April 2014 Archives

When public support for gun control peaked after the Newtown mass murder, the National Rifle Association decided to double down.

The NRA called in all its political chips to vigorously and successfully block even the mildest and most sensible of gun reform intended to limit easy access to military style weapons and ammo.

Instead, the NRA offered its own novel analysis of the problem and proposed its own gun friendly solution. It spread the word that our astoundingly high murder rate is not facilitated by the fact that we pack 300 million guns. No, the problem is just the opposite- the US has too few guns. The best way to prevent mass murder in the schools would be to arm the teachers and the security guards.

The recurrent shootings at Fort Hood have been met with the same 'the-best-defence-is-a-good-offense' NRA strategy. According to the Alice In Wonderland NRA logic, we need to repeal existing laws that restrict guns on military bases and make sure every soldier is armed at all times.

And, following the same logic, the way to make our offices, streets, and homes safer is to achieve a world in which everyone is armed and dangerous.

The necessary corollary to the NRA pitch is that anyone who does kill with a gun must have been crazy. So the solution to the violence problem is not to control the guns- instead, it is to identify and control the crazy people who are the only ones who misuse them.

The National Rifle Association propaganda has it all wrong. Most violent acts are committed by people who are not crazy. And even when mental illness does play a role, we do not have the tools to identify which person will go berserk or prevent it from happening. Mental health professionals can predict high risk groups, but can't pick out which specific guy is about to go haywire. Murder is too much a-needle in-the-haystack rare event to ever be reliably prevented with psychiatric tools.

Only one thing is predictable with statistical certainty. If there are more guns in the schools, streets, offices, military bases, and homes. more of them will be fired and more people will be killed.

If we arm all the teachers and security guards, the most likely school mass murderers will be teachers or guards who flip out and turn their guns in the wrong direction.This is not a case where we can fight fire with more fire.

Instead, we need sensible laws that allow responsible gun ownership while reducing the odds of wild west shoot-em-ups. A reckless arms race that makes guns ubiquitous will kill those meant to be protected.

The statistics tell us that our children are getting sicker and sicker. Attention Deficit Disorder has more than tripled in just 20 years- it is now diagnosed in 11% of all kids and in an astounding 20% of teenage boys. Autism is also on a rapid rise- the latest reported rate suggests it occurs in 1 in every 68 kids; 20 years ago it was less than 1 in every 500. Thankfully, childhood Bipolar Disorder has recently lost a good deal of its faddish luster, but for a while it had enjoyed a bizarre 40 fold increase in popularity. Don't believe the statistics- they are wildly exaggerated. Our kids are no sicker now than they have always been; its just that they are too often mislabeled for behaviors that used to be considered part of normal variation. We are turning childhood into an illness. 

The surest proof of misplaced diagnostic exuberance comes directly from the classroom. Research shows that the youngest kids in class are much more likely than the oldest to be diagnosed as having ADHD and to receive stimulant treatment. It is shameful that simple immaturity due to being younger is now mislabelled as mental illness and mistreated with a pill.  

A diagnosis of ADHD is useful only for those kids who have a early onset of very severe and persistent symptoms displayed in a wide variety of family, school, and social contexts. Children who are properly diagnosed after a careful evaluation and a period of watchful waiting usually benefit from the treatment and extra school attention.  
But the two thirds or more of active kids who have been mislabelled with ADHD suffer unnecessary stigma, reduced expectations, and harmful drug side effects. We need to do a better job of protecting our children from such widespread careless diagnosis and reckless treatment. 

One crucial step would be to tame the drug companies that have benefited from over-selling the ADHD ill in order to push their stimulant pills. Big Pharma has used its formidable lobbying might to gain the unprecedented right to advertise directly to consumers- aiming directly at parents and teachers. The only other developed country on earth that allows direct to consumer advertising is New Zealand.

Massive and cleverly misleading marketing has transformed the stimulant drug market from a minor player to a ten billion dollar a year cash cow. This is great for Pharma executives and shareholders, but bad for the kids who are mislabelled and mistreated. 

Wouldn't it be a much better world if most of this misspent and wasted money were instead budgeted toward better schools. We should be able to manage the more active kids with educational tools rather than subjecting them to fake medical diagnoses.

What makes more sense- promiscuous use of pills or smaller class sizes and more facilities for physical activity that allow kids to blow off steam. 

Our country is spending far too much on unnecessary and often iatrogenically harmful medical care and far too little on education. It is completely irrational to shortchange our schools and then spend a bundle on misguided medical treatment for normally active kids who don't do well in a stressed school environment. 

A first step would be to follow the lead of the rest of the developed world and end all drug company advertising. We shouldn't fall for the sales pitch that the problems in our schools should be treated by medicating our kids. 
Instead, let's diagnosis and treat our classrooms and playgrounds, not over-diagnose and over-treat our children.