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08-04 Chewable ADHD medication triggers controversy

Chewable ADHD medication triggers controversy

The Federal Drug Administration approval for a chewable amphetamine – in what The Fix calls “a tasty, convenient package” – for ADHD children six and older is “a recipe for people to request it and then sell it,” warns Mukund Gnanadesikan, a youth psychiatrist in California.

“I’m not a big fan of controlled substances that come in forms that can be easily abused—and certainly a chewable drug falls into that category,” Gnanadesikan emphasized.

Adzenys was given the nod for prescriptions back in January by the FDA, but the heated ethical debate of its usage for first graders and older make the idea of the new ADHD treatment variety hard to swallow.

Why a parent would buy a flavored chewable

One doctor in favor of Adzenys recounts the convenience as a welcome compromise for families of a child with Attention-deficit/hyperactivity disorder.

Greg Mattingly, M.D. made the first prescription of Adzenys to a 9-year-old boy who “hated the liquid formulation and had trouble swallowing pills.”  He said the chewable tablets offered new hope” to the family.

Statistics point to as many as 65 percent of children with ADHD have a co-occurring or co-morbid behavioral disorders including:

  • Anxiety/mood disorders: 25-48 percent
  • Oppositional Defiant Disorder: 40-60 percent
  • Conduct Disorder: 14-20 percent
  • Severe tics/Tourette’s Disorder: 11 percent
  • Bipolar disorder: 0.2 percent

While opponents of Adzenys would argue medications in general should be taken because one needs it, not because it’s enjoyable to take, parents of children with ADHD and comorbid aggressive conditions insist a more appealing medicine would lessen the literal fights to get a child to take needed calming medication.

Continuing the debate

Still, opponents argue the advent of a fruit-flavored chewable amphetamine is more than just “a spoonful of sugar to help the medicine go down” and will spur abuse.

“There’s a very real population of children and adults whose lives are vastly improved by medications like Adderall and Ritalin, which stimulate the central nervous system and affect chemicals in the brain associated with impulse control. But the line between need and want is increasingly blurry,” states an article in Statnews.

It would seem some of the same follies that perpetuate substance abuse – ease of access, lack of impulse control, physiological and emotional dependency to function – are the same arguments in favor of chewable amphetamine for kids.

Proponents of Adzenys say the chewable “quick-dissolving formulation will help harried mothers get their kids medicated faster before school.” According to the sponsoring pharmaceutical company’s CEO, Vipin Garg, “It could also be useful for the adult ADHD population … If they forget to take their pill with breakfast, they could just pop a tablet on the way to work.”

This advertisement of compliancy is what also fuels contraceptives such as spearmint-flavored chewable birth control and the heavily debated Plan B.

But compliancy is precisely what’s got those opposed wary. To maintain health with medication requires a degree of self-discipline, situational awareness and responsibility. To continue to cut-these corners in the name of ease, to circumvent teaching this mantle of responsibility to children who take long-term prescriptions into adulthood, could set them up for future prescription abuse.

Similar to the birth of the opioid abuse epidemic, the tolerance buildup of amphetamine-based ADHD medications necessitates increased dosage over time. Combine ever-more increased dosing with a tic-tac-like portability and indeed, an amphetamine epidemic could replace the opioid epidemic.

FDA contradiction

The FDA approved opioid agonist implant Probuphine late spring 2016. The main crux of the argument for the implant was that it can’t be sold, stolen or accidentally overdosed on, by children or pets who accidentally consume the medication.

In contrast, creating a medication looking and tasting like candy can be dangerous for the patient taking it, but it can also be confused by another child or pet, not to mentioned sold or stolen for its appeal.

It seems contradictory that the same FDA cracking down on opioid medication’s potential for abuse would push easier portability for a similarly abused medication.

Alexander Papp, a psychiatrist who works with UCSD, called the chewable ADHD drug “an orally disintegrating amphetamine for kids by the morally disintegrating FDA.”

Sovereign Health Rancho San Diego treats adolescents 12-17 who struggle with substance use and mental or behavioral disorders. To learn more about our programs please contact us through our 24/7 helpline.

About the author

Sovereign Health Group staff writer Kristin Currin-Sheehan is a mindful spirit swimming in metaphysical pools with faith as her compass. Her cover: a 30s-something Cinderella breadwinner of an all-sport blended family. Her repertoire includes writing poetry, lifestyle articles and TV news; editing, radio production and on-camera reporting. For more information and other inquiries about this media, contact the author at news@sovhealth.com.

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