In 1990, 900,000 American kids were on Ritalin. Today some estimate the total number of children on Ritalin has increased to 4 – 5 million or more per year America now uses 90% of the world’s Ritalin – more than five times the rest of the world combined. Emergency room visits by children ages 10-14 involving Ritalin intoxication have now reached the same level as those for cocaine which indicates escalating abuse of this highly addictive drug. 80% of children on Ritalin are boys.
Q) What is Ritalin?
A) Ritalin (methylphenidate) is a central nervous system stimulant, similar to amphetamines in the nature and duration of its effects. It is believed that it works by activating the brain stem arousal system and cortex. Pharmacologically, it works on the neurotransmitter dopamine, and in that respect resembles the stimulant characteristics of cocaine. When taken in accordance with usual prescription instructions, it would be classified as having mild to moderate stimulant properties, but when snorted or injected it has a strong stimulant effect. Ritalin is manufactured by CIBA-Geigy Corporation, and is supplied in 5 mg., 10 mg., and 20 mg. tablets, and in a sustained release form, Ritalin SR as 20 mg. tablets. It is readily water soluble and is intended for oral use. It is a Schedule II Controlled Substance under both the federal and Indiana Controlled Substances Acts. Since Ritalin is a Schedule II Controlled Substance, the federal government strictly regulates the amount that may be manufactured, through a system of rigid manufacturing quotas.
Q) How is Ritalin used?
A) When abused, Ritalin tablets are taken orally, crushed and then snorted, or dissolved in water and “cooked” for intravenous injection.
There are numerous reports in medical journals about permanent and irreversible lung tissue damage related to injection of crushed Ritalin tablets.
In order to make the 5- to 20 mg. dose tablets large enough to handle easily, at least 100 mg. of “inert ingredients” are added to the tablets to increase their size. Depending upon size and formulation, the following inert ingredients are found in Ritalin tablets, according to the manufacturer: lactose, starch, polyethelene glycol, magnesium stearate, sucrose, talc, cellulose, mineral oil, and various dyes and conditioning agents. While these ingredients are “inert” when taken by mouth, they can cause serious problems when injected or snorted.
Health Consequences of Intravenous and/or Injection Drug Use
The hypodermic syringe was designed to deliver a concentrated dose of a drug quickly and efficiently. In doing so, it bypasses many of the body’s natural defense mechanisms such as the skin, respiratory cilia, digestive acids, etc. The syringe allows anything in it (drugs, dust, bacteria, pollen, allergens, yeasts, viruses, fillers, etc.) to pass directly into the blood and body tissues. The rapid delivery of drugs via injection makes it difficult for the user to control the intensity of the drug effect, thus making toxic overdoses more likely.
When drugs are prepared for injection by a street user, dust, dirt, and other contaminants fall into the liquid. Bacteria, talc, lint, and other particles are injected along with the drug. The “inert ingredients” that manufacturers include to increase the bulk may be harmless when taken by mouth, but talc, cellulose, mineral oil, and sugars (among other fillers) can create serious problems when injected directly into veins or body tissues. Complications from injection drug use include:
- drug overdoses and toxic overdose reactions
- blood clots from scar tissue, particles in the liquid, cotton and lint fibers, etc.
- infections (“blood poisoning,” abscesses, hepatitis, AIDS, etc.)
- scars (“tracks” and adhesions)
- pulmonary problems (“addict’s lung,” embolisms, etc.)
- skin and circulatory problems
Health consequences of Snorting Drugs (Intranasal Insufflation)
The delicate epithelial tissues that line the nasal cavities and air passages may be damaged by direct contact with drugs. Ritalin tablets contain the hydrochloride salt of methylphenidate and yield dilute hydrochloric acid when they come into contact with moisture. While this is not a problem in the stomach (hydrochloric acid is one of the digestive acids used in the stomach), in the nasal passages the acid can “burn” the delicate nasal tissues, resulting in open sores, nose bleeds, and possibly in deterioration of the nasal cartilage.
Q) What are the side effects of Ritalin?
A) The side effects of Ritalin addiction include but are not limited to:
- drug addiction
- nervousness and insomnia
- loss of appetite
- nausea and vomiting
- changes in heart rate and blood pressure (usually elevation of both, but occasionally depression)
- skin rashes and itching
- abdominal pain
- weight loss
- digestive problems
- toxic psychosis
- psychotic episodes
- severe depression upon withdrawal
High doses of stimulants produce a predictable set of symptoms that include:
- loss of appetite (may cause serious malnutrition)
- tremors and muscle twitching
- fevers, convulsions, and headaches (may be severe)
- irregular heartbeat and respiration (may be profound and life threatening)
- anxiety, restlessness
- paranoia, hallucinations, and delusions
- excessive repetition of movements and meaningless tasks
- formicaton (sensation of bugs or worms crawling under the skin)
- While death due to non-medical use of Ritalin is not common, it has been known to occur.
Q) What are the symptoms of Ritalin overdose?
A) Symptoms of Ritalin overdose may include: Agitation, confusion, convulsions (may be followed by coma), delirium, dryness of mucous membranes, enlarging of the pupil of the eye, exaggerated feeling of elation, extremely elevated body temperature, flushing, hallucinations, headache, high blood pressure, irregular or rapid heartbeat, muscle twitching, sweating, tremors, vomiting.
A growing number of youngsters taking the drug Ritalin® (methylphenidate) experience overdose, researchers report. The study looked at the frequency of Ritalin overdose cases reported to a regional poison control center in Detroit. Children ages 6 to 9 years were at the greatest risk of overdose, compared with other age groups. Over a two-year period, 289 cases were reported. Of these, 31% developed symptoms. Most common adverse effects included tachycardia, agitation and lethargy. Most cases were due to parents or caregivers unintentionally giving patients excessive amounts of the drug.