Slashdot Mirror


The New School Nurse Is Nurse Ratched

theodp writes "In Ken Kesey's 1962 novel One Flew Over the Cuckoo's Nest, Nurse Ratched maintained order in the mental institution by dispensing antipsychotic and anticonvulsant drugs to the patients. Fifty years later, the NY Times reports that some physicians are prescribing stimulants to struggling students in schools starved of extra money, not to treat ADHD, necessarily, but to boost their academic performance. 'We as a society have been unwilling to invest in very effective nonpharmaceutical interventions for these children and their families,' said Dr. Ramesh Raghavan, an expert in prescription drug use among low-income children. 'We are effectively forcing local community psychiatrists to use the only tool at their disposal, which is psychotropic medications.'"

17 of 196 comments (clear)

  1. We've Given Up on Poor Kids by ohnocitizen · · Score: 5, Insightful

    We've gotten to a sick point as a society. We know what works when it comes to education, it is no great mystery. Smaller classes, highly qualified and motivated teachers, involved parents. Instruction that imparts a love of learning and cultivates the desire to investigate the world around us.

    Instead of providing this, we drain schools of funding and treat teachers with hatred and distrust. Students in low income schools are subjected to draconian learning environments where their future is ruled by testable metrics and a discipline fetish.

    So doctors - despite knowing the significant risks of drugs that alter brain chemistry (especially with children) - are using their own tools to step in and help. Either they are way out of line, or they have hit the nail on the head by classifying academic performance as central to a child's long term health. Either way: they wouldn't be in this mess if we just invested in schools with a fraction of the enthusiasm with which we invest in bailing out banks and fighting wars.

    1. Re:We've Given Up on Poor Kids by Anonymous Coward · · Score: 3, Insightful

      Smaller classes, highly qualified and motivated teachers, involved parents.

      And community values.

      Ever wonder why Asian stiudents, no matter where they go to school, excel at academics while their American counter parts don't do as well?

      Community values which includes lots of parental encouragement - not all good admittedly.

      Asians as a whole value academics above sports and other activities.

      We Americans value the football hero, the entertainer, and the bling and superficial.

    2. Re:We've Given Up on Poor Kids by Anonymous Coward · · Score: 3, Insightful

      Except that it's a money pit. We're spending $526 billion on primary education. Fire the administrators. Double the teaching staff. Eliminate tenure.

    3. Re:We've Given Up on Poor Kids by ColdWetDog · · Score: 5, Insightful

      You are over generalizing (on Slashdot? The Horror) and mixing up symptom and cause.

      One of the several root causes for academic failure is social failure. The vast majority of human children need a consistent, controlled and supportive environment if they are to get as much as possible out of schooling. Chaos doesn't work well for most. Since we've not done such a good job with the society at large, especially for economically disadvantaged people, we now try to take it out on the schools which are forced to be in loco parentis for a while. That hasn't been working out well either.

      So we turn to drugs. Simple. Easy. Better living through chemistry and all that.

      Ought to be an interesting experiment.

      If I were the DEA or persons of similar persuasion, I would be shaking in my combat boots. Another generation even more attuned to psychotropic medication than the last couple of generations - who were doing pretty good with just amateur status. How are you going to get these kids to try to make the artificial distinction between 'good' and 'bad' drugs. Especially since a lot of these are pretty 'bad' drugs - they can make you feel crummy, they have significant side effects. They work in the brain (natch) so somebody is going to actually like the way they make you feel and want to buy them off of you. Whatcouldpossiblygowrong?

      (Complacently sips caffeinated beverage).

      --
      Faster! Faster! Faster would be better!
    4. Re:We've Given Up on Poor Kids by ohnocitizen · · Score: 3, Interesting

      False. Total Expenditures for 2008 = 596 billion for both primary and secondary education. Of that, 506 billion was directly being spent by the districts (vs adult education, debt obligations, etc for the remainder).

      Plus, I wonder how much you know about schools that you would suggest firing administrators entirely.

    5. Re:We've Given Up on Poor Kids by RyuuzakiTetsuya · · Score: 5, Insightful

      But as an Actual Asian Person, there's more to this story than that. Hang around Canal St. in New York sometime. Not all Asians have that hard grit academic drive.

      What happened was, a lot of Asian American families are first or second generation immigrants who were already successful and higher status. So they had the strict Asian upbringing AND the tools to enable the hard work ethic.

      It's a complicated matter, and I think you're grossly simplifying the scenario here.

      --
      Non impediti ratione cogitationus.
    6. Re:We've Given Up on Poor Kids by colinrichardday · · Score: 4, Insightful

      If I were the DEA or persons of similar persuasion, I would be shaking in my combat boots.

      What's in it for the DEA to actually end the use of illegal drugs?

    7. Re:We've Given Up on Poor Kids by Anonymous Coward · · Score: 3, Interesting

      The only intelligent thing about your reply is your decision to post it as Anonymous Coward. You have no specific knowledge that supports your worthless claims, have probably never traveled extensively in Asia, and are not well versed in Asiatic cultures or educational practices.

      Asia, the content encompassing many diverse, non-Oriental cultural groups, has no unified or enhanced characteristics of diligence or excellence over the rest of the world.

      My wife is Turkish, which is a country within the continent you mentioned, and many of her family have emigrated to the US after excellent secular graduate level educations in the Middle East to complete their post-grads. Her father was an entrepreneur, a taxi driver, extortionist, and kidnapper, and has been barred from re-entry to the US, but she's earned several degrees and has a great job doing something she loves. I'm Japanese, but was from a poor fishing village with few educational opportunities and a dialect that is unintelligible to the mainland. My family builds boats and houses and fishes to stay alive, and some were out to sea trying to earn a living when the tsunami hit. They value hard work, whether it is applied to sports or academics. This is the only defining characteristic of our mutual successes, not the continent on which our mothers' waters broke.

      Your response was lazy, poorly informed, and stereotypical. Maybe you didn't learn not to speak in your 'American' (How ethnocentric. May I assume United States native?) school by your family when you didn't have anything to say. Maybe what separates your concept of what makes someone an Asian in your mind from Westerners is that they don't try to look smarter than they are and thus never risk looking stupid.

      Remember, if you want to do better, ganbatte!

    8. Re:We've Given Up on Poor Kids by Anonymous Coward · · Score: 4, Interesting

      Have you ever done Peace Corps?

      The reason why Asian-Americans excel is because wealthy Asians emigrate to America. If you actually go to Asia, you'll find that it's just like the U.S.: rich kids go to good schools and poor kids go to bad schools. The only difference is that cheating's a-ok beacuse it lets the school, the administrators, and the students all gain face.

    9. Re:We've Given Up on Poor Kids by Kurrel · · Score: 3, Interesting

      By the same logic, every humanitarian foundation also has a vested interest in preserving human suffering and disease. Every mechanic, doctor, technician, developer, or whatever profession that is paid to fix things should be intentionally not fixing them to maximize profit, yes?

      So why do any of these things work?

    10. Re:We've Given Up on Poor Kids by pspahn · · Score: 3, Interesting

      All it takes is working in education for even a brief time to understand that the majority of administrators should not be doing the job they are getting paid for.

      It's not so much that they are bad at their job, it's that their job is counter-productive.

      They dictate how classrooms should be run when they themselves have either never taught or haven't taught in 15 years. They are often completely out of touch with today's children.

      As a result, we end up with classrooms that are dictated to be run a specific way that simply DOES NOT WORK. Teachers get reprimands for straying from administrative policy even though it provides a better education for the kids.

      --
      Someone flopped a steamer in the gene pool.
  2. Ever notice the drug commercials... by Anonymous Coward · · Score: 5, Insightful

    Ever notice the drug commercials? None of them address the underlying cause -- they address only the symptoms.

    * Your dick doesn't work: Don't get exercise that could actually improve your blood flow. Don't eat right. Take this ridiculously expensive pill. Notice the age of the men on these commercials has dropped from what once was older mean, now the guys could be in their late 30s. WTF?

    * Your cholesterol is thru the roof: Don't cut out fatty foods and fried goodies. Don't get exercise. Take this pill that has more side effects that the black plague.

    It's all about the money -- and it should be illegal. America hates drugs? Start with big pharma. They kill more people every year than illegal drugs.

    If I had my way, I would dictate all pharm companies become non-profit. All money goes to R&D and moderate salaries. Then and only then would the research perhaps be about people and not profit.

    These commercials now about one kid in 110 being autistic. No fracking way is this possible. ADHD? Same thing. When I was a kid back in the 70s, kids were hyper. It's normal. Now? Drug the poor things until they comply. People think a pill can solve anything. Want to lose weight? Take in fewer calories than you burn. Make sure those calories are good calories like fruits, veggies, lean meats like fish, turkey. Actually exercise. Almost no one was fat when I was a kid. Fat people were rare. Now? Almost 40% of Americans are considered fat. Why? The crap that passes for our food should be illegal. We need to become like Europe and ban all the junk. When it's about profit, the people get screwed. What's next? Soylent Green?

    1. Re:Ever notice the drug commercials... by Anonymous Coward · · Score: 5, Informative

      As no one seems to believe these numbers are real, I'll quote the source: The Journal of the American Medical Association (JAMA) Vol 284, No 4, July 26th 2000, authored by Dr Barbara Starfield, MD, MPH, of the Johns Hopkins School of Hygiene and Public Health.

      That study, which is twelve years old -- and drug deaths have risen considerably since then -- documents 106,000 deaths per year from the "adverse effects" of FDA-approved prescription medications.

      To reach this number from outbreaks of violent shootings, you'd have to see an Aurora Colorado Batman movie massacre take place every HOUR of every day, 365 days a year.

    2. Re:Ever notice the drug commercials... by Sarten-X · · Score: 4, Informative

      He can't. He's quoting a website verbatim.

      However, the title of the JAMA article is "Is US Health Really the Best in the World?", and it's available here, though apart from the statement (accompanied by another citation that I'm not ambitious enough to track down) of the number of deaths, it says little else relevant to this story.

      However, I used to work with those adverse effect records, and citing them directly is incredibly misleading. The 106,000 deaths is only a tiny percentage (0.06%) of the 170,000,000 Americans on prescription medications (rough mental estimate of 48%), and it's inflated. The way adverse effects are recorded, any drug that could possibly be the cause of death is recorded as having definitely caused it. If an epilepsy drug causes a side effect, and the patient takes acetaminophen for it but overdoses and dies, the epilepsy drug is considered to be at fault, because the death was a result of its adverse effect.

      The reason for this odd system of inflated numbers is that its purpose. The system was designed to inform doctors and researchers of what could happen as a result of a drug's use, including any previously-unknown interactions. By recording that an epilepsy drug, when taken with acetaminophen, could cause overdose symptoms, researchers could be pointed to an interaction between the two medications.

      For direct deaths, the percentage (original research, no source) is closer to 0.001%, and the majority of these (to the point where I couldn't really differentiate "all") were where the prescription triggered an allergic reaction that wasn't already known (or at least recorded in the doctors' notes).

      --
      You do not have a moral or legal right to do absolutely anything you want.
  3. THX1138 by kurt555gs · · Score: 3, Insightful

    Really! They made a movie about this.

    --
    * Carthago Delenda Est *
  4. Slashdotters now the target! by openfrog · · Score: 5, Interesting

    I have mod points, but since you are well on your way to +5 insightful, I just want to add some data to this. I am interested in this topic, and I have noticed a series of articles in influential venues, like the Economist, the New York Times, etc. beginning a couple of years ago. They all have a common point: they are reporting some kind of controversial news, like here "doctors are prescribing drugs to poor kids to help them, is this good or bad", while the underlying message is unquestioned, that is, whether those drugs work at all. The underlying message is that they do and that would go without saying.

    In the case of the Economist article, unfortunately for the drug companies and the PR firms probably doing this work for them, the reader comments were devastating for this underlying assumption. This article was asking whether it was fair that some students could have recourse to "brain enhancing drugs" bought illegally (like the one used in the treatment of ADHD). Dozens of people having taken drugs as students in the hope of helping at exam times reported their horror stories, and shredded every point of the article.

    Big pharrna is financing PhD students in prestigious universities around the world, for work on the use of drugs, not for therapeutic purposes, but for enhancing the brain. This is something that I have myself confirmed meeting one of them.

    Now it is the Slashdot crowd being targeted. According to the comments I am reading already, I would say this is another mistake of theirs...

  5. You're looking at the very rich by rsilvergun · · Score: 4, Insightful

    most Asian parents work. A lot. 6, 13 hour days is standard fare. I always here Asian parents trotted out as the example, but fact is there's no way to work those kind of hours and raise a kid. How do the majority do it? They let the government, specifically school teachers, who take a MUCH more active role in the students' life.

    As for Asians valuing eduction, that's because in most places it's a dog eat dog hell hole due to their surplus population (that's surplus, no over, population. Over pop means there's not enough, surplus means there's enough to abuse). Americans value those things not because of a weak culture but because we're wealthy enough we can.
    Put another way, I'm sick and tired of this weird cult of frantic, desperate, dog-eat dog work. The puritan work ethic is a scam that the Romney's of the world use to make excuses for their grotesque wealth.

    --
    Hi! I make Firefox Plug-ins. Check 'em out @ https://addons.mozilla.org/en-US/firefox/addon/youtube-mp3-podcaster/