Ritalin Abuse by Tina Blue September 28, 2001 When I was an undergraduate (1968-1972), one commonly saw signs posted around college campuses warning, "Speed Kills!" The signs did not refer to traffic violations. By now most Americans are aware of a form of speed called methamphetamine, and most are also aware that people strung out on speed are a physical and psychological mess. What all too many people do not realize, however, is that meth is not the only--or even the most readily available--form of speed. That would be Ritalin. That's right--Ritalin. The drug little Tommy takes for his ADD, so that he can control his impulsive behavior and focus on his studies in school. Ritalin (methylphenidate) is a form of speed. Chemically, it is virtually identical to Dexedrine, another drug often prescribed for ADD, and its psychological and physiological effects are also virtually identical. Dexedrine was often used in the late 60s and early 70s as a prescription diet aid, because one of the effects of such stimulant drugs is to suppress appetite. Dexedrine (and its more potent cousin Benzedrine) was also commonly (and illegally) used by college students, either for the stimulant high it provided or as a study aid, since it was even more effective than megadoses of caffeine for keeping them awake and on task. These days Dexedrine and Ritalin are increasingly, even excessively, prescribed for schoolchildren who have trouble in the classroom because of supposed attention deficits. Shouldn't we be alarmed? Not necessarily. As I explain in "What About Ritalin?" and "Is Ritalin a Gateway Drug?" these drugs are prescribed in microdosages (5, 10, or 20 mg tablets, to be taken 2-4 times daily), not in the larger doses used by young people in my generation either to get high or to stay up for several nights in a row cramming for finals. Used in such microdoses and under appropriate medical supervision, Ritalin and Dexedrine actually have an excellent track record. In fact, after sixty years of clinical use and long-term studies, we know more about how to use Ritalin safely than we do about most other drugs, especially those that are routinely administered to children. But Ritalin is still speed, and in larger doses it is just as dangerous and addictive as other forms of speed. And therein lies the problem. Prescribed Ritalin is so cheap and so easy to get hold of that a higly profitable illegal resale market has sprung uparound it. Some kids in middle school, high school, and college have taken to buying the pills at an inflated, but still quite manageable, price (about $10 per pill for pills that only cost about 30-50 cents each when purchased by prescription), and then grinding several at a time into a powder that can be snorted or mixed with water for injection. Since snorting or injecting the drug enhances its effect, and since several pills are combined for each snorted or injected dose, what the user ends up with is not the safe microdose originally prescribed, but a far larger, more potent, and more dangerous hit. It is sadly ironic that many young people who start using Ritalin this way are actually good kids and excellent students. But they find out from a friend, or a friend of a friend, that they can get something to help them study for a final or finish a major project. Because so many of them are juggling more than they can really handle, some of them succumb to temptation. Just this once. You know how it is. But then a few weeks later, more exams, term papers, and projects loom overwhelmingly on the horizon. So they resort once more to the "study aid" that helped them ace their work the last time. And since in higher doses speed is powerfully addictive, a lot of these kids find themselves in way deep before they even have a clue that they might be having trouble. Of course there are laws to prevent the resale of Ritalin for such uses. But a lot of the kids who sell and buy the stuff are not aware of how serious a crime they are committing. Ritalin is a Schedule II drug. Schedule II drugs are potentially dangerous and addictive, but since they have recognized medical uses, they can be manufactured and prescribed under carefully controlled conditions. Schedule II also includes such drugs as morphine, cocaine, and Percodan, which should give you some idea of the potential danger inherent in this class of drugs. Furthermore, the physiological and psychological effects of large doses of Ritalin are quite similar to those of cocaine! Violation of the laws covering Schedule II drugs carries severe penalties. The penalties for a first trafficking offense (which is what your child would be guilty of even if he just shares one or two of his Ritalin pills with a friend) include 5-20 years in prison and a fine of up to $1 million. If the individual is part of a group selling or trading the pills, the fine can go as high as $5 million. If death or serious injury results from this first offense, the penalty is 20 years to life in prison. If the drug is injected, it becomes a Class A drug offense, which carries even harsher penalties ("Federal Trafficking Penalties," Department of Justice Drug Enforcement Agency). But most of these kids don't realize how serious a legal offense they are committing, any more than they realize how physically and psychologically dangerous it is to abuse Ritalin. After all, Ritalin is just a friendly little pill that their doctor has been prescribing for them for years, often since they were in grade school. How could it be that big a deal to share a few with a friend who needs to catch up on his studies?--especially if the friend is willing to pay 20 or 30 times what the pills originally cost! I've seen this sort of cavalier attitude toward a dangerous drug before. About twelve years ago some college students I knew began to use tiny little pills called Mini-Thins to stay awake to study. These pills were pure ephedrine, the same drug used in allergy medicines, in some diet aids, and in sports-energy drinks. The problem is that ephedrine, though perfectly legal, is also very dangerous. It has been implicated in cases of stroke and sudden cardiac arrest leading to death in young, healthy individuals. Like large doses of Ritalin, too much ephedrine can cause dizziness, jitteriness, high blood pressure, cardiac arhythmia, stroke, and even sudden death. But also like Ritalin, ephedrine doesn't seem dangerous to the young people who use it to lose weight, to work out, to get high, or to boost their energy for an all-night study session. Of course I gave some very serious talks to the young people I knew who were taking Mini-Thins, but it was hard to convince them of the drug's danger when that information was not out there where they would easily encounter it. It was a legal drug that could be purchased at the Kwik Shoppe, for heaven's sake! How dangerous could it be? That strikes me as a terrible failure of public education. I'm not talking about the schools here, but about the avenues through which the public gets its information about drug effects and safety. How many kids even know that Ritalin is a form of speed? How many of their parents know? How many understand the potential risks of abusing this drug? I am not suggesting that Ritalin should never be prescribed for ADD/ADHD. In fact, I sometimes use its generic form, methylphenidate, for my own ADHD. What I am suggesting is that it should not be prescribed as readily as it now is, by doctors who do only the most cursory examination, or none at all, before writing the prescription to satisfy a parent or teacher who is having trouble controlling little Tommy. Far fewer prescriptions should be written for Ritalin than is presently the case, and the patient's use and response to the drug should be far more carefully monitored. A widespread public information campaign should be undertaken to make sure that everyone knows the dangers of abusing Ritalin, and what sorts of legal penalties they risk if they do so. Furthermore, doctors who prescribe Ritalin should have information pamphlets to give to parents when their kids are put on this drug, and those pamphlets should very clearly explain the risks, both physical and legal, of abusing Ritalin. No child should be put on Ritalin until the doctor is sure that the child's parents have all this information. Just as my generation needed to be taught about the potentially deadly effects of dex, bennies, and meth, parents and children today need to learn the same lesson about Ritalin: Speed Kills! |
