ADDA Responds to the New York Times!
asked Board of Directors Member Celeste A. Jacque, M.D. to respond to a recent
article that appeared in the New York Times on behalf of ADDA. Dr. Jacque is also a key member of ADDA’s
College Committee, a group particularly interested and active in issues
affecting young adults preparing for and attending institutions of higher
learning. Dr. Jacque is board certified
in both Psychiatry and in Child and Adolescent Psychiatry.
Focus on the Real Issues
A. Jacque, M.D.
3, 2013, the New York Times published an article entitled, "Drowned in a Stream
of Prescriptions.” The article, chronicling the descent into psychosis
and subsequent death of Richard Fee, is extremely sad. However, the
article’s emphasis on another "bad medication” is misleading. There
is no "bad” medication; there is no "bad” food, "bad” books or even
"bad” music. These items, all frequently decried as "bad,” are inanimate
objects so may be utilized in inappropriate ways. They carry no valence,
in and of themselves, neither good nor bad. They do not make decisions
nor do they act independently. When properly used they may lead to
The stimulants prescribed
to Richard Fee have significantly improved the lives of children, adolescents
and adults who have been accurately diagnosed with Attention Deficit
Hyperactivity Disorder. Stimulants were not appropriate for Richard, as
he did not meet the DSM IV criteria for Attention Deficit Hyperactivity
Disorder based upon the information reported in the article and attributed
to his parents and friends. He initially accessed and used the
medication illegally as a diversion in college.
college students do not have credentials or sufficient training to legally or
safely distribute medication to fellow students. Although this type of
activity usually goes undetected, as with any drug exchange, it may lead
to severe academic and legal consequences for the distributing student.
It may also lead to significant psychological or physical consequences for the
receiving student. Again, the stimulant did not upset the exchange; the
humans involved diverted the medication.
indeed have become addicted to the "high” of the stimulant medication, as
it does, in some instances, cause a "rush” in people who do not
have Attention Deficit Hyperactivity Disorder. But that alone may
not have led to his spiral into psychosis. Richard developed a
belief about his ability to function on stimulants and he followed this in a
feverish manner. This belief was not grounded in reality.
Richard’s misuse of stimulants certainly did not improve his grasp of
reality, but it may not be the only cause of his delusions.
situation was tragic, both for him and for his family. Unfortunately,
human factors compounded illegal misuse of medication with a medical situation
when important observations of bizarre behavior by Richard's family and
friends were ignored. Blaming medication is easy, and the "bad” inanimate
object "du jour” makes an easy target in many of our news reports.
Demonizing any inanimate object does not help the public understand or attempt
to find solutions to complex issues affecting our young adults.
should not become another issue sensationalized or trivialized until the next
"bad” thing is discovered. It should instead raise important questions
about mental health issues in the young during times of transition, appropriate
diagnosis and monitoring of treatment when considering the use
of potentially abused medications such as stimulants and prescription
pain medication and diversion of medication from one student to another.
Committee has developed and distributed a medication information sheet
specifically for students in higher education settings. In addition to
addressing both the potential benefits and possible side effects, the
information sheet outlines the ethical and legal responsibilities of taking
stimulant medications. One responsibility that is strongly emphasized is
to never give or sell one's medication to another student.