Ritalin

Main type

Ritalin belongs to the category of drugs known as stimulants. It is the brand name for the drug methylphenidate, which is a form of medication that is most often given to children who have ADHD (attention-deficit hyperactivity disorder). As a stimulant drug it is also sometimes prescribed for the treatment of narcolepsy, a condition which causes excessive sleep.

Ritalin comes in the form of pills or tablets with the word ‘Ciba’ stamped upon them. Ciba refers to the manufacturer, the pharmaceutical company formerly known as Ciba-Geigy, which now goes by the name Novartis.

This drug works by stimulating the central nervous system, acting in the same way as other stimulants like amphetamine, although the effect of Ritalin is much less powerful. Upon children with ADHD, Ritalin has a calming effect and helps them focus on tasks.

Originally synthesised in 1944, Ritalin was first tested on humans in 1954. The original purpose of the drug was to treat chronic fatigue, narcolepsy and the psychotic effects of depression, as well as to combat the sedating effect of other prescribed drugs. In the 1960s Ritalin was used to treat the symptoms of overdose from barbiturates. Research into the use of Ritalin to treat ADHD began in the 1960s when the disorder was known as ‘hyperkinetic syndrome’. Throughout the 1970s and 1980s it became the most commonly prescribed drug to treat ADHD.

At the levels at which Ritalin is usually prescribed, the professional consensus is that the drug is not addictive and has great therapeutic benefit. Ritalin is, however, seen by some as a controversial drug because of the belief that it is over-prescribed to children who are simply naughty and do not have a condition medication. There have also been claims that as a stimulant, Ritalin can put strain upon the heart. When Ritalin is used for recreational use or by those who have not been prescribed it, the drug has potential for great harm. Firstly because the doses used by recreational users are far greater than those that would be prescribed for medical benefit, and secondly because of the way Ritalin may be taken by recreational users - by crushing the pills and snorting them like cocaine or else mixing with a liquid and injecting the drug intravenously. Ritalin is soluble in water, making it easier for intravenous abusers of the drug to inject it.

Recreational users who binge on the drug are highly vulnerable to psychological addiction as well as causing great physical harm to their bodies with risk of heart damage and psychosis.

Other Types

Ritalin pills come in 5mg, 10mg and 20mg doses and all are stamped with the company name ‘Ciba’. Ritalin is the commercial name for the drug methyphenidate, which can also be sold under the names Methylin, Equasym, Medikinet, Metadate or Concerta.

On the streets Ritalin might go by the names ‘rit’, ‘rids’, ‘kibbles and bits’, ‘kiddy cocaine’, ‘poor man’s coke’, ‘skippy’, vitamin R’, ‘R-ball’, ‘diet coke’, ‘pineapple’, ‘smarties’ or ‘skittles’.

Illicit users who inject the drug in conjunction with the drug Talwin, a prescription pain reliever, might refer to the mixture as ‘ritz and Ts’, ‘Ts and rits’, ‘Ts and Rs’, ‘one and one’s’, ‘crackers’ or ‘set’.

As a stimulant drug, Ritalin may generically be referred to as ‘uppers’.

Major Effects

The short term effects of Ritalin may include insomnia, anxiety, loss of appetite, irregular heartbeat, headache, nausea and vomiting. In most cases Ritalin will have the effect of increasing a person’s heart rate and raising their blood pressure, although in some cases it might actually depress both blood pressure and heart rate. Ritalin might make someone break out in skin rashes, feel itchy and experience abdominal pains and indigestion. It may also in some cases cause hallucinations or unpredictable or violent behaviour.

In the long term, habitually taking large doses of Ritalin can cause malnutrition by continually robbing a person of their appetite, so that they don’t eat. Long term Ritalin use can also cause involuntary muscle movements in the form of twitching, shaking and convulsions. Severe headaches are a common symptom of continual high doses of Ritalin as are an irregular heartbeat, sweating, skin rashes, restlessness, blurred vision, hallucinations, paranoia and severe anxiety.

People who take large amounts of Ritalin regularly may continually perform repetitive movements or become involved in pointless tasks. They may also experience something called ‘formication’ which is when people feel like there are maggots or insects crawling under their skin.

Taking Ritalin over a long period of time can lead to depression, psychosis and psychological addiction. It can also cause irreparable damage to organs of the body including the lungs, liver, heart and kidneys, as well as permanently damaging blood vessels leading to heart attack, strokes and death

Some people may have an instant allergic reaction to Ritalin resulting in rapid heart rate, fever, chronic headache, sore throat, blistering and peeling skin rashes, chest pain and dangerously high blood pressure.

Production countries

The United nations recently estimated that the USA both produces and consumes around 85% of the total global production of Ritalin.

Ritalin is produced by the pharmaceutical company Novartis, a Swiss company formerly known as the Ciba-Geigy Corporation. Ciba-Geigy was formed in 1970 when two pharmaceutical companies, Ciba and R.J Geigy merged. The company name was shortened to Ciba in 1992 and the company was named Novartis when Ciba merged with another Swiss pharmaceutical company, Sandoz.

Novartis is one of the largest drug companies in the world with manufacturing plants all over the globe, including much of Europe and the United States. The company has affiliates in around 140 countries and develops and manufactures a wide variety of prescription drugs, insecticides, herbicides, ‘over-the-counter’ medications and veterinary medicines. The company’s figures show that nearly 50% of the company’s yearly revenue is earned in the USA.

Production of Ritalin is regulated in the USA and as a Schedule II Controlled Substance, the amount that can be manufactured is maintained according to a strict set of quotas.

There is considered to be no instance of illicit manufacture of Ritalin on the streets. All Ritalin used for recreational and illicit use is that which has been diverted from legal sources, in other words from people who have been legitimately prescribed Ritalin to treat a medical condition. In some cases illicit users will get the drug from family members or friends. In other cases, those with prescriptions for the drug will sell their supply. The drug is also stolen from individuals or from storage facilities, including from school dispensaries. Out of all medications, Ritalin is one of the most commonly stolen.

Facts and stats

Ritalin is the name under which the drug methylphenidate is most commonly marketed. It is used to treat attention deficit hyperactivity disorder (ADHD). When used recreationally Ritalin has a similar effect to other stimulants like cocaine and amphetamine. Here are some further essential facts about Ritalin.

Facts

  • Ritalin is the commercially marketed form of the drug methylphenidate
  • Ritalin is identified by the manufacturer name ‘Ciba’ stamped onto all of its pills.
  • The drug is most popular in the USA, where around 85% of its production and consumption is centred.
  • Ritalin helps children with ADHD by calming hyperactivity and increasing the ability to focus on tasks.
  • Ritalin is at the centre of an ongoing debate about whether it is over-prescribed to children with some saying that it is given to children with no medical requirement for it.
  • Ritalin is one of the most stolen prescription drugs for illicit use.
  • Experts say that all Ritalin used recreationally has been manufactured legitimately and diverted to illicit use.
  • The drug is available in pills of varying doses and is taken orally. Illicit users may crush the pills and snort the powder of dissolve the Ritalin in water and inject it.
  • People who take large doses of Ritalin face extreme physical and mental consequences including headache, sickness, convulsion and death.
  • Those using Ritalin long-term risk becoming psychologically addicted to the drug.
  • Long-term habitual use of Ritalin by recreational users can cause permanent damage to vital organs and lead to stroke, heart attack and death.

STATS

  • In the USA from 1990 to 2000 there were allegedly 186 deaths related to the abuse of methylphenidate, which were notified to the voluntary reporting scheme in the country. It is estimated that these figures represent around 20% of the true figures.
  • According to research in 2007, 3.8% of 16-17 year olds in the USA admitted to using Ritalin without being prescribed the drug at least once during the past year.
  • Also in the USA, the number of prescriptions issued for stimulants including Ritalin increased from approximately five million in 1991 to around 35 million in 2007.
  • It is estimated that in some schools in the USA up to 20% of the student populous regularly take Ritalin.
  • Ritalin use was responsible for around 3,600 hospital emergency department admissions in 2004, an increase from 271 in 1990.
  • Out of all the countries on the world, the United States continues to have the highest rates for the diagnosis of ADHD and the prescription of Ritalin.
  • It is estimated that one and a half million US children take Ritalin every day.
  • The consumption of Ritalin in USA is five times higher than the rest of the world’s combined consumption.
  • In the UK the prescription rates for Ritalin varies greatly across the country. In 2008 in the Wirral region, for example, Ritalin or similar stimulant drugs were being prescribed to one child in seven compared to Stoke-on-Trent which was prescribing the drug to one child in 159.
  • In 2007 there were around 700,000 prescriptions for Ritalin issued in the UK, compared to around 100,000 ten years previously.

Addiction Signs

When used for the therapeutic purposes of controlling ADHD there is little evidence of any addiction to Ritalin. However, when used recreationally there is great potential for psychological addiction, just as there is for other stimulant drugs like cocaine and amphetamine.

Those who take large doses of the drug can easily become addicted to Ritalin and will display the classic signs of stimulant withdrawal in between binges. This pattern of high dose followed by withdrawal can make someone seem severely depressed, detached from reality, irritable and potentially violent.

Someone addicted to using Ritalin recreationally may also show signs of their dependency by their lack of appetite and resultant rapid weight loss, leading to malnutrition. They may feel nauseous and vomit a lot, feel dizzy, experience severe headaches, have rashes on their skin and continually scratch themselves.

Ritalin addicts will experience insomnia and may show signs of sleeplessness in the way of dark circles around their eyes, cold sweats and skin pallor.

Those dependent on Ritalin may display signs of great anxiety, nervousness, irritability, depression and paranoia. They may also be subject to violent mood swings.

Ritalin addicts who abuse the drug are susceptible to overdose. Signs of Ritalin overdose include dilated pupils, a high temperature, twitching or convulsions, skin flushes, rapid heart rate, vomiting and sweating. Those who have consumed large doses of Ritalin may also experience hallucinations.

Some Ritalin addicts will snort the drug as a powder, in which case they may show signs of redness around their nostrils and be constantly sniffing.

Those that inject Ritalin may reveal puncture marks on their arms or legs or have lesions and scabs on their skin from the effects of dirty needles.

Treatments

Ritalin is highly addictive if habitually taken recreationally and as such breaking the addiction may require admission into a treatment programme. This may in the form of live-in treatment in a residential rehab centre or an out-patient programme with regular addiction counselling, depending on the severity of the addiction and other factors to do with the patient’s background and social situation.

Detoxification from Ritalin under the supervision of medical professionals can last up to a week. The most common symptom that addicts experience during detoxification are insomnia, anxiety and strong cravings for the drug and medications are given during this time in order to treat these symptoms and ease suffering. Anti-depressants, anti-anxiety medication and drugs to lower blood pressure may all be prescribed to an addict undergoing Ritalin detox.

The loss of appetite experienced by Ritalin addicts can lead them to be severely malnourished and as such vitamins and other nutritional supplements may also be given throughout the addiction treatment programme.

Withdrawal from Ritalin may cause suicidal thoughts in some addicts, so all are closely monitored for suicide risk. It is essential that addicts do not have access to any non-prescribed drugs during this initial stage of treatment and as such visitors may be restricted and the addict may be confined to the rehabilitation centre. Throughout the programme the addict will be given regular urine tests to ensure they have stopped taking the drug. The best success rates for Ritalin addiction treatment are those that involve residential treatment for at least three months.

When detoxification from Ritalin has been completed, counselling and therapy follow in order to stop the addict returning to the drug in the future. One-to-one therapy is usually required in order to address the underlying psychological impetus for the addict using Ritalin recreationally. These may involve family issues, pressure to achieve academically or the influence of peers. Group sessions with other ex-addicts, who share their experiences and offer support to each other are common, in conjunction with one-to-one counselling. In some cases family members and partners are also brought into the counselling process. Many ex-addicts of Ritalin enrol in 12 Step programmes with regular meetings, which allow them to continue getting support throughout their lives.

Because of the ease in obtaining Ritalin in the outside world, in most cases the Ritalin addict is given strategies to deal with situations where the drug is available to them.

Without the help from a rehabilitation programme an addict who attempts to stop taking Ritalin has a statistically higher chance of returning to the drug than those that seek professional help. This is because long-term habitual use of the drug leads to changes in the way the brain functions and as such medication is required to deal with the withdrawal symptoms and cravings that occur when an addict stops taking the drug.

Relapse rates are high with Ritalin addiction and an addict may require repeated detox and rehabilitation treatments before they may be said to be freely free of their addiction.