Hilary Wilce talks to academic Richard DeGrandpre about his book on the use of cocaine-like drugs on hyperactive children.
SITTING in a Bayswater cafe, Richard DeGrandpre is discussing his book Ritalin Nation when the woman at the next table spots the cover and lunges over crying that she needs to read it. In fact, she needs Ritalin.
"I never can focus on anything," she says. "I don't know why. I just can't do it!" DeGrandpre doesn't respond. He waits for her to leave, then says mildly that if he carried his book around in the United States, he'd be having these conversations all the time.
He'd be on the radio and television all the time, too. Did you know there are four million kids on Ritalin? That more girls are going on it? And younger children? And that smaller and smaller numbers of kids are ever coming off it? That, in fact, one of its leading advocates now likes to compare it to a wheelchair for a disabled child?
By writing this book, this quietly spoken academic, who agrees that he looks far younger than his 36 years, has pitched himself right into the centre of one of the pharmacological whirlwinds of modern medicine. So did he know what he was letting himself in for when he started?
Well, he says, he has a background in psycho-pharmacology, which means studying drugs and human behaviour, and when he saw a major television documentary on Ritalin and realised how widely it was coming to be used, and how flawed and inaccurate was the popular understanding of what it did, he knew he had to get involved.
Ritalin is the amphetamine-like drug now handed out routinely to children in the US who show signs of attention deficit disorder (ADD) and things are heading the same way here. Prescriptions in the UK rose more than 36 times between 1993 and 1998, from 3,500 to 126,500, including some being issued to very young children despite the manufacturers' recommendation that it should not be given to the under sixes.
However, DeGrandpre is hopeful that Britain can still stop itself sliding into the same drug-bath as the US. Last month, a group of British parents announced its intention of launching a legal action against doctors for over-prescribing Ritalin, while a new group, Stimulants Are Not The Answer (SANTA), has just been founded to support non-drug treatments for ADD. DeGrandpre flew to London to set speak at its inaugral seminar last week.
Ritalin Nation argues that ADD is not a physiological disorder needing drugs but the direct result of the over-stimulation of a speeded-up culture. Children, says DeGrandpre, are so bombarded by stimuli that the more vulnerable can become addicted to them, crave them, and as a result grow unable to deal with the slower tasks of life such as reading a book or paying attention in class.
Ritalin works, he says, because its qualities are "pharmacologically almost indistinguishable from cocaine - that is, it's chemically different but its effects are the same". Far from calming children, it actually provides them with a chemically-induced backdrop of stimulation which meets their craving and thus frees them from the need to carry on with the sensation-seeking restlessness, aggression nd impulsiveness that define the ADD child.
But, while Ritalin manages immediate symptoms, it does nothing to address underlying problems. Research shows that it has no significant long-term effect on academic, athletic or social skills. "People believe that it must have. They think that because it keeps a child better focused and on task, then that child must invariably be doing better, but that isn't necessarily so."
Much better would be a regime that slowed children down and offered them time, attention and active engagement with the world as opposed to constant electronic input.
"Normal child development takes place like the hour hand on the clock; it's moving but you can't see it. So, with something such as the whole family sitting down together and eating with no distractions - eventually you pay a price for not having that on a day-by-day basis.
"After a time, children start to get a little rough around the edges, and if nothing is done, you've got a problem."
However, DeGrandpre himself has no children and lives an enviable writer's life, loosely attached as an adjunct professor of psychology to St Michael's College in Vermont, but currently dividing his time between the mild winters of Vancouver and the sunny summers of his home state of Montana.
As such, he knows he is open to criticism and makes clear he is aware of the extreme stress faced by parents and teachers battling with hyperactive children. Pressured adults, he believes, are as much victims of the rushed society as their children, and he does not believe it is for him to say whether any individual child should be given Ritalin or not.
Neither, surprisingly, are the drug companies the villains of his piece. What makes him most angry is the "dishonesty of the medical establishment", which receives huge amounts of money from the drug companies, while brushing aside the findings which highlight Ritalin's failure to treat the underlying problems of ADD and ignoring indications of possible links with cancer.
When he flies back, he plans to pick up his interrupted work on a book examining the history of drug use in the 20th century, which will include a look at the rise of coffee, and patterns of intoxication, which vary widely between different cultures. He outlines the absurdity of a society which prohibits cocaine use, but at the same time puts a significant percentage of its schoolchildren on a very similar substance. "The thing about drugs is that they always teach us more about ourselves than they do about themselves," he says.
But it seems unlikely that the Ritalin issue will leave him alone. If ADD was once seen as a question of delayed development which children would grow out of, it has now, he says, come to be viewed as a persistent, chronic condition which means taking drugs for life. Paradoxically, such an awful diagnosis is often welcomed by parents because "it shifts the need to do anything away from families, and says it is something inherent in the child's brain".
Ritalin Nation: Rapid-Fire Culture and the Transformation of the Human Consciousness, Richard De Grandpre Published by W.W.Norton, pound;9.95. SANTA: www.santa.inuk.com