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Central nervous system stimulant medications (CNS stimulants) have numerous medicinal uses.
In general, stimulants can be used to:
An important finding in treating ADHD was the discovery that stimulant medications can help someone with this disorder to focus, reduce impulsivity, and reduce hyperactive behaviors (the three major signs/symptoms of ADHD). A CNS stimulant that has been used extensively in the treatment of ADHD is methylphenidate.
Ritalin contains the immediate-release form of methylphenidate, whereas Concerta contains an extended-release form. Both drugs are typically taken orally, and the use of Concerta reduces the need for multiple administrations of the medication throughout the day. Another medication, Daytrana, is a patch form of methylphenidate that can be used by some individuals for the treatment of ADHD, narcolepsy, etc.
Methylphenidate is the active ingredient in very recognizable medications, such as Ritalin and Concerta.
The CNS stimulant methylphenidate works by blocking the reuptake of the excitatory neurotransmitters dopamine and norepinephrine. This mechanism of action also has residual effects. For instance, dopamine is a neurotransmitter that is associated in the development of nearly every type of addictive behavior. Massive releases of dopamine cause increased feelings of euphoria that are associated with reinforcement or repeating a particular action or behavior.
Drugs that directly increase the availability of dopamine, such as cocaine, methamphetamine, and methylphenidate, are also significant drugs of abuse, and many of these are classified by the United States Drug Enforcement Administration as Schedule II controlled substances. The drugs in this category represent the highest level of control for substances that are available with a prescription from a physician. These drugs are considered to have significant potentials for abuse and for the development of physical or psychological dependence. These drugs also have numerous potential side effects and long-term effects; as a result, they can only be safely used under the supervision of a physician.
The Substance Abuse and Mental Health Services Administration (SAMHSA) publishes some of the most reliable figures regarding the abuse of prescription drugs. According to the latest data in 2015, nearly 3.5 million individuals reported using drugs containing methylphenidate, and nearly 1 million individuals reported misusing methylphenidate at least one time. Misuse of a drug is not the same as abuse; however, the cycle of a substance use disorder (chronic abuse and/or addictive behavior) involves repetitive misuse of the drug. Research provided by The University of Michigan reported that in the same year about 2% of high school seniors reported abusing methylphenidate products.
Other research studies have suggested that the CNS stimulants like methylphenidate are most often abused by a particular demographic sector
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SAMHSA and numerous research studies have also investigated other factors associated with the abuse of stimulants like methylphenidate and have concluded the following:
A person who abuses Concerta may qualify for an actual diagnosis of a substance use disorder (a stimulant use disorder) as defined by the diagnostic criteria presented by the American Psychiatric Association (APA). Only a trained mental care clinician can diagnose a stimulant use disorder; however, the diagnostic criteria for a stimulant use disorder and other information provided by organizations such as SAMHSA are helpful in helping individuals to recognize signs and symptoms of Concerta abuse. Some of these include:
There is no such thing as a drug that does not have some type of side effect profile. Because drugs alter chemicals in an individual’s body, the alteration results in numerous effects, some of which can be medicinal and others that can be oppositional to normal functioning. Individuals who use drugs under the supervision of a physician and according to their prescribed instructions often experience side effects that can be controlled by the physician or remit over time. Individuals who abuse drugs do not use them according to their prescribed dosages, frequencies, etc., and are far more susceptible to numerous side effects as a result of both short-term and long-term use.
Individuals who abuse CNS stimulants like Concerta are at risk for numerous side effects that include:
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It was once believed that abuse of stimulant medications resulted in a relatively mild and easily treatable condition compared to the abuse of other drugs, such as opiates. However, this misconception has long been abandoned in favor of the notion that any type of substance use disorder, including a stimulant use disorder, represents a severe manifestation of a mental health disorder that requires a targeted intervention.
Because individuals can develop physical dependence on Concerta (having both tolerance and withdrawal), anyone who has abused the drug for more than a few weeks should consult with a physician before discontinuing it. Chronic abusers will benefit from a formal physician-assisted withdrawal management program to address cravings and withdrawal symptoms, and to help them get on the road to recovery. Most often, withdrawal management for stimulant medications (medical detox) can be successfully completed in an inpatient treatment setting, a residential treatment setting, or even an outpatient treatment setting, depending on the needs of the individual.
Following withdrawal management, individuals should become involved in a formal substance use disorder treatment program that should include the following components:
Success is often just a matter of remaining in treatment and trying to improve one’s condition despite experiencing inevitable setbacks that occur as a result of living in the world. Relapses occur frequently, even in individuals who are involved in the most comprehensive forms of treatment. Remaining involved in treatment helps individuals learn from their experiences, develop stronger plans of recovery, and eventually experience success. There is a strong relationship between successful recovery from any substance use disorder and the length of time that one remains actively involved in treatment-related activities, such that those who remain in treatment-related activities for longer periods of time have far greater rates of success in recovery.
Concerta contains the CNS stimulant methylphenidate. Methylphenidate is a controlled substance and a significant potential drug of abuse. Individuals who abuse Concerta are often younger, well-educated, and abuse it in conjunction with other drugs. Chronic abuse of Concerta can lead to the development of a stimulant use disorder.
Any individual who has developed a stimulant use disorder as a result of Concerta abuse requires formal intervention and long-term treatment. The potential for successful recovery increases as a result of maintaining involvement in treatment-related activities for years following initial abstinence from Concerta.
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