Letters to the Editor
-
Apathetic pseudoskepticism takes on pop psychology and cynical corporate marketing -- yawn.
David's article uses a pop voice to say vague, pop-ironic things about popular perceptions of the popular controversy about an uncommon (unpopular, if you will, and certainly not a backbone issue of our society), frustrating, pain-in-the-ass disorder called ADHD.
It's "popular" because overheated hype was generated from media coverage. A vocal but tiny number of folks latched onto the diagnosis as a panacea. Big Pharma jumped on board to try to drive doctors to their products and they used the issue as an springboard to develop new products. Wooo. Now it's a popular issue.
It's an even more popular issue because a vocal but tiny minority of folks rose up in outraged opposition to ... I dunno, science? Whatever. Then quack-medicine industry jumped in and generated a never-ending flood of FUD about the science to market its "alternative" EEG feedback therapy, dietary supplements, self-help books, expensive crackpot religions and plain old guilt.
Cursory examination of credible, good-faith information about research, data, and the history of ADHD would make a much better basis for an article than just adding more blah-blah-blah about the blah-blah-blah.
Credible information I've found can be summarized thus:
ADHD has been noted and studied in various forms since the 19th century. Its positive response to stimulant medication has been repeatedly confirmed since the 1940s. The disorder can be fairly easy to spot in children, but while symptoms can be compensated for in adulthood, the underlying problem does not go away with age. The cognitive performance of children and adults with ADHD has a distinctive fingerprint that can be identified with a standard set of tests that are continually refined but are not fundamentally new or exciting. The disorder affects 1 to 3 percent of the population. This could be considered a "large" number of people but the proportion does not make the disorder what most would consider "common." Effective treatment includes stimulant therapy and coaching to train the mind to make use of its new ability to apply techniques of organization and self-discipline. Injecting, smoking, or snorting the medication works against any long term therapeutic intent. When injected, smoked, or snorted, the concentration in the brain spikes quickly beyond normal therapeutic levels. The felt effects of the medications when misused this way are neither as acute nor as pleasant as cocaine or methamphetamine. Oral overdoses build the concentration in the brain slowly and don't produce a "rush." Without a rush, the overdose is chiefly unpleasant. In general, these medications have been around for a long time and are relatively cheap, safe, and effective.
I'm one of the new crop of adult diagnoses. I didn't have the opportunity to be diagnosed when I was young. We didn't have TV. My mother fed me healthy food and didn't let me sugar out. I consistently test to a high intelligence, I am consistently noted by my coworkers and employers as ethical, hard-working, creative, and helpful. I am ambitious. I have big ideas and lofty goals. I value details and I understand how the integral of constant progress is more productive and valuable than magical, frenzied leaps forward. I am a good person capable of good judgement. I value critical thinking, education, and discipline. But in over 15 years of repeatedly trying college, I haven't been able to achieve grades consistent enough to keep me from becoming overwhelmed and dropping out. While people tend to find me likable and interesting, my relationships invariably fall apart. I'm unable to move beyond sub-professional technical jobs. I'm thirty-four years old and there's definitely something wrong with me. It isn't a "quasi-societal ill".
I've seen the casual drug usage culture that David refers to. Coming as he does from a history of being a drug dealer, it isn't surprising that this body of anecdotal experience is what forms the authority of his article. However, he falls into the same trap that all my alcoholic pothead friends fall into when they examine some issue more subtantive than whether Paris Hilton is a crassly vicious whore or merely a delightfully wicked slut: what you read in Newsweek, the New York Times, the Wall Street Journal, Slate, and yes, Salon, is not guaranteed to be anything but crap. It sometimes isn't crap. It is sometimes demonstrably crap. Usually, it regresses to a crap mean (see the Wikipedia entry on regression to the mean). If you want to actually research an issue with the goal of not forming a conclusion that is crap, find the actual significant research cited by the quietest, most productive and degree-laden people in the field, put your nose in that pile of books, and voila. There's a basis for an article.
If David had just noted the pop goofiness of the issue for its entertainment value and tried to dig past it to the information rich meat that is readily available, he wouldn't have come off as just another ignorant jabbering mouth -- a lesson I hope this pile of letters teaches him.
andy
-
Obviously, there's some confusion.
After reading some of the other letters in response to David's article, looking over his article on the nicotine patch, and reading the reviews of his novel Important Things That Don't Matter on Amazon, I note a significant gap in my response. I wrote from the point of view that the article was contentless fluff. I suggested that it would have been useful for David to go beyond his seat-of-pants exposition and do some research on some factual matter. I often make the mistake that points of view are based on understandings or misunderstandings of data. This isn't always true.
I was also wondering if he was for real or just some kind of professional troll. However, looking into where he's coming from a little more, I think my advice to him was spot on, but I would like to translate to the rest of the folks what I think is going on in David's writing. His article notices the kind of fuzzy, relativistic way people mix life improvement and life destruction but he's unable to claw his way out and provide context and meaning. When it comes time to present points and discuss their merit, he engages in a kind of simplistic surface ruffling.
I've traveled with some drunks and potheads and tweakers. In order to make sense of that culture, it is necessary to realize the strength of the tendency of drunks, potheads, and tweakers to be incorrect. This ranges from "holy crap that's wrong," to "well meaning... correct in a narrow sense... but wrong." David Amsden has had ample opportunity to note the hypocritical ideas and behavior of drug abusers he's known. Merely noticing the inconsistencies as he does is good, but he extends it oddly to equivocate medically supervised Ritalin use (of which he seems to be completely ignorant as to the details) and the casual use of pot and uses that as a basis for legalization. If I read him correctly. It's a little unclear from the text, although that's what Salon seems to think he meant.
It would make no more sense (although the route is more common) to rebel entirely, find Jesus and scream from the rooftops "Drugs are bad! Drugs are bad!." To go beyond where he is it's necessary to present meaningful facts and tell us less ambiguously what he thinks that means.
For an example, the simple fact is that the effects of theraputic medication are nothing like the effects of recreational drugs. You cannot use one to justify the other, just as you cannot use one to condemn the other. Do all the research you like. The more you look, the more this becomes obviously true. What then, David?
Growing up in the care of drunks, potheads, and tweakers, many if not most of the people around you have serious issues with drug dependency, post-traumatic stress, anxiety, etc. You will continue to hang with drunks, potheads, and tweakers because it's easy and seems accepting. The idea of getting help for your own dysfunction, if you have one, may seem ludicrous because you're no worse off than your friends. When you hear about a case of someone who got help, you say "well, they weren't so bad off, that's nowhere near screwed up as I've seen." You see what's going on, but the significance doesn't hit you. Your tolerance of bullshit is too high.
I think this is David Amsden's perspective, and it has resulted in an incomprehensible article.