Attention deficit hyperactivity disorder (ADHD) is a condition defined by the National Institute of Mental Health (NIMH) as causing lack of attention, hyperactivity, or impulsivity control (NIMH, 2008). The condition is believed to effect between 5 to 10 percent of the population (Faupel, Horowitz, & Weaver, 2010). With a world population of about 7 billion, the number of people affected comes to 350 to 700 million. In the USA this number comes to nearly 16 to 31 million people. With such staggering numbers one has to wonder whether ADHD really is a disorder. Perhaps instead ADHD is more of a societal problem. If this is the case society must more closely examine the ethics of using Ritalin, or similar medication, to treat ADHD. Ritalin may better serve as the method of last resort than the method of choice.
Every year 11 million Ritalin prescriptions are written for children with ADHD (Faupel et al., 2010). It is actually a stimulant, which seems paradoxical since it is prescribed to treat hyperactivity (Faupel et al., 2010). In low doses, however, Ritalin can act to improve neuron connectivity in the prefrontal cortex without the stimulant effects. Higher doses of Ritalin, in addition to the stimulant effects, actually reduce the prefrontal cortex neurons’ ability to receive signals (Fisher, 2008). Additionally, although there were fears relating Ritalin’s potential addiction, these low doses have shown not to affect the brain centers responsible for addiction (Fisher, 2008). Ritalin, it seems, may be a fantastic treatment when dosed correctly.
If the entire story was that ADHD is a disorder that needs a fix, and Ritalin was a means to bring dysfunction into order, then there would be no question that Ritalin is a great solution. But there is more to the story. With up to 10 percent of the population experiencing ADHD, it seems more like ADHD is a biological norm, than an anomaly. In fact, genetics seems to corroborate this idea. Remember the neurons we spoke of before? There is a high correlation between people with ADHD and the gene variant responsible for encoding DRD4, which is a dopamine receptor (Lewis, 2012). This particular variant handles the neurotransmitter dopamine less efficiently than other variants thereby contributing to what society has labeled ADHD.
If ADHD is so widespread, and has genetic roots, why did evolution not eliminate the gene through natural selection? It turns out that populations native to the Americas offer a fantastic answer. At approximately 16,000 years ago the first natives migrated to Alaska through a now flooded land bride from Asia (INSTAAR, n.d.). They eventually migrated all the way down to South America, leaving populations of people along the way. It turns out there is a correlation between the ADHD variant DRD4 gene and the latitude at which each population settled. Native Canadians, for example, have only a 2% occurrence rate of the gene variant while those in Southern USA have as much as a 10% occurrence rate. As we go further south, Native Populations in South America have as high as a 50% ADHD gene variant rate (Lewis, 2012). What this indicates is that the ADHD DRD4 gene variant had a role in driving migration. It was, in other words, beneficial to the survival of the human species.
What all of this indicates is that society has changed to such a degree that it is intolerant of our basic biology. Society has evolved to such a degree that it has caused a rift between societal expectations and our biological reality. Additionally, ADHD is not the only so called “disorder” for which society has applied a label because of its own intolerance. There are numerous other examples of this rift between society and biology. This rift is masked by a society that denies its evolutionary roots in favor of a seven day creation. As a result, society fails to see problems as they are and would rather put a Band-Aid on it through the form of Ritalin than change itself.
The culmination of all this information leads me to question the widespread use of Ritalin. ADHD, after all, has very strong genetic factors. Additionally these genetic factors, once upon a time, served the human species very well. How can we say then, that ADHD is a disorder, when it has served the human species far longer than our society existed? Also, how can we say it is a disorder when up to 10% of the population experiences it? In a society where it seems everyone has a diagnosis, I think it must be the society itself that must change. Ritalin use, when seen from this evolutionary perspective, has new ethical meanings that may be seen in a new light; a form of population control.
Faupel, C. E., Horowitz, A. M., & Weaver, G. S. (2010). The Sociology of American Drug Use (2nd ed.). New York: Oxford University Press Inc.
Fisher, M. (2008, June 24). Study uncovers how Ritalin works in brain to boost cognition, focus attention. Retrieved from University of Wisconsin-Madison: http://www.news.wisc.edu/15342
INSTAAR. (n.d.). Postglacial Flooding of the Bering Land Bridge. Retrieved January 27, 2013, from Colorado.edu: http://instaar.colorado.edu/QGISL/bering_land_bridge/
Lewis, M. (2012, May 21). Disease, Disorder, or Neurodiversity: The Case of ADHD. Retrieved from Psychology Today: http://www.psychologytoday.com/blog/addicted-brains/201205/disease-disorder-or-neurodiversity-the-case-adhd
NIMH. (2008). Attention Deficit Hyperactivity Disorder. Retrieved January 28, 2013, from National Institute of Mental Health: http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml