What is Ritalin?

Ritalin is a prescription psycho-stimulant medication mainly used for the treatment of Attention Deficit Disorder (ADD), Attention Deficit Hyperactive Disorder (ADHD), and sometimes for sleep disorders like narcolepsy. Ritalin is the most popular brand name for the drug, methylphenidate, with nearly 16 million prescriptions written in 2016 alone.

Ritalin abuse is a cause for concern, mainly in schools and colleges. Sometimes called the “smart drug,” many people believe it will help them become more intelligent. Those who use it feel more focused and energetic, while also claiming it induces feelings of euphoria. Other people use it simply to stay awake and study, while others feel it aids in weight loss. However, if it is taken without a prescription, it is considered abuse with a high risk of addiction.

Methylphenidate is a central nervous system stimulant which increases dopamine levels in the brain. Dopamine, known as the “reward chemical,” is a neurotransmitter and is known to provide feelings of well-being and euphoria. Interestingly, stimulants such as Ritalin are first-line treatments for ADHD as they increase focus and mental stamina. Because it is widely prescribed for children and even toddlers, many people wrongly believe the drug is benign with a low potential for abuse or addiction. This is simply not true.

Some addiction experts believe over 400,000 people who use prescription stimulants also abuse the drug, but most abuse occurs within the population that uses it with no prescription. While only about 16% of users illegally buy Ritalin from drug dealers, the rest is obtained through friends and even family members. Studies show that misusing Ritalin makes it just as addictive as cocaine. Misuse happens as people take it without a prescription, take higher doses than prescribed or take it improperly such as crushing the pills and snorting the powder.

Too many children and adults are abusing Ritalin, while too many others are addicted. We live in a fast-paced, competitive society where people believe that methylphenidate helps them focus, work long hours, complete classes, pass tests and stay competitive. According the US Drug Enforcement Agency, teens are not the only ones misusing the substance, mothers and father often steal it from their children for their own personal use. Some even shop around for doctors to keep the prescriptions flowing. At the same time, there are some doctors who feel the cognitive enhancement of the drug should be more acceptable and therefore widely available.

Education about Ritalin and methylphenidate use may be the necessary start to intervene and help ourselves or a loved one. This drug is not benign and carries the same potential for abuse as amphetamines like cocaine or speed. It does have a similar chemical structure and long-term effects on the brain just as cocaine.

Signs of Ritalin Use

There are physical signs and behaviors that may indicate someone is using Ritalin. Some physical signs may appear to be the same as those produced by amphetamines such as "speed". These signs can include:

  • Anxiety
  • Fast talking
  • Panic attacks
  • Hyperactivity
  • Loss of appetite
  • Headaches
  • Sweating
  • Vision problems
  • Insomnia

Psychological changes become apparent with Ritalin abuse. Depending on the amount being used, some behaviors may be a cause for concern and intervention. These can include irritability, depression and extreme fatigue, and could indicate the user is crashing from a methylphenidate high. More severe signs may include: paranoia, hallucinations or repetitive behavior which mimics OCD, or Obsessive-Compulsive Disorder.

Behavioral changes may occur if someone is abusing Ritalin. Signs of Ritalin abuse may be noticed as the user becomes more secretive, avoids family or friends, or becomes obsessed with filling a prescription in order to get their fix. Mood swings, irritability and depression become more prominent as the user's tolerance increases, causing them to use more of the drug which results in more extreme side-effects.

Chronic use and abuse have also shown some noticeably disturbing behaviors by some. Psychotic symptoms have appeared, such as hallucinations and a phenomenon known as depersonalization, or the belief that one's thoughts and feelings are not their own. Intervention should be considered if you notice any of these signs.

Street Names for Ritalin

Ritalin is often sold on the streets between friends or acquaintances, and although not as common, sometimes through drug dealers. It is fairly easy to get, so knowing the street names for Ritalin can help to identify if someone is using it illicitly. Some of the street names, or nicknames for methylphenidate are as follows:

  • Speed
  • Kiddie Coke
  • Kiddie Cocaine
  • Diet Coke
  • Kibbles and Bits
  • Rids
  • Vitamin R
  • Skippy
  • Smart Drug
  • Skittles
  • Poor Man's Cocaine
  • Uppers
  • R-Ball

Ritalin Withdrawal Symptoms

If someone has been abusing Ritalin and stops or delays a dose, they may experience withdrawal symptoms. The first and worst noticeable symptom is “the crash,” which occurs after the last dose of the drug it taken. When the drug is removed, the brain stops producing excess dopamine, resulting in difficulty concentrating, racing thoughts, sluggishness, and extreme fatigue. The symptoms that arise correlate to how much of the drug was taken and for how long.

Clinically, withdrawal symptoms are not much different than withdrawal symptoms of other stimulants. Aside from the physical symptoms discussed above, some people may experience more severe symptoms with longer term use, which may include headaches, ongoing nausea, insomnia and anorexia. These may linger for a week or more, with anorexia lasting longer as the patient slowly rebuilds their health.

Knowing what to expect during Ritalin withdrawal may help with treatment. Sometimes if a person knows what to expect, they know there will be an end to the discomfort and can recognize that the withdrawal symptoms are common.

The first 72 hours are the acute withdrawal stage and may include drug cravings, agitation, fatigue and fluctuating heartbeat. They may also experience mood swings as the body detoxifies, working the drug out of its system.

During the first week of abstinence, the user may experience exhaustion, nervousness and disturbed sleep as the brain adjusts to life without the drug. Depression may set in, but appetite should increase, which helps the patient eat nutritious foods for faster healing.

After the first one to two weeks, the initial physical detoxification should be close to complete, and psychological symptoms may become more prominent. These are the same as above, but feel more intense as the physical symptoms subside. Depression, anxiety, fatigue, nervousness, and sleep disorders may linger. Cravings may stabilize or subside around this time. Hospitalization is recommended for those who exhibit psychosis, severe depression, or suicidal thoughts.

Withdrawal from Ritalin is not considered deadly. However, the psychological symptoms may be serious as they can lead one to relapse, and even possibly overdose. Severe depression with thoughts of suicide may require monitoring. Ritalin overdose may be seen first as confusion, aggression and panic. It may progress to a heart attack, seizure, psychosis, stroke or death. If you suspect someone has experienced an overdose from methylphenidate, call emergency services.

Treatment for Ritalin Addiction

Treatments for Ritalin addiction can be done in a variety of settings and methods. Physical detoxification is the first stage of any treatment and, while not considered deadly, is best done under supervision as challenges and health issues may arise. This first stage of treatment can be extremely uncomfortable, causing the patient to relapse or become suicidal. Medical detoxification intervention can help ease the side effects of withdrawal and make the patient more comfortable.

Medical intervention for Ritalin addiction treatment is somewhat trickier than with other drugs. While the brain can become physically or chemically dependent on it, there are no drugs approved as replacement drugs for methylphenidate, which are often used to eliminate cravings. Because of this, the patient must taper down from methylphenidate slowly. A physician will set a schedule for the patient to take less of the drug every few days until they are no longer dependent on it.

Treatment may be done at an inpatient or outpatient facility. Both will aid in physical detoxification if necessary, as well as recovery methods for behavioral or psychological substance abuse and addiction.

Inpatient treatment may be a clinical setting or more residential. In either case, the patient stays at the facility for an extended period of time, often around 28 days. Medical detoxification is supervised to ensure the patient remains healthy during the early phase of treatment. This is followed by various methods of therapy or counseling to provide the patient with insight, tools and skills to continue their recovery beyond their stay. Inpatient recovery may be more successful for those with co-addictions or long-term addiction profiles.

Outpatient facilities may be necessary for some due to work or school responsibilities. In this case, a person may check into a hospital or clinic on a regular basis for monitoring as they taper off the drug. Vitals can also be checked to ensure no problems arise during treatment. The patient is then guided to counseling or therapy to complete their rehabilitation. They may utilize group therapy, individual therapy, or specialized programs to aid in recovery. These can help the addict turn to a life without substance abuse and find other tools for coping.

Group therapy may include 12-Step programs or settings where others who have abused Ritalin can join. They may be weekly sessions (or more), and include supervised peer-to-peer sharing of experiences, advice or stories of hope.

Individual therapy is important in addiction to other therapies. The patient can delve into their background and find possible reasons that led to addiction, or possibly uncover psychological issues that may have played a role in the path they chose. Both individual and group therapy may be offered at an inpatient or outpatient facility, while some neighborhood community centers may offer group therapies like a 12-Step program.

Other types of recovery therapies may include Motivational Interviewing (MI) or Cognitive Behavioral Therapy (CBT). While MI is proven and reserved for those who need motivation to desire recovery, CBT is proven to help addicts successfully change their behavior with more positive patterns.

Trying to recover from Ritalin addiction alone is not recommended. Addiction has likely caused a change in brain chemistry, which may result in severe symptoms such as suicidal thoughts, panic attacks, dehydration and even seizures. If you or a loved one need help recovering from a Ritalin addiction, enroll in a treatment center as soon as possible to prevent overdose, and regain your life and health.