Ritalin - The Growing Problem

We often hear of the ever growing problem that is methamphetamine, as it continues to be a cheap, easily accessible drug that is used in both rural and urban areas. However, it is certainly not the only amphetamine on the streets to choose from. There is another 'upper' quickly gaining popularity amongst intravenous drug users and recreational users alike. Prescription stimulants, specifically Ritalin, are becoming just as much of an issue as meth, and are only adding to the lengthy list of abused prescription medications that are already flooding the streets.

Ritalin, also known as Methylphenidate, was first created in 1944 and intended as a non-addictive stimulant, and by 1963 had showed means of regulating the behaviour of children. Pharmaceutical companies quickly took notice, and by 1970, 15 different drug companies manufactured over 30 kinds of prescription stimulant-type products.

Plenty to go around. This table shows a very brief, but interesting history of methylphenidate abuse.

Methylphenidate is a favourite in my area. According to the 2012 I-Track Survey of people who inject drugs, the most commonly used and abused drugs in my hometown of London, Ontario are of the prescription sort. Absolutely no surprise there! Rounding out the top of the list are Morphine and Hydromorphone (more than 75% indicating they had used both in the past 6 months), followed by Oxycontin (69.1% in the past 6 months), Methamphetamine (68.1%) and last but certainly not least is Ritalin (66.2%).

Interestingly enough, while Methamphetamine and Ritalin are very hot commodities here in London, there are no national numbers to compare against.

As it quickly grows in popularity, it is increasingly easy to find on the street, and with prices ranging from only $5-$15 per pill, Methylphenidate is an easily affordable prescription drug when compared to the high prices of prescription opiates on the street. Many intravenous drug users I have spoken with will interchangeably use crystal methamphetamine and Ritalin, as they find the high to be very similar, and often perceive Methylphenidate to be the cleaner, safer version.

That however, is not necessarily the case.

"A review of 60 studies suggests that the reinforcing or subjective effects of methylphenidate (in 80% of these studies) functions similarly to d-amphetamine or cocaine (i.e., as a reinforcer, in drug discrimination substitution, and subjective effects such as producing a "high" or "rush"), and that there is definite abuse potential. Tolerance develops and characteristic stimulant withdrawal symptoms have been reported including fatigue or exhaustion, depression, unpleasant and vivid dreams, insomnia or hypersomnia, increased appetite, psychomotor retardation or agitation, or irritability. Similar effects may by expected with all repeated scripting stimulants".

There can be serious medical complications that arise from frequent abuse of Ritalin, particularly if administered intravenously. Certain formulations of Methylphenidate include binders, fillers and/or waxes; which can make intravenous use particularly dangerous. 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. Overdoses, toxic reactions, blood clots, scar tissue, infections, and skin, circulatory and pulmonary problems are all serious side effects associated with the intravenous use of methylphenidate.

Snorting or insufflating methylphenidate has its consequences as well.

"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 deterioration of the nasal cartilage".

Recreational use of Ritalin isn't all fun and games, as it turns out. While London's numbers might be high, the problem of methylphenidate abuse is certainly not unique to my hometown. It is a growing concern and a dangerous trend that needs to be more widely studied and addressed in order to further understand, support, and educate users on the risks associated with the misuse or abuse of methylphenidate.

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Studio L is a freelance writer living in Southwestern Ontario. She is a recovering IV drug user, methadone patient, and harm reduction advocate, and covers these issues in her blog.