Violence In Our Schools And Streets
Violence in our schools and streets never gets proper analysis. We have studies that could help us understand some of the medical reasons a teenager becomes aggressive with others and even to the point of killing classmates. However, our society is focused on the weapon rather than the person wielding the weapon. Their weapon of choice is often a gun, and this is the usual focus, as if a violent person would not simply use a knife, a car, a bomb, or their own two hands if they did not have a gun. Indeed we have seen many people plow through crowds of people with cars and there are knife stabbings often in our society. Bombs are less common in the USA than other countries.
One of the common factors in many of the school shootings that is almost never brought up, is that many of these young shooters are using a medication for depression or attention-deficit hyperactivity disorder. The most common medication the shooters and other violent students are found to be using is a selective serotonin reuptake inhibitor for depression. Could it be that these drugs tip susceptible individuals over the brink? Additionally, amphetamines, both prescribed and illicit, are associated with increased aggression. By prescription, amphetamines are given to children as well as adults for attention deficit and hyperactivity disorder/attention deficit disorder, and they are the second most common nonprescription, illicit drug used by students after marijuana.
Drugs Are Associated With Violence In Young People
There appears to be a correlation between the prescription selective serotonin reuptake inhibitor drugs, as well as amphetamine drugs (prescription and illicit) these young people are using and the aggression that ensues. However, correlation does not always mean causation and this is what supporters of these drugs attempt to point out as they sweep this researched data under the rug.
Who are the companies or individuals who take our attention away from this association between the drugs and violence in our schools and streets? They would be drug companies and people with private agendas. In relation to the shootings I hear a lot about guns, and the NRA having control of congress, but it is interesting that the NRA only spent 4.8 million lobbying congress in 2021, compared to the pharmaceutical companies spending just under $163 million. Please do not let them the pharmaceutical companies take your focus off of the issue of the actual shooters, their aggression and SSRIs, as well as the amphetamine drugs and move it to guns. A gun without an aggressive person is just a lump of metal. This aggression in our country is getting worse as time goes by, and if we keep ignoring it, we can expect to see more shootings, more drivers in cars running over crowds, more bombings, more people being pushed in front of subway trains, more people being stabbed etc. Please look a little deeper at the person using the gun, the car, the knife, their hands, bombs and what is driving them to do this. As a naturopathic physician I was trained to look upstream for the cause of an issue, rather than looking at downstream activities or symptoms. Therefore, I want to know where this aggression is coming from and why it is not being addressed appropriately. I understand there are many factors involved such as genetics, medical issues, and other psycho-social factors that may fan the flames of these aggressive individuals. However, in this article I am looking at one of the possible reasons that may cause an individual to become so angry/fearful or so psychotic that they attack others with intent to harm or kill them. In this article we will look at two different classification of drugs and how they may be triggering aggressive behavior in school shootings and other violence in our society.
We will first examine selective serotonin reuptake inhibitors and then amphetamines. There is research for both types of drugs that supports them as a possible causative factor in the increasing aggression seen in young people as well as some adults.
Selective Serotonin Reuptake Inhibitors As A Factor In Aggression
Selective serotonin reuptake inhibitor (SSRI) drugs block the reabsorption or reuptake of serotonin in the brain. Serotonin is a naturally occurring neurotransmitter (nervous system chemical) that is used by brain cells to communicate. As SSRIs mainly affect the levels of serotonin and not levels of other neurotransmitters, they are referred to as “selective.”
Serotonin influences many cognitive functions including mood, social behavior, impulsive behavior, and decision-making. Disorders in serotonin modulation are linked to such clinical issues as autism, attention deficit hyperactivity disorder, bipolar disorder, depression and schizophrenia.
SSRIs are thought by mainstream alopathic practitioners to be effective, and to have fewer side effects than other antidepressants. However, there are those that disagree with this well accepted idea by the industrial medical model. In one research study review, it was pointed out that only 50 per cent of patients respond to the SSRI's and effective remission occurs less than 30 per cent of the time. Dr. Paul Andrews pointed out in 2015 that the role of serotonin in depression and use as an antidepressant has not actually been elucidated. He completely negates the idea that serotonin is lowered in the population of depressed people and you can find his research article here. Besides the fact that low serotonin may or may not be the main issue, I think there is enough evidence to show that SSRIs may be involved in additional violence including suicide and murders. There is at least enough evidence to take it seriously and study SSRI's more thoroughly in relation to aggression.
The following antidepressants are included in the SSRI category
Citalopram (Celexa), dapoxetine (Priligy), Escitalopram (Lexapro), Fluoxetine (Prozac), Fluvoxamine (Luvox) Fluvoxamine CR (Luvox CR), Paroxetine (Paxil), Paroxetine CR (Paxil CR), Sertraline (Zoloft, Lustral), vortioxetine (Brintellix)
Support For The Idea That SSRI's Are Linked to Increased Violence In Our Schools and Streets
I have heard over and over again that these young shooters (and young people with other types of aggression) are on an antidepressant. The question was how many of them were on SSRIs? I found a lot of data supporting the idea that the shootings correlated with SSRI prescription use. I list some of this data below, but they are just a drop in the bucket.
This link has a list of 66 school violence incidents being related to SSRIs. http://www.democraticunderground.com/10022021581
The Top Ten Legal Drugs Linked to Violence
This link has a list of various stories on school shootings/violence and includes data on the antidepressants, usually SSRIs.
In a 2016 meta-analysis of scientific research the reviewers found "Treatment of adult healthy volunteers with antidepressants doubled their risk of harms related to suicidality and violence."
In another meta-analysis in 2016 the researchers found no increase in adults with the use of SSRI's, but in children and adolescents there was a risk of both suicidality and agression that doubled with the use of SSRI's. I would note that there was some inforamtion around suicidal ideation that was not avialable in the data that would have made this study less complete.
A 2015 study examined SSRI effects related to age. They concluded " With age and sex stratification, there was a significant association between SSRIs and violent crime convictions for males aged 15 to 24 y (HR = 1.40, 95% CI 1.13-1.73, p = 0.002) and females aged 15 to 24 y (HR = 1.75, 95% CI 1.08-2.84, p = 0.023). "
More on SSRIs
So, it is obvious there is a correlation of SSRIs and violence if you look at the studies. A number of studies have indicated that SSRIs may have different effects in the young population compared to adults. There has been a consistent indication in research that children and adolescents treated with SSRIs may experience higher rates of suicidal ideation. There are also clinical trials that suggest an association between SSRIs and an increased risk of violence in children and young adults.
Young people still have developing brains. There is little research on these antidepressants when used with children, but they are still given to children in the USA. In animal research with antidepressants used in early development, the animals showed increased depression and anxiety in later life.
Low serotonin levels may be linked to aggression. Serotonin lelvels may be linked to impulsive aggression we see in violent behavior. Low serotonin is thought to be linked to depression, and aggression towards oneself and others. Why then would young people using SSRIs have violent outbursts and even kill others when their serotonin levels are higher? It may be that these young people treated with SSRIs are having violent episodes when they have dips in their serotonin due to the SSRI having a short half-life. So, the aggressive behavior may have something to do with enhancing the amount of serotonin, and then getting sudden dips in the serotonin level due to the difference in the adolescent brain, increased metabolism of the drug in young people and a shorter half-life of the drug. What happens if the individual forgets a dose or decides to go cold turkey off the medication? It seems not only should the use of SSRI's be studied in children and young adults, but that we should examine other methods that can be used to support serotonin rather than using SSRIs. Suggestions for natural serotonin support can be found at this link.
There is also another possibility. The lack of sulfation of serotonin may be the issue for increased anxiety and aggression seen in these young people, rather than a lack of enough serotonin. Mice engineered with a knockout gene for 3-mercaptopyruvate sulfurtransferase (MST) exhibited increased anxiety along with elevated levels of serotonin in the brain. (Nagahara N, et. al., 1986.) MST can produce hydrogen sulfide gas, which can subsequently be oxidized to sulfate, so it probably plays an important role in the production of serotonin sulfate and therefore in serotonin biotransformation. Its deficiency would be predicted to result in an accumulation of unsulfated serotonin. This also suggests that it is a deficiency in serotonin sulfate rather than a deficiency in serotonin that leads to anxiety, and this could explain contradictory research results seen on the relationship between serotonin and anxiety. (Morley, Seneff, 2014). This is another area where we should spend time and money on research.
In a Swedish study of 850,000 individuals, they found SSRI use was linked to 43% increased risk of violent crimes in 15 -24 year old young people. This association was not found to be significant in older individuals.
Among individuals 15 to 24 years old, there were significant associations between SSRI use and arrests for violent crimes with preliminary investigations (HR, 1.28; P <.001), nonviolent crime convictions (HR, 1.22; P <.001), nonviolent crime arrests (HR, 1.13; P <.001), nonfatal injuries from accidents (HR, 1.29; P <.001), and emergency inpatient or outpatient treatment for alcohol intoxication or misuse (HR, 1.98; P <.001). The researchers also found that the association between violent crime and SSRIs remained significant among individuals 15 to 24 years old after analyzing the results with regard to gender (among boys and young men: HR, 1.40; P =.002; among girls and young women: HR, 1.75; P =.023). The researchers pointed out that there were other things going on in the lives of these people that could be confounding the data. However, I believe with the current research and the fact that many violent crimes by young people are associated with SSRIs, this should give us cause to take a closer look at these drugs and consider reevaluating how they are used. At the same time we should examine the reason for depression in our society at large. Depression is an emotional response to complex problems and those issues are not solved with a drug or by banning weapons people use to commit crimes.
There is a black box warning on SSRI drugs regarding the risk of suicidality in young adults (suicide is aggression against yourself). Perhaps we will have a black box warning for these drugs regarding general aggression in the future.
Methamphetamine Use And Aggression
Methamphetamine drugs are used for attention-deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. Amphetamine type stimulants are also the second most commonly used illicit drug in the world after cannabis. Methamphetamines affect serotonergic (5-HT) neurons, and they too like SSRIs increase serotonin. In fact, they are known to increase levels of dopamine, serotonin, epinephrine and norepinephrine. Methamphetamine abuse leads to the development of psychosis in some individuals, either acutely when the drug is active or from chronic abuse creating a long-term symptom. One study found that 60% of METH-dependent individuals sampled in the USA reported at least one type of psychotic symptom. Chronic use appears to increase the liklihood of psychotic symptoms. Certainly psychotic behavior is known to become violent, however Methamphetamines can increase aggressive behavior even without the psychotic symptoms. A 2014 study found there is a dose-related increase in violent behaviour during periods of methamphetamine use that is largely independent of the violence risk associated with psychotic symptoms. Another study found students reporting methamphetamine use were more likely to be at risk for mental health and aggressive behavior problems. The odds of them having an aggressive behavior were increased though when they had psychotic symptoms.
Amphetamine Type Drugs
Adderall, Concerta, Desoxyn, Dextrostat, Dexedrine, Focalin, Mydayis, ProCentra, Ritalin, Vyvanse, Strattera, Suprenza, Zenzedi
Methamphetamine/Ampehtamine And Analogs Used As Prescription Drugs For Kids
Methamphetamine related drugs are prescribed for attention-deficit hyperactivity disorder (ADHD). They are usually prescribed for children and some individuals continue taking these drugs right up into adulthood. Even the elderly have been prescribed this drug. Is this drug treatment for ADHD also a possible culprit in children, or adults with aggressive behavior? In an analysis of research studies undertaken by Yale university, they analyzed two classes of ADHD medications which were methylphenidates, such as Ritalin, and amphetamine derivatives, such as Adderall. In their study, only the amphetamine-derived medications used for ADHD, such as Adderall, were associated with increased irritability, which were defined as angry and overly reactive moods that are associated with acts of aggression. In 2014 Adderall was the 24th most commonly prescribed medication in the USA. Adderall increases levels of dopamine, serotonin, epinephrine and norepinephrine. This is similar with all amphetamines. These are powerful neurotransmitters and they can make us feel happy, satisfied and increase our attention span. However, our body usually keeps a tight control of them and tries to balance them out.
When I look at the Adderall XR label on the FDA website, I see that it claims adults may get reactions of anxiety and agitation. For children it warns about possible psychotic or manic symptoms with no prior history, or exacerbation of symptoms in patients with pre-existing psychosis. They also warn to monitor for aggressive behavior. Here is how they word it, "Aggressive behavior or hostility is often observed in children and adolescents with ADHD, and has been reported in clinical trials and the post-marketing experience of some medications indicated for the treatment of ADHD. Although there is no systematic evidence that stimulants cause aggressive behavior or hostility, patients beginning treatment for ADHD should be monitored for the appearance of or worsening of aggressive behavior or hostility. " The company who owns Adderall has been fined 56.5 million by the US government for making false claims and allegations relating to drug marketing of Adderall and other drugs they own. Sounds like we can trust them, right?
When serotonin is low naturopathic/functional medicine practitioners assist the body in balancing these neurotransmitters. Practitioners support normal serotonin when needed with nutrients, supplements and lifestyle changes to help the body make serotonin. Poor diets contribute to low serotonin as does lack of sunlight, prolonged stress, genetic predispositions, toxic substances such as pesticides, heavy metals and some prescription drugs. Therefore, alternative practitioners use methods to change lifestyle choices that are causing low serotonin, provdide diets that will support creation of serotonin and supplements and herbs when necessary to also support normal serotonin levels.
Using a drug is entirely different than using natural methods to support normal serotonin levels. The drug is not trying to balance or support anything. It is causing dramatic changes in the bodies neurotransmitters. There are individuals who have theorized that these drugs are causing erratic changes in serotonin that induce feelings of psychosis and aggression in some people because of peaks and valleys of serotonin take place. Some people may be more genetically likely to have this happen when taking amphetamine drugs. Additionally, having poor diet, and lifestyle choices may also make these highs and lows more likely to take place in an individual. Lastly, there is the fact that people forget to take medications, and sometimes they will accidentally, or purposefully take more of a medication. This too would create swings in serotonin levels as well as other catecholamines.
Decreasing Violence In Our Schools And Streets
As we can see, both SSRI's and amphetamine type drugs may be a factor in aggressive behavior seen in school age indivdiuals as well as adults. I hope our society takes a closer look at these drugs and how they affect people. We can't afford to ignore the correlations between these drugs and violence in our society. Seriously studying the affect of these drugs on aggression is a step towards finding a solution to this societal problem.
For Future Discussion
These drugs are just one area we need to focus our attention on. You cannot solve a problem without finding out what the causes of that problem are. Otherwise you are simply attending to symptoms and will never eradicate the causal issue. Ultimately, we need to dig deep and get to the cause of why we have an epidemic of depression, and aggression in kids/adults who do not value their life, or the lives of others. Not just in young people, but in all citizens.
I realize there are problems with programs at schools called "restorative programs" and "promise programs" which lead to schools not turning kids into the police for violent acts. This program is why Nikolas Cruz (the shooter in Florida) was not turned into the local police when he should have been for numerous previous violations. This would have put his name on a government list and kept him from being able to purchase guns when a gun-check was undertaken. Since this shooting, I continue to hear of violent indivduals who have either not been turned into the police (in the case of school age children) or with adults they have been repeat offenders that either had no jail time, or little jail time repetatively for offences. There was no accountability for the crimes they committed. There was no psypchiatric treatment,or retritbution, and therefore no reason or assitance for them to change their behavior.
I also realize there are problems with kids spending so much time on Facebook, watching TV, texting, playing videos and being in chat groups. They lack the real one-on-one socialization and replace it with a digital world. Face-to-face socialization is important to learn the real value of having friends, connecting and having a communication that leads to a real conversation and learning to value other human beings.
Herbicides, pesticides, GMOs, sugar, food additives and hormones in the standard American diet do not build healthy bodies or minds. Add in a dash of alcohol, street drugs, and prescription drugs and things really get complicated.
I would add that many kids do not get out into nature enough, or ever. This is important as it is a way for them to connect with something that moves their soul. Even a kid that has trouble socializing can connect with nature in a way that can significantly touch their life. Taking kids to farms or the woods can allow them to connect in a "real" way if they have trouble connecting with other kids. It can be a step to connecting with other humans in a more meaningful way.
I think I will stop here as I don't want to simply list all the societal problems young people face these days. They are coming into a world that could use some improvement and I know the place I start with all improvements is usually with myself. So, perhaps I need to help a young person to live a more meaningful life this week. We can all start with one kid that crosses our path and assist them. Even small things can make a difference.
For those of you wondering how serotonin can be supported naturally, I have created a second article to follow this one that gives you exactly that information. You can find the Natural Serotonin Support article here.
Thanks for considering non-drug methods to support people with depression, as well as looking deeper into the drugs used for depression, and how they may be adding to violence in the USA.
Please send this to your colleagues, friends and family that may benefit from it.