Anthony Patterson Sports Journalism Final Story 12/10/13 What The Doctor Ordered Richard Scott Fee played

first base on the baseball team at Greensboro College for four years. Key word: played. In 2011 Fee died suddenly. The culprit? A Clue-like murder mystery? No, Fee died from the effects of Adderall, an amphetamine drug given to people diagnosed with ADD and ADHD. His story was expounded upon in The New York Times article Drowned in a Stream of Prescriptions. It paints a terrible picture of what happened to Richard Fee. Nearly 14 million monthly prescriptions for ADD and ADHD were written for Americans ages 20 to 39 in 2011, two and a half times the 5.6 million just four years before, according to data company I.M.S. Health. Dr. Richard Lustberg is New York State Licensed Psychologist and according to him, the usage of these drugs is not easy to determine. Its been pervasive for a long time, said Lustberg. People have gone in and taken tests for others and done papers for others. The prevalence of ADHD in American adults is about 4 percent according to the National Institute of Mental Health. And a 2006 study in the journal Drug and Alcohol Dependence claimed that about 10 percent of adolescents and young adults who misused A.D.H.D. stimulants became addicted to them. That doesnt seem too condemning given the fact that it is in the context of misuse. However, even proper, doctor-supervised use of the medications can trigger psychotic behavior or suicidal thoughts in about 1 in 400 patients, according to the 2006 study in The American Journal of Psychiatry. There are more than 1,000 user comments on Drowned in a Stream of Prescriptions. One in particular sticks out. Jimmianne, the spotted owl writes: ADHD medications are very tricky. I've been on one for three years. I tell myself I could stop any time I want, but I know I'm an addict that can't function without the drug because once you've taken it, even for a short time, stopping makes you confused and despondent. I'm 65 years old and smart enough to limit my dose. I found that I need only 1/8 of the recommended dose to function, but of course on that you miss out on the euphoria and intense concentration. Even at the lower dose I feel the drug is keeping me alive and killing me at the same time. I

don't connect to people as well as I did and have fewer emotions. My psychopharmacologist writes me Rx's for so much that I could become a street vendor. When I tell her I think it's become a problem, she tells me I need it and writes another 90 days worth. Of course I fill the Rx to stockpile in case it gets hard to get, as it has at certain times. Those teens and 20's don't stand a chance. Dr. Lustberg writes a sports column called The Psychology of Sports and has been featured on ESPN and The New York Times. He wrote a column in November called Adderall and Major League Baseball: Another Way of Cheating. I spoke to him about the use of Adderall and other similar drugs. He believes that they are often over-prescribed and that ADD and ADHD is often misdiagnosed. Ben Deese, a student at the University of Illinois Urbana-Champaign, also commented on the Times article, []I am disappointed in a lack of proper mental health education in high schools and colleges around the country. Most students who are taking the drugs illegally are not inherently malicious, but just trying to achieve more. It upsets me to no end when my grades are then curved against these possible drug abusers, students who can score much higher on exams than I could. His comments sound like competitive sports jargon, not a reflection on academic fairness. Right? Perhaps Deeses comments expose a reality we arent comfortable with. College and academic achievement is just like professional sports. Deeses comments lend readers to think that he may be upset with the thought that people are using drugs to get an edge. Isnt that the same problem players have when people are caught cheating? In November of 2012, All-Pro wide receiver Brandon Marshall of the Chicago Bears said that he knows of some NFL players using Viagra to get an edgeon the field. I've heard of guys using Viagra, seriously, because the blood, it's supposed to thin. . I don't know. Some crazy stuff. It's kind of scary with some of these chemicals that are in some of these things, so you have to be careful, said Marshall. Marshall is an active advocate in the mental health community and has been diagnosed with Borderline Personality Disorder.

*** *** *** Danny was a physical therapist, a body builder and a wrestler. Cheryl says Danny wrestled part time in the San Antonio community and put on shows for kids. During one wrestling match, I guess they were part way into it, Danny didnt feel well and walked over to a chair, Cheryl explains. He sat down, apparently grabbed his chest, threw up, fell over and he was gone

Guess what prescription Danny was using? My son was only 31 years old and healthy, says Cheryl, but there is a history of heart disease in our family so why was he prescribed this drug, knowing that he could have an Adderall heart attack? Danny and Cheryls story is told in Jane Mundys article Adderall: A Mothers Heartbreak. According to the Substance Abuse & Mental Health Services Administration, emergency room visits whose listed reasons included an ADHD stimulant rose from 13,379 in 2005 to 31,244 in five years. Who is to blame? The FDA is aware of the cases of the deaths. So far, the only noticeable action is the revision of labeling on some prescriptions. Maybe this is the parents fault for resorting to giving their children drugs. In February of 2005, the FDA made an official statement on Adderall and Adderall XR. Adderall XR is approved in the United States for the treatment of adults and pediatric patients 6 years of age and older with ADHD, and Adderall, the immediate-release formulation of the drug, is approved for pediatric patients with ADHD. The Food and Drug Administration (FDA) has been aware of these post-marketing cases, and evaluated the risk of sudden death with Adderall prior to approving the drug for treatment of ADHD in adults last year. Applaud the FDA for looking into the issue of serious side effects. No, on second thought, stop clapping. In the same statement the FDA says, When one considers the rate of sudden death in pediatric patients treated with Adderall products based on the approximately 30 million prescriptions written between 1999 and 2003 (the period of time in which these deaths occurred), it does not appear that the number of deaths reported is greater than the number of sudden deaths that would be expected to occur in this population without treatment. For this reason, the FDA has not decided to take any further regulatory action at this time. Sorry everyone at home. The FDA justified not taking further action because people die suddenly all the time without these drugs. Did you notice that the FDA also said Adderall is approved for use starting at six years old? Scientists say that the brain is not fully developed until approximately age 24. Why is there such a hushed tone when it comes to the issue of ADD and ADHD treatment? The answer may be in the money. Shire manufactures Adderall and Vyvanse, another leading ADHD medication. In 2012 Vyvanse made $1.1 billion and Adderall made $429 million. In August, the NFL and ex-players agreed to a $765 million concussions lawsuit that stated the NFL had evidence concussions were drastic injuries with life altering effects. Even after settling, the NFL has been mum on the claims made against them.You may be wondering what this has to do with

Adderall or ADD and ADHD. In 2012, the NFL suspended 19 players for a violation of the league's substance-abuse policy; in eight of those, the player was linked to Adderall or publicly blamed it for a failed test. The number of exemptions granted by the NFL is confidential, but MLB granted 116 exemptions in the 2012 season, meaning about 9 percent of baseball had the exemption. That is 5 percent more than the national average. Do baseball players tend to have ADD or ADHD more than other adults? Thats not certain.

In August, Miguel Tejada was suspended for 105 games for unauthorized Adderall use. Tejada previously had an exemption to use the drug. According to Denver-area adult ADHD specialist Dr. William Dodson, a doctor must provide an exhaustive evaluation, which then goes to the league, where it is reviewed by one or more independent specialists. It also requires a doctor who treated the player in adolescence to confirm his childhood history. The league pays for the process. Why do sports leagues go through so much work before allowing players to use Adderall and similar drugs? Is it simply to protect their product? Caitlin Swieca of the Denver Post included a very good detailing of Adderall restrictions in various sports in her article NFL, other leagues deal with players' use of amphetamine Adderall:

NFL: A doctor must fill out an exhaustive diagnostic form documenting the presence of lifelong impairments, and childhood history must be confirmed by a physician who treated the player as a child. The form goes to an NFL administrator, who sends it to an independent expert in ADHD. Everyone must agree the case is legitimate before the player can get a exemption. The exemption must be renewed every year. MLB: A player must be diagnosed with ADD or ADHD by an MLB-certified clinician using a specific diagnostic interview. If the player hasn't been diagnosed by an MLB-certified clinician, the case is referred to the MLB's Expert Panel on ADD/ADHD, which can then request additional information or tests before issuing an exemption. NBA: Players can apply for an exemption with the medical director of the league's anti-drug program. NHL: A player must apply to the league's Program Committee, which will review the application and decide whether to grant an exemption. This process must be repeated yearly. NCAA: The student-athlete can show proof of an earlier ADHD diagnosis and course of treatment, or undergo an assessment through the university in order to get an exemption. The paperwork must be

maintained by the athletic administration to show in the case of a positive test. *** *** ***

Our culture has created this monster. We want instant, gratifying results. If we know something will help us achieve what we want, we will most likely use it. Whether it be people, sports, doctors or drugs it doesnt matter. A popular saying in professional sports is: What have you done for me lately? Such is the realm of addictive drugs. For some, these drugs have given focus, drive and hope. Others have received an inevitable death sentence. Healthcentral.com is conducting a poll on medication use for ADD/ADHD. The poll is a simple yes or no response to the question: Have you used medication to treat ADHD? Of 1926 responses as of December 9, 2013, 76 percent responded yes. No matter how skewed those results may be it shows just how much of a problem we have. If 4 percent of adults actually deal with ADD and ADHD, why have so many people used the medication? Maybe some want an edge, a high or the like. But does anyone want sudden death?

In the Times article, Richard Fees father recalls him saying that The doctor wouldnt give me anything thats bad for me and Im not buying it on the street corner. Unfortunately, Richard Fee was very wrong. Adderall is a sanctioned amphetamine and it is possible that the drugs on a street corner come with more of a warning than Ritalin, Adderall, Focalin, Methylin, Concerta, Strattera, Daytrana, Wellbutrin, Metadate, Vyvanse, or Quillivant XR. The names of those drugs are almost as scary as their potential side effects. Too many psychologists, doctors, pediatricians and physicians are prescribing these dangerous medicines. All of them arent prescribing them for the money. But certainly some are. Some might not even be aware that these drugs come with great monetary and health cost. I dont think that 14 million subscriptions a month would occur if the public knew about the dangers of Adderall and the like. Its similar to what happened in sports with steroids. Players figured out that they could become much stronger and faster with these untested drugs. Some people were eventually suspended for using banned substances but the bigger picture is that some people lost their lives using steroids. Chris Herren played in the NBA from 1999-2006. He became addicted to several painkillers during his time in the league and eventually started using crystal meth before overdosing on heroin soon afterward. Adderall is not very different chemically than crystal meth. Chris Herren was seen as a junkie, drug addict while there are people abusing prescriptions that are virtually the same. We, as a society, have to evaluate how we view things and stop condemning illegal things while praising legal things that have the same effect. Such is the hypocrisy of our culture. If something is personally useful to us, we allow it. If something is a nuance, we outlaw it. How about we call me meth, meth, and stop sugar coating things to suit our needs. Its not fair to parents, doctors or

children. If we want what is best for each other we need to take a long, hard look at what we allow in the pharmacists closet.