigmatizing; ” the unwarranted drug treatment that invariably follows--nothing but “harmful”—a  physical assault.

[slide #2: “ADHD” = no abnormality = no disease = NORMAL = “stigmatizing and harmful”]

Buitelaar and Bergsma,19;2:

“‘ADHD is a manifestation of a ‘deficiency in family, school, society and medicine’ [23].  These words show that there are serious doubts about the diagnosis and treatment of ADHD...one should investigate if there is something wrong with child psychiatry.  The claim that children are harmed  is serious enough to investigate.”

Absent evidence of an abnormality/disease, DeGrandpre is entirely correct.  Claiming these are diseases, with no proof whatsoever, there is, undoubtedly, something wrong with child psychiatry.  

All who are “diagnosed” and “treated”—6 million previously normal schoolchildren, in the US—are being harmed.  Surely this is serious enough to launch a criminal investigation. 

The US Food & Drug Administration (FDA), MedWatch* program, a wholly voluntary system for the reporting of post-marketing complications of drugs, reported the following   adverse reactions (AR) from methylphenidate (Ritalin and all generic and proprietary forms), from 1990-1997: 

    160 deaths**

    569 hospitalizations--36 life-threatening.

    949 central or peripheral nervous system occurrences

    126 cardiovascular occurrences:    

         6 cases of  "cardiomyopathy"

       12 of "arrhythmia"

         7 of "bradycardia" (slow pulse)

         5 of "bundle branch block" (impairment of heart’s conduction apparatus)

         4 of "EKG abnormality"

         5 "extrasystole" (heart rhythm abnormalities)

         3 "heart arrest"

         2 heart failure, right"

       10 "hypotension," (low BP)

         1 "myocardial infarction"

       15 "tachycardia" (rapid pulse).

*Figures from post-marketing, voluntary reporting systems, such as this, in which the physicians having had bad luck with a drug are the one's deciding whether to report or not, are estimated to report no more than 1 to10 percent of actual adverse reactions.  All of these are real, bona fide instances of abnormality/disease, while, by comparison, no psychiatric condition/diagnosis for which the drug treatment was undertaken, is. 

**Between 1997 and 2000 there have been an additional 26 deaths attributed to methylphenidate (all prescription forms of it) bringing the total reported to FDA, MedWatch for the decade, 1990-2000, to 186.

The following children are no longer hyperactive or inattentive--they are dead.  Between 1994 and the present I have been consulted, medically or legally, formally or informally, in the following death cases.   

Stephanie Hall, 11-year-old, Canton, OH.  “ADHD,” Ritalin,  cardiac arrhythmia.

Matthew Smith, 14-year-old, Berkley, MI. “ADHD,” Ritalin, cardiomyopathy.

Macauley Showalter, 7-year-old, Ritalin and 3 other psychiatric drugs. Cardiac arrest.

Travis Neal 13-year-old, Chattanooga, TN.  Ritalin, cardiomyopathy

Randy Steel, 9-year-old,  San Antonio, TX.  Dexedrine + several drugs, cardiac arrest.

Cameron Pettus, 12 -year-old, Austin, TX. Desipramine, hyper-eosinophilic syndrome. 

In the Ventura County (California) Star, Friday, October 19, 2001, we learned of another such death.  The article read:

“California heart death of 17 year old Ritalin case…Ventura High teen's death a mystery, tests pending. Many mourn popular senior found dead in bed by stepbrother at Oxnard home…She functioned with attention deficit disorder (ADD) all her life.  From age 10, she was on Ritalin for three years before she was taken off it because it caused severe  heart problems.”

This is a high price to pay for the ‘treatment’ of a ‘disease’ that does not exist.  Much to the liking of the psycho-pharm cartel, we, in the US, have no nation-wide data- gathering system that allows us to know the exact number of Ritalin-induced deaths, or, of those induced by any other psychiatric medications.  

 Buitelaar and Bergsma, 22;2:

“The first of the three core symptoms of ADHD is a developmentally inappropriate level of attention and concentration.”  

Saying “developmentally inappropriate” they mean subnormal/abnormal/diseased, as they must to make ‘medical patients’ of normal children. Addressing the subject:  Is ADHD a Valid Disorder? at the November 16-18, 1998, NIH, Consensus Conference on ADHD, Carey [24] concluded:

"…common assumptions about ADHD include that it is clearly

distinguishable from normal behavior, constitutes a neurodevelopmental

disability, is relatively uninfluenced by the environment…  All of these

assumptions…must be challenged because of the weakness of empirical

(research) support and the strength of contrary evidence…What is now

most often described as ADHD in the United States appears to be a set of

normal behavioral variations… This discrepancy leaves the validity of

the construct (ADD/ADHD) in doubt…" 

With no proof with which to counter Carey's assertions, the final statement of the Consensus Conference Panel read (p.3, lines 10-13):

"…we do not have an independent, valid test for ADHD, and there are no data to indicate that ADHD is due to a brain malfunction."

Remarkably, this wording appeared in the version of the final statement of the Consensus Conference Panel distributed at the press conference, the final session of the conference, November, 18, 1998.  This ‘confession’ appeared for an indeterminate few weeks on the NIH web site, but was subsequently removed and replaced with wording claiming ‘validity’ for ADHD. 

Buitelaar and Bergsma, 22;4-23;1:

“…ADHD can co-occur with various other child psychiatric disorders.  This is called comorbidity … forty percent may also meet the diagnostic criteria for ‘oppositional defiant disorder’ (ODD)… twenty percent…have a conduct disorder (CD)…Learning disorders, especially trouble with reading…are more prevalent. To put it simply: when ADHD children are in trouble they know only one way out: violence.”

They refer to each behavior pattern as a disease.  None of them are.  When ADHD is comorbid with CD and ODD, violence--biologically determined--they would have you believe--is inevitable.   In 1972, Baughman and Mann [10], reported that XYY was not a “criminal” genotype,  as previously thought.  Nor have, “mean genes” or a criminal genotype otherwise, ever been validated [25].  Writing: “ADHD children know only one way out: violence” could not possibly be more demonizing/stigmatizing.  And they do it with not a shred of scientific evidence.

Buitelaar and Bergsma, 24;3:

“The evidence suggests that ADHD is caused by interplay between genetic and environmental factors, with the genetic factors being most important [18,19].”  

Again, they refer to behavioral patterns--as separate diseases, each with it’s own causal, genetic defect.  None are abnormalities/diseases/abnormal phenotypes due to a gene defect--an abnormal genotype.  Normal women have a 46 XX genotype and a normal physique/phenotype.  In psychiatry there is no abnormality/no abnormal phenotype, begot by an abnormal genotype—not even one! 

[slide:  no abnormality =  no disease = normal phenotype = normal genotype = NORMAL]

Buitelaar and Bergsma, 25;1:

“It has been shown that ADHD is associated with several abnormalities of the brain.  The frontal lobes of the brain…are about seven percent smaller than average in children with ADHD.”  

The title of the Swanson and Castellanos, [18] Consensus Conference presentation was  “Biological Bases of Attention Deficit Hyperactivity Disorder,” as if there was a biological basis or bases.  Reviewing the brain scanning literature, they reported  that the brains of ADHD subjects were, on average, 10% smaller than those of normal controls.   What they  neglected to say, until Baughman [26] challenged Swanson (presenting), from a floor microphone, was that virtually all ADHD subjects, in the 12 years of brain scanning research reviewed, 1986-1998, had been on long-term methylphenidate/amphetamine therapy, and, that this—their medication--was the only physical difference between the ADHD subjects and normal controls, and the probable cause of their brain atrophy.          

Buitelaar and Bergsma, 25; 3:

“The medication (stimulants) is addictive for animals, but surprisingly, not for children with ADHD when prescribed and used appropriately.”

Incredibly,  they claim that methyphenidate/amphetamines, classified, since 1971, as highly addictive, Schedule II, are not addictive by virtue of their being “prescribed and used appropriately.”  Regarding the addictive potential of methylphenidate, Vastag  [27]  recently wrote, in the prestigious Journal of the American Medical Association (JAMA): 

“Taken orally, in pill form, methylphenidate rarely produces a high and has not been reported to be addictive.” 

The US Drug Enforcement Administration [28] makes no such exception:

 “In reality… there is an abundance of scientific literature which indicates that methylphenidate shares the same abuse potential as other Schedule II stimulants.”

In a prospective, longitudinal study of 492 ADHD subjects, Lambert [29] finds that childhood use of stimulant treatment “is significantly and pervasively implicated in the uptake of regular smoking, in daily smoking in adulthood, in cocaine dependence, and in lifetime use of cocaine and stimulants.

Biederman [30], assessing substance use disorders (SUD) in 56 medicated subjects (with ADHD) and in a mere 19 (nineteen) non-medicated, subjects, conclude (1) that untreated ADHD—a non-disease, mind you—was a risk factor for SUD in adolescence, and (2) that treatment with psychostimulants was associated with an 85% reduction in risk for SUD in ADHD youth.   In other words, the greater the percentage of those with ADHD who take their Schedule II, controlled, methylphenidate/amphetamine, “appropriately,” and, “as prescribed,” the fewer who will develop SUD.  Those who favor this view regularly site Biederman [30], while failing to site Lambert [29] .

Buitelaar and Bergsma, 26; 2:

“The overall aim of psychosocial treatments is to try to change the environment in a way that compensates for ADHD children’s lack of self-regulation”

Here, psychiatry reiterates that we are dealing with an abnormality within the child.  “It’s Nobody’s Fault.”  This is the name of a popular book by NYU psychiatrist, Harold S. Koplewicz who says such “no-fault” brain disorders” are the result of “DNA Roulette”—psychiatry’s  mysterious, never proved, genetic abnormality.  They cite the high prevalence of familial cases, ignoring the fact that classrooms and whole elementary schools with more than 50% affected, abound in the US, defying scientific explanation.

Buitelaar and Bergsma, 29;1 (regarding the evolution of psychiatry):

“Mental disorders changed from being intra-psychic problems, to the consequences of unhealthy social environments, and finally to biological abnormalities in the neurotransmitter balances of the brain.  Psychotropic medication is the product of biological psychiatry and has revolutionized the treatment of psychiatric patients.”  

In 1948 the American Board of Psychiatry and Neurology [31] decreed that “neuropsychiatry,” be split into the two, new, specialties: “neurology” and “psychiatry.”   By mutual understanding, neurology would deal with physical abnormalities/diseases of the brain/nervous system, while psychiatry would confine it’s attention to the emotional and behavioral problems of physically/medically normal persons.  All non-psychiatric physicians know it is they who do the ruling out of abnormalities/diseases before referring patients to a psychiatrists.  Only the public is deceived.  Psychiatry’s claims of “diseases” and “chemical imbalances” have no basis in medical science and is nothing more than a contrived, market-place deception—one authored and orchestrated by the American Psychiatric Association in collusion with Big Pharma (the world-wide pharmaceutical industry.  In this scenario every emotional/behavioral problem becomes a “brain disease” due to a “chemical imbalance  of the brain,” needing a “chemical balancer”—a pill. 

Pearlman [32], a concerned psychiatrist,  wrote to the American Psychiatric Association:

 “…elimination of the term ‘organic’ (from DSM-IV) conveys the impression that psychiatry wishes to conceal the nonorganic character of many behavioral problems that were, in previous DSM publications, clearly differentiated from known central nervous system diseases.”

Buitelaar and Bergsma, 30;2:

“While a child psychiatrist claims that ADHD has to do with genetically determined deficiencies in…the brain, parents or teachers may think the real problem is lack of motivation.”

All that matters are the scientific facts.  In calling ADHD an abnormality/disease, without scientific facts,  psychiatry knowingly lies, and violates the informed consent rights of the patient and his parents.  This is de facto medical malpractice.  

Buitelaar and Bergsma, 31;1:

“Armstrong [33] has found an emotional way of saying that all the scientific talk about ADHD just does not feel right.  Texts like this are not uncommon among authors opposed to the medical treatment of ADHD…” 

Psychiatry has demonstrated no abnormality/disease within the children, but proceeds to drug them nonetheless—by the millions.  An emotional reaction, even outrage, seems entirely appropriate.  

 Buitelaar and Bergsma, 32;1:

“The first question is whether ADHD is a disease or not.  The second is the situation specificity of ADHD.  The third subject is at the heart of the controversy and deals with medication for ADHD.” 

There is no abnormality/disease to treat--to make normal.  The disease/no disease question is the heart of the controversy.  Claims that ADHD and all other psychiatric conditions/diagnoses are abnormalities/diseases is the lynch-pin of the psycho-pharmaceutical fraud.   

Buitelaar and Bergsma, 32; Table. “Summary of opposing views of the concept of ADHD and its treatment with stimulants”  (herein, Buitelaar and Bergsma provide the text for “Opposing” and “Psychiatry” and I (Baughman) append my opinion)

Opposing: “ADHD is not a real disease or disorder but a social stigma…”

Psychiatry: “…well-defined ADHD is associated with brain abnormalities…”

Baughman: no abnormality/disease has been proven in untreated subjects with ADHD.  The only   brain abnormalities/dysfunction in ADHD are those due to it’s drug treatment. 

Opposing: “there is no biological or psychological test available to diagnose ADHD.”

Psychiatry:  “true, but (this) applies to all psychiatric syndromes like schizophrenia, depression and even dementia.”

Baughman: the term ‘syndrome,’ in medicine means the same thing as disease.  There must be an objective abnormality.  No psychiatric condition is an abnormality/syndrome/disease.  The dementias, as in Alzheimer’s and Huntington’s disease, are neurological, not psychiatric entities—actual diseases.  Diffuse, abnormality/disease of the brain can always be verified, if not during life, then at post-mortem examination.  This cannot be said of any psychiatric condition/diagnosis, schizophrenia and depression included.  A favored lexical stratagem of theirs is to co-mingle psychiatric names/terms with neurological, hoping the reader will think that the psychiatric entities of which they speak/write, are brain diseases, as well.   

Opposing:  “treatment with medication medicalizes a psycho-social problem.”

Psychiatry: “wrong.”

Baughman: ADHD is not at all an abnormality/disease/medical problem.  To the extent it is believed to be, efforts to address it as the psycho-social-educational problem that it is, will be diverted.  Treatment with medication, once begun, furthers the mistaken belief it is a medical problem.  

Opposing: “side-effects of treatment with psychostimulants are underestimated and outweigh beneficial effects.”

Psychiatry: “wrong; the side-effects of stimulants have been thoroughly studied and found to be mild.”

Baughman: Both wrong.  There is no abnormality/disease, the children are not medical patients; there is no justification for any drug treatment—all of which bear risks.

Opposing: “the abuse potential of psychostimulants…is underestimated.”

Psychiatry: “wrong; there are hardly any cases of ADHD reported  who are abusing stimulants.”

Baughman:  The DEA [28], observes:

“Whereas the majority of children experience only minor side effects under medically supervised controlled conditions, there are a significant number of case reports documenting more severe abuse.  The reports and scientific studies of abuse potential are routinely down-played, if referenced at all.  As a consequence, parents of children and adult patients are not being provided with the opportunity for informed consent or a true risk/benefit consideration in deciding whether methylphenidate therapy is appropriate.”

The largest such study, the prospective, longitudinal study of 492 ADHD subjects of Lambert [29] who finds that childhood use of stimulant treatment “is significantly and pervasively implicated in the uptake of regular smoking, in daily smoking in adulthood, in cocaine dependence, and in lifetime use of cocaine and stimulants.  Saying to individual patients and to the public-at-large that “there are hardly any cases of ADHD reported who are abusing stimulants,” psychiatrists/psychiatry is violating the informed consent/self-determination rights of one and all.  This, in most jurisdictions in the US, is tantamount to medical malpractice.  More fundamental, by far than claiming these drugs are not addictive or dangerous is the total, 100% fraud of saying that ADHD is a disease, for the purpose of making normal children into medical patients and then, medicating them.

“A significant amount of data from school surveys, emergency room reports, poison control centers, adolescent drug treatment and law enforcement encounters all indicate a growing problem with the abuse of MPH among school children,” wrote Gretchen Feussner [34], a DEA pharmacologist, in a recent report.   The DEA cited a 1997, Indiana University survey of 44,232 students that included a question about the non-medical use of Ritalin.  Nearly 7 percent of high school students surveyed reported using Ritalin recreationally at least once in the previous year, and 2.5 percent reported using it monthly or more often.  The DEA also counted nearly 2,000 cases of methylphenidate theft from January 1990 to May 1995 - ranking the drug among the top 10 controlled pharmaceuticals most frequently reported stolen.  Emergency room admissions studied by the federal Substance Abuse and Mental Health Services Administration found that in 1995 and 1996, patients ages 10 to 14 were just as likely to mention methylphenidate as cocaine in a drug-related emergency room episode. Nearly 75 percent said they had been using the drug for psychic effects or recreation.

Assessing substance use disorders (SUD), in ADHD in 56 medicated, and 19 (nineteen) non-medicated, subjects, Biederman, et al [30], conclude (1) that untreated ADHD (a non-disease) was a risk factor for SUD in adolescence, and (2) that treatment with psychostimulants was associated with an 85% reduction in risk for SUD in ADHD youth.  They would have us believe that the greater the number of ADHD patients who take their Schedule II, controlled, methylphenidate/amphetamine, “appropriately,” and, “as prescribed,” the fewer who will develop SUD.  Those who favor this view regularly site Biederman, et al [30], while failing to site Lambert [29] .  

Opposing: “the risk of promoting substance abuse is underestimated.”

Psychiatry: “wrong, treatment with stimulants by contrast may decrease the risk for later substance-abuse.

Baughman: Here again, we have not just a denial of the truth--a statement that the Schedule II, psychostimulants are not addictive—but an inversion of the truth, a claim that “treatment” with these substances of addiction for a disease that does not exist, will result in less addiction—‘substance use disorder’—than would result were there no such “treatment.”  This is the view promulgated by Biederman et al [30] with follow-up of just 19 (nineteen) non-medicated ADHD subjects.  This same view, always citing the Biederman study, is championed by none other than Alan I. Leshner, Director of the National Institute of Drug Abuse (NIDA), just as he pushes ADHD (the non-disease) itself, as a disease/physical variable which predisposes to addiction (just as obesity predisposes to diabetes).  

The burden of proof always lies with those who say an abnormality/disease is present; with those who would start treatment without having first demonstrated the abnormality/disease.  In diabetes we do not inject insulin before having proven the blood sugar is low, and exactly how low.  We do not remove the amino acid phenylalanine from the diet of the newborn without having proved they have the real chemical imbalance—phenylketonuria (PKU).  The burden of proof never rests with the questioning parents or patients, or their advocates who say “show me proof of the abnormality; proof of the disease.”   It always resides with those who say an abnormality/disease is present that must be treated, and before treatment is begun

A young father-of-divorce, a podiatrist, was meeting his son’s psychiatrist for the first time.  He asked the psychiatrist why his son was on Ritalin.  The psychiatrist responded, “that’s because he has a ‘chemical imbalance of the brain.’  To that, the father responded: ‘Please show me the laboratory results.’  The psychiatrist, immediately uncomfortable, managed: ‘Those charts are filed away…I can’t get to them just now.’  But the father persisted in his demands to see confirmatory laboratory tests.  To this, the psychiatrist became increasingly flustered, finally ‘losing it,’ banishing father and son from his office—permanently.  Exposing the fraud was that simple.