Ritalin and Concerta are the brand names of drugs that contain the stimulant medication methylphenidate. Methylphenidate is a medication that is useful in the treatment of attention deficit hyperactivity disorder and the sleep disorder narcolepsy. It is also used to treat lethargy and sedation associated with a number of neurological conditions, including stroke.
Medications containing methylphenidate are classified as Schedule II controlled substances by the United States Drug Enforcement Administration (DEA). All of the drugs in this class have a significant potential to be abused and to cause physical dependence in individuals who use or abuse them. Concerta is simply an extended-release form of Ritalin.
The abuse of prescription medications like Ritalin has recently received quite a bit of publicity.
Professional organizations, such as the DEA, recognized that individuals who use prescription medications under the supervision of a physician and according to their prescribed purposes and instructions are not considered to have issues with abuse or addiction. This is true even if the individual becomes physically dependent on the substance (expresses both tolerance and withdrawal symptoms). The terms substance abuse and addiction refer to the nonmedicinal use of drugs or alcohol in a manner that indicates that the individual has lost control over their use of these substances and is suffering a number of negative ramifications. In addition, these terms have been replaced by a better descriptive term: substance use disorder.
Stimulant Use Disorders
The term addiction evokes a specific image in the minds of many. In actuality, even though the term is still used in professional and clinical circles, it was determined some time ago that this term is not descriptive of the actual behavior of individuals who abuse drugs or alcohol, that it evoked too many stereotypical and often inaccurate images, and that other, more descriptive terms should be used. The American Psychiatric Association has replaced the term with the more descriptive phrase: substance use disorder. This term accurately reflects the related issues that occur in individuals who suffer from substance abuse at all levels. Substance abuse and addiction are actually two points of the same disorder.
Individuals who develop a substance use disorder as a result of Ritalin abuse would be diagnosed with a stimulant use disorder.
Some of the signs and symptoms that should be of concern to a person who is using Ritalin are:
- Obtaining and using Ritalin without a prescription on a regular or semi-regular basis, including frequently buying the drug from someone who has a prescription, buying pills from someone on the street, stealing the drug, etc.
- Using Ritalin to stay awake for long periods of time
- Frequently using Ritalin to deal with everyday stressors
- Attempting to get numerous prescriptions of a drug like Ritalin from different physicians
- Using Ritalin in a manner that is inconsistent with the instructions, such as using more of the drug than prescribed or using it more often than prescribed
- Grinding up the pills and snorting the powder, mixing it with water and injecting the substance, or taking the pills with other drugs, such as alcohol, other stimulants, or other prescription medications
- Frequently using more Ritalin than originally intended or for longer periods of time than originally intended
- Continuing to use Ritalin in spite of experiencing problems in life
- Cravings for the drug
- Using more of the drug to get the same effects
- Feeling extremely depressed or down, irritable, anxious, jittery, sluggish, unmotivated, etc., after going without Ritalin
- A desire to stop using Ritalin but being unable to do so
Certainly, anyone expressing one of these signs should consult with a mental health clinician, and anyone expressing two or more of these above signs shouldconsider seeking formal treatment. Many of the above signs suggest that the individual is having difficulty controlling their use of the drug.
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A simple tool often used by clinicians to screen an individual for the presence of a substance use disorder is the CAGE questionnaire. This screening tool is often used to identify alcohol abuse, but it can be adapted to other drugs. For a potential stimulant use disorder as a result of Ritalin use, simply ask yourself these questions and be honest with your answers.
- C: Have you ever tried to cut down your use of Ritalin?
- A: Do you get angry when someone mentions that you use Ritalin too often or too much, or that your use of Ritalin is somehow dysfunctional?
- G: Do you ever feel guilty about your use of Ritalin?
- E: Have you ever felt the need to use Ritalin as an eye-opener, to get yourself going?
Because CAGE is a screening tool, it is never used to make a formal diagnosis. Instead, it is used as a quick method to determine if an individual may have issues related to substance use. Individuals who answer “yes” to any of these questions should consult with a licensed mental health clinician to further evaluate their situation.
It is very humbling and often frightening to admit that one may have a substance use disorder. Society has stigmatized substance use disorders to the point where these issues are considered to reflect some type of moral ineptitude or weakness in those who develop them. Nothing could be further from the truth. Those with substance use disorders come from every ethnic background, socioeconomic status, profession, and level of education. And there is hope for those who suffer from substance use disorders; with professional care, long-term recovery can be reached.
Ritalin (methylphenidate) is a medicinal drug that has significant clinical uses, but it is also a drug with a high potential for abuse. The actual designation of a stimulant use disorder as a result of Ritalin abuse can only be formally identified after an assessment by a licensed mental health clinician.
Individuals with substance use disorders often question their behavior at some point and begin to wonder if they are abusing the substance or if their use of the substance has become dysfunctional for them. However, substance use disorders (addictions) have become so stigmatized that individuals may be under the wrong impression that an addict is the stereotypical “skid-row” type. The reality of the situation is that substance use disorders can occur in most people under the right circumstances, and individuals with severe substance use disorders often maintain the illusion to themselves and to others that they are in total control of their behavior. An honest examination of one’s behavior will indicate that this is not the case, and then, real help can be sought.
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