Dr. Harold Koplewicz is one of the nation’s leading child and adolescent psychiatrists. He is widely recognized as an innovator in the field, a strong advocate for child mental health, and a master clinician. He has also been at the forefront of public education to dispel the myths and stigma surrounding children and adolescents living with psychiatric disorders. Koplewicz has been repeatedly recognized in America’s Top Doctors, Best Doctors in America, and New York Magazine’s “Best Doctors in New York.” In 2006, he was appointed Director of the Nathan S. Kline Institute for Psychiatric Research (NKI), making him the third person to hold that position since the institution’s founding in 1952. He is also the founding president of the Child Mind Institute.
Question: Are we over-medicating our children?
Harold Koplewicz: I think one of the great myths is that we are over-diagnosing and over-treating and over-medicating the children of America. Nothing could be further from the truth. While there’s tremendous increase in the identification of something like Attention Deficit/Hyperactivity Disorder and therefore more children are able to get ahold of medication, the overwhelming majority do not get identified and don’t get treated.
The good news is that these medicines have been available since the 1930s, no one has ever died of taking a psychostimulant like Adderall or Dexedrine or Ritalin. And more importantly, kids who get treated early are less likely to use illicit drugs than kids who don’t get treated or kids who get treated late when they have ADHD.
And it makes perfect sense. If you don’t diagnose and treat a real psychiatric illness and a kid feels demoralized and feels irritable and feels terrible about themselves and about their self-esteem, the psychiatric medicines don’t work, they start treating themselves with alcohol, with marijuana, with cocaine, with ecstasy, with illicit drugs, with cigarettes. And so ignoring these disorders and worrying about the fact that we’re medicating too much... when in reality I think we need to get better at identifying kids when they’re in trouble, recognizing that these are not "feel good" medicines. They have no street... I mean, take this pill, take this Prozac, you’ll feel better in six weeks. You know, it has not street value—is really a problem and America has to get their head around the fact that psychiatric illness is real and at times needs not only real treatments like cognitive behavioral therapy or behavioral treatment or whether it’s remediation or accommodations for learning, but also needs medications at times.
And with medication there’s always the risk of side-effects and the potential of a positive effect that at the end of the day will let a child or a teenager truly be able to live a full life, at work, at school, at play and in love, with friends and with their family.
Recorded August 18, 2010
Interviewed by Max Miller