Ritalin And Its Uses Essay, Research Paper

Ritalin and Its Uses

In recent years, more and more kids seem to be on a prescription drug

called Ritalin(methylphenidate). This drug is being handed out more and more by

doctors as a way of treating Attention Deficit Hyperactivity Disorder, a complex

neurological impairnment that prevents kids from concentrating. According to

the Drug Enforcement Agency, it rose fron 200 grams per 100,000 people to over

1400 grams per 100,000 people in the last fifteen years. The National Institute

of Mental Health estimates that about one student in every classroom is believed

to experience the disorder. The rate of Ritalin use in the United States is at

least five times higher than in the rest of the world according to federal

studies. Are doctors just catching this disabling affliction more often? Or

does society just want a convenient way to solve a complicated problem.

Ritalin is a central nervous system stimulant that is somewhat similar

to amphetamines. It was created in 1955, classified as a controlled substance

in 1971, and became the drug of choice for ADHD in 1981. It is also used in

treating narcolepsy. It is thought to activate the brain stem arousal system

and cortex, and, like cocaine, works on the neurotransmitter dopamine. It

appears to increase the levels of dopamine in the frontal lobe where attention

and impulsive actions are regulated. When taken in its intended form under a

doctor’s prescritption, it has moderate stimulant properties. There has been a

great deal of concern about it’s addictive qualities and adverse affects.

ADHD is a relatively new disorder. It was introduced in 1980, where it

was labeled ADD(attention deficit disorder). In the 1950’s, children were

simply labeled “hyperkinetic.” The term “hyperactivity” was added in 1987,

hence the name ADHD. Not all children have the hyperactivity, and thus are

labeled to have ADD. ADD is not treated with Ritalin; antidepressants are more

commonly used. One of the problems with the label ADHD is that just because a

child may be overly hyper, doesn’t mean the child is not paying attention. The

problem is, the child is paying too much attention to too many things at the

same time.

ADHD is children’s #1 childhood psychiatric disorder. The prevalence is

three times as likely in boys than girls. The children tend to be very bright,

but are poor students because they cna’t settle down. They blurt questions out

before they are asked. They can’t wait their turn, stop fidgeting their legs

and tapping their pencils. They tend to be forgetful, have problems following

directions, and lose things easily, as well as their tempers. This behavior

occurs constantly. This may be a reason why teachers and school psychologists

are adament in their beliefs; these kids are disrupting their classrooms, so

they want the problem solved immeditately, and take the “quick fix” approach.

Experts believe that more than two million children (3-5%) have the disorder.

Some scientists believe ADHD is a result of a problem in pregnancy

ranging from fetal alcohol syndrome to exposure to lead in utero. Others

suggest that ADHD is hereditary. Dr. Russel Barkley, of the University of

Minnesota reports that nearly half the ADHD children have a parent, and more

than one third have a sibling, with the disorder.

Ritalin as prescribed is taken orally, and takes effect in about 30

minutes and lasts for about 3-4 hours. Kids usually take 5-10 mg doses three

times a day. Although many experts report that Ritalin is a positive treatment

in 9 out of 10 patienst, and many parents and students claim the drug is a

benefit in their lives’, there are many who question the drug’s long-term

effects, dangers, misdiagnosis, and non-medical abuse. Diagnosis for

ADHD isn’t as easy as you think. There is no blood test, no x-ray, or no cat

scan to determine a biological cause for the disorder. Teachers, even in

preschool strongly advocate the drug(negative reinforcement???). School

psychologists are even prescribing the drug before giving an evaluation because

there are so many referrals and a lack of school psychologists (1:2100 students).

Many times, it has been shown, that psychiatrists who often diagnose for ADHD

in children, are disdiagnosing disorders similar to ADHD such as learning

disabilities, depression or anxiety disorders; disorders that do not

neccessitate Ritalin as a therapy. Some doctors who are reluctant to prescribe

Ritalin find that the childeren’s parents just switch doctors and find doctors

who will. Unfortunately, this is surprisingly easy. Doctors surveyed by the

Archives of Pediatric and Adolescent Medicine said they send ADHD children home

in about an hour. The children are not only sent home with just a prescription,

but rarely any follow up care of additional therapy is adnministered. Experts

in the field of ADHD say behavior modification techniques and extra help in

school is a better way in treating the disorder. Since it takes time to sit

down and go through therapy sessions, and it takes time for parents to fit tis

all into their lifestyle, a pill is much more convenient. There are no long

term studies on the effects that it has on children, so many fear what

complications may occur later on in life.

Correct diagnosis would occur if doctors would take the time to provide

a complete examination of the patient. To make a correct ADHD diagnosis, it is

important to review the child’s family history, give abstract cognitive tests,

observe their behavior, and run a slew of behavioral exams. Other disorders

must be ruled out first. Parents need to make sure a complete evaluation is

carried out before putting a pill in a child’s mouth. One would think that

every parent would explore every option before relying on medication only.

Diagnosis would also be much easier if doctors could find a flaw in the

brain. Several studies have shown that ADHD brains look and function slightly

different that “normal” brains. PET(positron emission tomography) has shown

that ADHD brains use less glucose in the prefrontal lobe. The prefrontal lobe

is the center for impulse control and attention. By using less glucose-or

energy, this would then agree with the child’s behavioral problems. Other tests

show that there is less electrical activity in the same region of the brain.

Nonetheless, these studies have not yet been proven to be the cause for the

disorder.

Many people are concerned with the non-medical use of Ritalin, also.

Ritalin is a Schedule II controlled substance, which means it is a very powerful

drug, and in the same category as cocaine, methadone, and methamphetamines. The

Manufacturer of Ritalin, Ciba-Geiby Corporation, cautions doctors that many

adverse side effects are possible under normal dosage such as: nervousness,

insomnia, decreased appetite, nausea, vomiting, dizziness, heart palpitations,

headaches, rise in heart rate and blood pressure, skin rashes, itching,

abdominal pain, weight loss, digestive problems, toxic psychosis, psychotic

episodes, and severe depression upon withdrawal. Many question if such a drug

should be so freely handed out to children because of it’s possible dangerous

effects. Parents are even trying to lessen the restrictions on Ritalin so they

won’t have to make monthly doctor visits.

It’s rise on the black market has also been increasing. Since it is so

widely available, many kids sell the pills for 3-15 dollars a pill. The buyers

then crush up the pill and snort it, giving an intense high similar to cocaine.

Some also dissolve it in water and inject it intravenously. In these forms, it

is highly addictive, and withdrawal symptoms are also similar to cocaine. Some

of the side effects at these high doses may be life threatening: loss of

appetite(may cause serious malnutrition), tremors and muscle twitching, fevers,

convulsions, and headaches(may be severe), irregular heartbeat and

respiration(may be profound and life threatening), anxiety, restlessness,

paranoia, hallucinations, delusions, excessive repetition of movements and

meaningless tasks, and formicaton(sensation of bugs or worms crawling under the

skin). It seems to be abused by high school kids and college students

predominantly. Although the drug is too complex to manufacture illegally, and

it doesn’t create the euphoric effect that cocaine has, it seems to be an aid in

studying for final exams. It allows students to stay up all night allowing them

to cram much easier.

It is important to remember that too many children in America are

suffering from this ailment, and yet too many kids are getting pills instead of

proper care. Although Ritalin currently seems to be an effective way in

treating Attention Deficit Hyperactivity Disorder, we must not treat this

disorder hastily. Our society must realize that prescription drugs can have

just as many complications as street drugs. Befor writing out a prescription,

or carelessly diagnosing ADHD, we must remember that these are kids we are

dealing with. They put all their faith in us to help them, and not just to

medicate them.