Essay/Term paper: Ritalin and its uses

Essay, term paper, research paper:  Alcohol and Drugs

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.