Ritalin (Concerta) Addiction and Withdrawal
Ritalin and Concerta are both brand name medications that contain methylphenidate hydrochloride, a central nervous system stimulant. The effects of methylphenidate hydrochloride are more intense than caffeine but less potent than amphetamine, and doctors typically prescribe Ritalin and Concerta to treat attention deficit hyperactivity disorder (ADHD). People abuse these drugs for the effects that they produce, including wakefulness, euphoria, increased focus, and appetite suppression.
What Is the Difference between Ritalin and Concerta?
Ritalin and Concerta are essentially different versions of the same drug. Because they both contain methylphenidate hydrochloride, they have similar effects on the brain when it comes to controlling symptoms of ADHD, but they differ in strength, dosage, and duration of the intended effects. Concerta is a long-lasting stimulant that increases dopamine steadily throughout the day. Users only need to take it once a day because it lasts for 10-12 hours.
Ritalin, on the other hand, is a short-acting stimulant. That means it works quickly and increases norepinephrine and dopamine levels almost immediately. People who need immediate relief find Ritalin especially helpful, while those whose ADHD symptoms get worse as the day goes on tend to do better when taking Concerta.
Who Abuses Ritalin?
According to the National Drug Intelligence Center, a component of the US Department of Justice, Ritalin abuse is typically associated with younger people, including preadolescents, teenagers, and young adults. ADHD is prevalent among young people, and the Drug Enforcement Administration reports that the increased use of Ritalin to treat symptoms has resulted in a corresponding increase in abuse.
According to the 2015 Monitoring the Future Survey, 2 percent of 12th graders have used Ritalin within the past year. People who abuse Ritalin often obtain it from peers, friends, or family members who have a legitimate prescription for it. Individuals abuse Ritalin by crushing the tablets and snorting the powder to deliver a powerful high. Some people who abuse the drug also dissolve the tablets in water and inject the solution directly into a vein.
Methylphenidate hydrochloride is habit-forming, and even individuals who take it as directed by a doctor can develop a dependence on it; however, people who realize they have developed a dependence on Ritalin should not simply stop taking it. According to the US National Library of Medicine, stopping Ritalin immediately could result in serious negative side effects, including severe depression. For individuals struggling with a dependence or addiction to Ritalin, there are treatment options that have proven to be effective. The first step to sobriety is recognizing and acknowledging that there is a problem.
Signs of Ritalin Abuse
Though people often associate Ritalin abuse with teenagers because of its accessibility among students, adults often abuse Ritalin too. The medication is classified as a Schedule II drug, which means it has a high potential for abuse. Some signs that a loved one might be abusing methylphenidate hydrochloride are:
- Weight loss and reduced appetite
- Pupil dilation
- Dizziness or fainting spells
- Excessive sweating
- Impaired vision
- Rapid heart rate
Abusing Ritalin can have serious consequences, and it is a growing problem around the nation. According to the Drug Abuse Warning Network, the number of emergency room visits due to complications from stimulants used to treat ADHD more than doubled from 13,379 in 2005 to 31,244 in 2010. Stimulants can increase heart rate, blood pressure, and body temperature while decreasing appetite and making it harder to fall asleep. The National Institute on Drug Abuse (NIDA) reports that when taken in high doses, stimulants can also cause serious cardiovascular complications, including stroke.
Abusing methylphenidate hydrochloride is dangerous, and it can lead to a powerful addiction. Addiction occurs when individuals develop a dependence on the drug and proceed to use it compulsively regardless of the consequences. People who are addicted to Ritalin cannot stop taking it without outside intervention, and they should not attempt to do so on their own because they could put their health at risk. According to the Substance Abuse and Mental Health Services Administration, a quality health assessment at the start of treatment can help individuals evaluate how and why they began using Ritalin, explore any underlying medical issues, and screen for other mental health issues, so appropriate treatment and any necessary aftercare can be provided.
Methylphenidate Hydrochloride Withdrawal
Like many substance abuse problems, treating an addiction to Ritalin begins with undergoing medical detox. During the medical detox phase, healthcare professionals monitor withdrawal symptoms and make clients more comfortable as their bodies adjust to life without Ritalin. Both the intensity and duration of withdrawal can vary due to a number of factors, and it typically takes anywhere from three days to one week or more for symptoms to subside. The most common symptoms of Ritalin withdrawal are:
- Disturbed sleep patterns
- Extreme fatigue
- Prolonged periods of sleep
During the medical detox phase, healthcare professionals ease the worst symptoms for their clients using various medications. These include:
- Antidepressants to minimize the risk of harming oneself or others
- Benadryl to ease itching and hypersensitivity of the skin
- Bromocriptine and amantadine to ease cravings for Ritalin
- Neuroleptics to treat psychotic episodes that can occur from high doses of methylphenidate hydrochloride
Some symptoms of withdrawal can persist for 1-2 weeks, but the worst of the symptoms usually subside within five days. In order to reduce their intensity, doctors taper clients off methylphenidate hydrochloride slowly. With drugs like Ritalin, the psychological symptoms of withdrawal can be worse than the physical symptoms, but people can manage both when they know what to expect. According to a review originally published in The Primary Care Companion to the Journal of Clinical Psychiatry, methylphenidate hydrochloride toxicity produces manic-like states, schizophrenic symptoms, psychoses, various anxiety conditions, and depression, which is especially common during withdrawal.
Treatment Options following Detox
After medical detox, treatment programs for Ritalin addiction focus on therapy. People who enter recovery will meet with counselors and other healthcare professionals to undergo both individual and group therapy, which will help them get to the heart of their addiction. Quality counseling is key to preventing relapse, and clients can take advantage of it during residential treatment, partial hospitalization programs, and intensive outpatient programs.
Counseling is an important part of treatment for any substance abuse disorder, but it’s especially relevant when it comes to combatting Ritalin addiction because of the way the chronic use of methylphenidate hydrochloride affects the brain. According to the FDA, the use of Ritalin and other stimulants can result in psychiatric problems, including new or worse behavior and thought problems, bipolar illness, and aggression.
All of the treatment modalities incorporate therapy that will help individuals who are struggling to quit methylphenidate hydrochloride. When it comes to addiction, individuals are usually aware of the dangers of their behaviors but continue to use despite the potential consequences. Two of the most common obstacles they face in treatment are ambivalence or uncertainty and the fear of change. Motivational Interviewing is one form of therapy that addresses that ambivalence directly.
Motivational Interviewing is a goal-oriented treatment that attempts to reduce ambivalence and give clients the desire to change for the better instead. During this type of counseling, clients establish a rapport with their counselors, who encourage them to consider the consequences of abusing Ritalin. According to a review originally published in the Journal of Clinical Psychology, Motivational Interviewing is 10-20 percent more effective than no treatment at all when it comes to treating substance abuse and minimizing other risky behaviors.
Cognitive Behavioral Therapy (CBT) has proven to be another effective component of addiction treatment. According to NIDA, Cognitive Behavioral Therapy was originally developed as a way to prevent relapse for those fighting an addiction to alcohol, and it was later adapted to help individuals who abuse cocaine and other stimulants, like Ritalin and Concerta. The strategies employed in CBT are based on the theory that learning processes play a critical role in the development of maladaptive behaviors. Individuals who attend CBT during treatment learn how to identify and correct negative behavioral patterns, like drug abuse, by applying specific tools.
A core element of CBT is learning how to anticipate problems before they arise and gaining the self-control to address them appropriately once they do. Individuals in CBT will learn how to recognize cravings early and avoid situations that might put them at risk of using again. They will also explore the negative consequences of continued drug use and gain skills they can carry with them long after they finish therapy.
It is important for both clients and family members to recognize that the road to recovery does not end when treatment for Ritalin addiction does. Following residential treatment and outpatient care, it is critical for clients to put into place an aftercare plan that addresses the issues they are likely to face once they return to their everyday lives. A good aftercare plan might include peer group sessions, continued therapy, and loved ones who promise to support the individual every step of the way.
Ritalin is a powerful drug, and under the right guidance, it can do a lot of good. Many parents are satisfied with the way Ritalin and Concerta help their children focus, and the prevalence of prescription stimulants in schools only appears to be increasing as time goes on. According to the CDC, the number of children ages 4-17 years old who were taking ADHD medication increased from 4.8 percent in 2007 to 6.1 percent in 2011.
Abusing Ritalin is dangerous though, and preventing an addiction to it is far easier than treating one. It’s never too early to talk to children about the dangers of drugs. Parents should monitor their children’s use of stimulants and talk to them about the potential consequences of abusing Ritalin and Concerta; however, family members should keep in mind that if an addiction does develop, there is always hope of recovery. With the right treatment modality and aftercare plan, as well as a supportive family or support network, it is entirely possible to fight a Ritalin addiction and lead a fulfilling life of sobriety.
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