FAQ

THE "SECRET" OF CHADD'S SUPPORT FROM CIBA (NOVARTIS)

by Joe Parsons

There has been a certain amount of brouhaha over the last few years about the financial ties between ChADD (Children and Adults with Attention Deficit Disorder) and a certain pharmaceutical company. A 1995 PBS broadcast ("ADD: A Dubious Diagnosis," John Merrow) purported to uncover secret contributions made to ChADD by Ciba-Geigy (now Novartis), the manufacturer of Ritalin.

Merrow, in the best tradition of ambush journalism, confronted Dr. Leslie B. Roth, then executive director of the lay advocacy group, with the accusation that ChADD was being bankrolled by Ciba-Geigy. The lighting on Dr. Roth was undiffused, which created the illusion that, guilty and humiliated, he was sweating profusely.

Merrow's intent clearly was to make a case that ChADD is a marketing shill for the pharmaceutical giant--that in return for a "fee" of "nearly a million dollars," they would mobilize their 35,000 members to petition the Drug Enforcement Agency to loosen the stringent controls and quotas on the drug. Presumably, they would also promote Ritalin to their members, thus lining Ciba's pockets. This "bombshell" revelation was followed by several soundbites from apparently shocked parents, ChADD members who said they felt
"betrayed" by this new revelation.

Lurid, sensational stories do not necessarily make for responsible journalism, however. There are some facts worth considering.

Assuming that many members of ChADD were NOT aware of C-G's corporate largesse, it is still a FACT that ChADD is organized as a nonprofit corporation under S. 501(c)(3) of the Internal Revenue Code. In order to be granted and to retain tax exempt status, an organization must file regular, audited financial statements. Under 501(c)(3), these documents must be available for public viewing at no charge.

Does everyone read the financials before becoming involved with a nonprofit organization? Of course not--just as we don't read the entire Motor Vehicle Code before driving to the grocery. But since the information IS publicly available, no one can say "I didn't know." This is called "constructive notice."

So much for the "secret contribution" red herring.

The amount of the contributions: ChADD was incorporated in 1987. They approached the pharmaceutical company, seeking financial support for specific projects. Ciba agreed, and over the next seven years, ChADD received $813,000. Given that ChADD's annual budget exceeds $2 million, Ciba's contributions hardly constitutes "bankrolling," as has been charged.

It is true that ChADD initiated a petition to the DEA to ease some of the controls on methylphenidate, the stimulant manufactured by C-G (and others). Moving methylphenidate to Schedule III from Schedule II would make life easier for doctors and patients alike, since prescriptions could be written for more than 30 days, they would be
refillable and a doctor's visit would not be necessary for each refill--a burdensome procedure.

While there's no doubt that easing the controls and quotas on methylphenidate would benefit its manufacturers, the question that critics seem to ignore is what effect it would have on the parents. If prescriptions for Ritalin could be filled with fewer administrative roadblocks, would there be an epidemic of overdosing? Or would the
removal of the DEA's artificial quotas mean better availability for people needing the drug? Was it unethical for C-G and ChADD to collaborate in ANY mutually beneficial way?

Some have correctly pointed out that methylphenidate (Ritalin) is listed on Schedule II under the Controlled Substances Act of 1970. The Drug Enforcement Agency (an arm of the Department of Justice) uses these criteria for placing a drug on Schedule II:

       1) The drug must have a high potential for abuse;
       2) The drug must have a legitimate, recognized medical use;
       3) Abuse of the drug may lead to severe psychological or
           physical dependence

It is important to be aware that the scheduling of a drug occurs as an administrative and law enforcement matter--NOT as a medical one. To put this issue of "controlled substance" into perspective, there is another stimulant used in treating ADHD: pemoline (Cylert). This medication is listed on Schedule III, so it is less rigorously controlled. There have been some serious instances of hepatic (liver) failure associated with the use of pemoline. There have been eleven cases (IIRC) that were serious enough to result in liver transplantation--or death.

Call me crazy, but I'll choose Schedule II Ritalin, with nearly half a century of safety behind it. And if I can avoid a monthly doctor's visit just to pick up a triplicate prescription, I am going to consider that a *good* thing.

Š2000 Joe Parsons

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