06 Mar Health Effects of Ritalin Abuse
Ritalin is the brand name for one popular form of methylphenidate, a medication commonly used to treat symptoms of attention deficit hyperactivity disorder (ADHD) and narcolepsy. Other methylphenidate-based products sold in the US include Concerta, Rubifen, Metadate ER, and Methylin ER. Methylphenidate has a chemical structure that’s similar to the structure of the illegal drug cocaine, and inside the brain it produces stimulating effects that closely resemble those produced by drugs called amphetamines. Despite these similarities, when taken in low doses under a doctor’s supervision, the drug presents relatively minor risks for serious harm to human health. However, illicit methylphenidate abuse can have much more profound health-related consequences.
Methylphenidate was developed in the 1940s and first used in human in the 1950s. In addition to narcolepsy, doctors initially used it to treat health problems such as depression, depression-related psychosis, and chronic fatigue; the drug also served as an antidote for the effects of sedative medications called barbiturates. Use of methylphenidate in the treatment of ADHD (then known by other names) began in the 1960s, although the drug only became widely popular in the 1990s. According to the University of Maryland’s Center for Substance Abuse Research, the vast majority of the world’s Ritalin/methylphenidate supply is made and consumed in the US.
Like amphetamines and cocaine, methylphenidate achieves its stimulating effects by increasing the brain’s supply of a chemical called dopamine; in turn, this increase generates heightened activity in the brain’s pleasure centers. Compared to cocaine and amphetamines, the dopamine increase triggered by low doses of methylphenidate is relatively small; still, it’s enough to produce therapeutic effects for ADHD patients that include a heightened sense of calm and an improved ability to focus and concentrate. Methylphenidate products usually come as tablets available in 5 mg, 10 mg, or 20 mg sizes. Daily therapeutic dosages of the drug usually range from 15 mg to 30 mg for children age six and over, adults typically receive maximum therapeutic dosages of 60 mg a day.
Many people confuse drug abuse with drug dependence and addiction; however, the concepts are distinct. Drug abuse occurs whenever you use your own prescription drugs in a manner not intended by your doctor; when you use someone else’s prescription drugs under any circumstances; or when you use legal or illegal drugs supplied without a prescription of any kind. While dependence and addiction can result from drug abuse, you can abuse a drug without ever developing these conditions. Abuse is dangerous not because a drug is legal or illegal, but because it takes place outside of a medically legitimate context and, typically, without a doctor’s awareness.
Ritalin/methylphenidate abuse commonly occurs among high school and college students who use the drug’s stimulating effects to focus attention during study sessions. For this reason, Ritalin and another ADHD medication called Adderall are frequently referred to as “study drugs.” While people who follow their legitimate prescriptions typically take no more than 30 mg to 60 mg of methylphenidate per day, abusers of the drug may consume as much as hundreds of milligrams of the drug each day, the Center for Substance Abuse Research explains. Potential side effects of high-dose methylphenidate intake include vomiting, agitation, anxiety, sweating, fever, paranoia, confusion, hallucinations, abnormally high heart rate, abnormally high blood pressure, pupil dilation, uncontrolled muscle movement, delirium, and seizures. In some cases methylphenidate-related seizures result in the onset of a coma. Long-term Ritalin abuse can also trigger chronic, medically significant anxiety and sleep disturbances.
Dependence and the Potential for Addiction
When Ritalin abusers habitually take high doses of the drug, they create long-term changes in the way their brains produce dopamine. Over time, these changes create a condition called tolerance, which occurs when a given dose of a drug no longer produces the “desirable” effects it produced in the past. To offset the effects of tolerance, Ritalin abusers (like abusers of other drugs) commonly start increasing their daily drug intake. In addition to creating the conditions for serious short-term side effects, this increased intake also creates the conditions for physical dependence, which arises when the brain gets so accustomed to a drug that it no longer functions “normally” without it. When dependent people stop using Ritalin, or abruptly decrease their daily intake of the drug, they can develop withdrawal symptoms that include severe physical fatigue (exhaustion) or extreme symptoms of depression.
In addition, some heavy Ritalin abusers experience strong, persistent cravings for the drug and develop anxiety-related symptoms of panic when they can’t readily secure their drug supply. The presence of persistent drug cravings is one of the main factors that doctors use to diagnose a full-blown drug addiction.
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