Recently Dr. Al Mohler responded to an article by Erica Komisar in the Wall Street Journal which addresses the problem of overmedicated children. His entire article is reprinted below my comments. He highlights what Komisar says is a major problem – way too many children are medicated.
Simply put: it is not wrong for a doctor to prescribe a child medicine. In fact, a doctor may have valid reasons to do so. As Christians, these types of medicines would fall under the general category of common grace. As a biblical counselor, I do not regularly suggest or oppose psychopharmaceutical drugs. Since biblical counselors are not medical doctors (nor do I play one on TV), the issue of medicine is outside my purview; it is an issue between doctor and patient. Every case is different and the ultimate decision regarding medication must flow out of a conversation between the parent, doctor, and child. I make no assumptions related to any individual child and his or her need for medication.
We can however receive a word of caution related to medication. Just as we would not perceive it to be sinful or wrong, at the same time, we also do not want medicine to be a substitute for good parenting with regular, meaningful conversations or spiritual discipleship and development. Therefore, do not take this article as a criticism of what you do or your neighbor does; instead, receive this as a general statement of warning related to the possibility of overmedicating children. We do not want to functionally practice what we would formally reject; that is, medicine actually changes the hearts of our children.
Medicine may provide certain kinds of relief when necessary; however, medicine does not help train, nurture, or disciple a child. We must never allow a drug in our minds to replace the importance of Christ-centered, Gospel-focused parenting or discipleship. As a close friend recently asked, Do psychotropic medications address heart issues? Do they help a person change and grow out of sinful desires, thoughts, and emotions using biblical methods as outlined in God’s Word (i.e. identifying suffering or sin, confession of known sin, repentance, putting off manifestations of the old man, renewing one’s mind, putting on manifestations of the new man, seeking forgiveness from God and others, working toward restitution, etc.)? No, they do not.
Whereas spiritual growth and soul care used to be the treatment of choice, we must not think that a pill alone can fulfill that function. Dr. Mohler simply reminds us of this truth and challenges us to consider how we functionally view psychiatric drugs to treat depression and anxiety.
The drug problem of American children: Why no pill can ever fully treat the deepest issues of the human heart
Now, staying in the Wall Street Journal. There was another article yesterday that falls on the same theme. Erica Komisar wrote an article with the headline: We’re Overmedicating Our Children. The second paragraph begins with the line: American children have a drug problem. But what’s the drug problem? It’s not in this case illicit drugs, but rather it’s drugs, psychiatric drugs to treat ADHD or malady such as depression and anxiety in children and in teens.
Komisar goes on to tell us what we already know really, and that is that the use of these drugs is both extensive and excessive. She writes, “A study published last year in the Journal of Clinical Child and adolescent psychology found that some 5% of American children were on stimulants like Ritalin and Adderall to treat ADHD and behavioral problems, and that was in 2016 that the study was based.”
“The Centers for Disease Control and Prevention,” she says, “Reported a nearly 400% increase and antidepressant use in patients between ages 12 and 19 just between the years 1988 and 2008.” 2008 shockingly enough, is the most recent year for which the data are available, but then shockingly enough, Komisar writes, “Yet many of these young people don’t actually have ADHD, clinical depression or anxiety.” She cites a 2000 study that found that, “The majority of children and adolescents who were being medicated for ADHD did not fully meet the diagnostic criteria for the condition.”
“Criteria,” she says, “That are so subjective,” that a 2018 study in the New England Journal of Medicine, “Showed that the younger a child is relative to his classmates, the likelier he is to be diagnosed with ADHD.” “That findings,” says Komisar, “Suggest the disruptive behavior is the result of immaturity, not illness.” When that study came out, I discussed it on The Briefing. Komisar’s latest article brings together a monumental amount of data demonstrating that the use of psychiatric drugs is excessive amongst American children and teenagers.
She points out, “Psychiatric drugs can often stop undesirable behaviors and silence the symptoms of emotional pain, but the use of drugs as a quick fix does not,” she says, “Help children become emotionally mature or resilient to stress. Instead, it teaches them to avoid painful or uncomfortable feelings. Medication,” she says, “Can also have significant side effects including addiction.” But this takes me back to Philip Rieff and the 1960s, his book: The Triumph of the Therapeutic because even then he pointed to the fact that increasingly Americans were looking for therapeutic salvation in some form of a pill.
Such efforts explicitly began to expand during the 1950s and the 1960s, but we’re now living in a time in which many Americans just assume that the answer to any problem, even immaturity or developmental issues, behavioral issues in their children or teenagers, they must be resolvable if not by therapy, then by a pill. Now again, I am not a medical doctor. I am not speaking about any specific psychiatric or medical situation.
I’m talking about as Erica Komisar is writing about, the overarching problem of overmedicating our children or believing that some kind of medication must be the answer to what really amounts to some of the normal traumas and developmental and behavioral issues of childhood and adolescence. Indeed, Komisar ends her article by saying, “This is not to say children should never be medicated. Psychiatric medication,” she writes. “Is an important tool in treating serious mental illness,” but she concludes, “It’s no substitute for attention, understanding and connection.”
Here, Christians would have to add, there’s something even more fundamental. It cannot be a replacement for love and understanding and patience and kindness and correction and discipline and instruction summarized in the Scripture as raising children in the nurture and admonition of the Lord, and furthermore, no medication, no pill, no therapy can provide what can only come by the gospel of Jesus Christ.
Most ultimately, we do not need mere healing. We do not need mere wholeness. The greatest need of our lives is not inner peace or even some kind of balance in our lives. What we need more than anything else is salvation. Now, that doesn’t imply that Christians do not sometimes struggle with some of these same issues, but it’s categorically different to understand that some may struggle with these issues and then on the other hand, to say that therapy is clearly the answer.
Looking at Erica Komisar’s article, it’s really important for us to recognize that it’s one thing, it’s bad enough for adults to be overmedicated and to look to the pill cabinet for some kind of deliverance, but there’s something even sadder, and even more ominous about the fact that we are now as a culture overmedicating our own children. Again, Komisar’s most graphic sentence begins her second paragraph when she tells us, “American children have a drug problem.” But this is where Christians have to understand if so, the culture has an even bigger problem.
About the Author:
Dr. R. Albert Mohler Jr. serves as president of The Southern Baptist Theological Seminary in Louisville, Kentucky. He is a prolific writer and produces a daily show “The Briefing.” In addition to these responsibilities, he also serves on the faculty of Southern and is a leader in the Southern Baptist Convention. He is married to Mary, and they have two children, Katie and Christopher, as well as one grandchild.
