Ritalin in the United States

Schedule II—The drug or other substance has (1) a high potential for abuse, (2) a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions, and (3) abuse of the drug or other substances may lead to severe psychological or physical dependence. Examples cocaine, PCP, morphine, fentanyl and meperidine, codeine, amphetamine and methamphetamine, Ritalin . 

Methylphenidate (Ritalin), dextroamphetamine (Dexedrine), and pemoline (Cylert) are currently available in the United States. Methylphenidate has been the most widely used and is usually the first choice. Pemoline sometimes impairs liver function and is rarely used today due to the potential for toxicity. 

Methamphetamines are still legally produced in the United States for attention-deficit disorder (ADD) under the trade names Desoxyn or Ritalin (methylphenidate). As the street name speed suggests, amphetamines elevate mood, heighten endurance, and eliminate fatigue. 

In the United States, a 1998 study of Wisconsin children who were prescribed Ritalin for the treatment of ADHD reported that 16% of the children in the study had been asked to sell or share their medication. Security was also an issue, with 37% of schools reporting that stimulants were stored in an unlocked space and 10% of... 

Methylphenidate is marketed in the United States under the prescription names Concerta, Metadate, Methylin, and Ritalin (26). It is available in immediate and sustained-release formulations for the treatment of attention deficit/hyperactivity disorder (ADHD) and the symptomatic management of narcolepsy (a disorder characterized by excessive daytime sleepiness). 

Methylphenidate (e.g., Ritalin and Concerta ) is a stimulant drug prescribed to treat hyperactivity, impulsivity, and inattention in millions of American children. Methylphenidate was first synthesized in the mid-1940s in Europe. In the United States, it was approved by the Food and Drug Administration (FDA) in 1955. The effects of methylphenidate in the human body are almost identical to those of the amphetamines. Amphetamines—the collective name for levoamphetamine (Benzedrine), dextroamphetamine (Dexedrine ), and methamphetamine (Methedrine or speed )—are known to be potent psychomotor stimulants. 

Methylphenidate was synthesized in 1944 in Europe in an unsuccessful attempt to create a stimulant that would not produce addiction or tolerance (Figure 1.1). Introduced in the United States in 1955, it was first approved by the FDA for the treatment of drug-induced lethargy, mild depression, and narcolepsy. In the early 1960s, the drug was first marketed under the name Ritalin to improve memory in elderly patients and to treat several behavioral problems in children. 

The most common treatment for ADHD in the United States is the stimulant drug Ritalin in its different formulations. The drug is taken by 70% of all school-age children who are diagnosed with ADHD. Alternative medications to Ritalin are Dexedrine or Cylert. 

It is not surprising, then, that the number of children diagnosed with ADHD and taking Ritalin has increased. Between 2 and 3.5% of children in the United States are taking Ritalin in some schools, the figure is as high as 18%. 

The United States produces and uses about 85% of the world s total Ritalin supply. Although Ritalin consumption in Canada quadrupled between 1990 and 1996, it stills remains less than one-half of that in the United States. Australia is the only other country to note a similarly large increase in the use of Ritalin during the 1990s, although that nation s rate of usage remains only one-tenth that of the United States. 

None of the industrialized nations of Asia has experienced a recent increase in the use of stimulants. In Europe, the prevalence rates run as low as one-tenth of 1%. Even in England, where Ritalin s use has increased over 20-fold since 1990, children are from 10 to 50 times less likely to be diagnosed with ADHD than in the United States (Figure 4.1). 

If Ritalin is such a dangerous drug, then why has it become so widely used in the United States Why are so many doctors prescribing it Why are so many parents and teachers asking for Ritalin prescriptions for children ... 

The reason that pharmaceutical companies would support the view that ADHD has a biological cause seems obvious. A biological cause means that a drug (usually Ritalin) is the treatment of choice, and selling stimulants is a profitable business. The DEA estimates that pharmaceutical companies earn approximately 450 million a year from the sales of stimulants, and nearly all of the stimulants sold legally in the United States are prescribed for ADHD treatment. 

POSSIBLE REASONS FOR THE INCREASE IN THE INCIDENCE OF ADHD AND RITALIN USE IN THE UNITED STATES... 

Another factor in the ADHD/Ritalin boom in the United States may be the disintegration of the family and the pressure of working in the corporate environment. The American family has changed dramatically over the last few decades. It is no longer composed of two parents and children with a close extended family nearby for support. Today, the nuclear family has shrunk to two parents and the children or to one parent and the children. The extended family now often refers to remarried parents, each of whom brings his or her own children to the mixture. This type of extended family, with so many conflicting needs as part of its very nature, may not be the ideal situation for giving individual attention to every child. 

Many of the 80 million baby boomers born in the United States between 1946 and 1964 have had their lives affected by drugs, including Ritalin, Prozac, lipton, and Elvira. We need better understanding of the biochemistry of these drugs and their effects on behavior. Well-planned, ethical research relating brain chemistry and behavior can be carried out in the criminal justice system, although some daim that prisoners can never give truly informed consent to such research. 

In the United States, methylphenidate is classified as a controlled substance, with medical value but also a high potential for abuse. People abuse MPH by crushing the tablets and snorting them to produce the high. Ritalin has the same problem as cocaine or amphetamine in leading to possible addiction. As the number of children taking Ritalin has increased, it is at times over-prescribed to sedate problem schoolchildren to stop their disrupting class. 

Figure 4.1 The United States consumes some 85% of all the Ritalin produced in the entire world—an astonishing figure. This graph, based on data from the United Nations on methylphenidate consumption, demonstrates the dramatic difference between U.S. use of Ritalin and similar stimulant drugs and that of the rest of the world.

ADD/ADHD Statement of Drug Enforcement Administration. Gene R. Haislip, Deputy Assistant Administrator. Office of Diversion Control, Drug Enforcement Administration. United States Department of Justice, Washington, D.C. At the conclusion of the conference on Stimulant Use in the Treatment of ADHD. Available online at http //www.add-adhd. org/ritalin.html. 

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