Ritalin


Many drugs plague us in this setting we call modern society. The word drug by itself conjures up images of heathens slumping in the alleyways of America’s violent streets injecting train-tracked arms full of milky white euphoria. Perhaps even scarier might be those drugs prescribed to us daily by physicians we know and trust. Millions of prescription drugs with heavy side effects and sometimes-unknown characteristics and workings are being doled out to us every day. Ritalin, a drug prescribed to 1.5 million American children aged 5 to 19, is particularly indicative of today’s prescription drug problem. (Safer, 1996) Relatively little is known about how the drug works, what chemicals it changes in the fragile human brain, and yet we give it out to school aged children across America. The problem with Ritalin, however, is not the drug itself, but the way in which it’s prescribed to and taken by millions of people eager to fix a problem that really isn’t defined.


Ritalin, manufactured by the CIBA-Geigy corporation, is the brand name for Methylphenidate, a drug commonly used in the treatment of Attention Deficit Disorder or ADD. (Bailey, 1998) The pills come in 5, 10 and 10 milligram doses. (Bailey, 1998) Ritalin, which is close in chemical structure to cocaine, is considered dangerous enough to be classified as a schedule II controlled substance under the Federal Controlled Substances act. (Bailey, 1998) Illegal distribution of Ritalin could result in a 10,000 dollar fine and up to 45 years in prison. (Bailey, 1998)


The exact function of Ritalin is unknown. It is known that Ritalin is a central nervous system stimulant that manipulates the neurotransmitter dopamine. (Bailey, 1998)


Drugs such as cocaine and other amphetamines work on the same principal. (Bailey, 1998) The main site of the drug’s activity appears to be in the Cerebral cortex and the Reticular Activating System. (Chohan, 1998) CIBA-Geigy discloses many side effects for Ritalin including nervousness, insomnia, loss of appetite, nausea, vomiting, dizziness, headaches, changes in heart rate and blood pressure, skin rashes, itching, abdominal pain, weight loss, digestive problems, toxic psychosis, psychotic episodes, drug dependence syndrome, and severe depression upon withdrawal. (Bailey, 1998) These severe and dangerous side effects are important to consider when deciding whether Ritalin is an appropriate drug to prescribe to children.


Doctors often have trouble diagnosing ADD, which unfortunately defies definitive chemical tests. (Gibbs, 1998) To determine if a child has ADD, doctors depend on a list of symptoms described by the American Psychological Association (APA) to indicate the disorder. (Gibbs, 1998) This list describes potential tendencies observed in children said to have ADD, such as trouble paying attention, making careless mistake in schoolwork, trouble concentrating on one activity at a time, talking constantly at inappropriate times, running around in a disruptive manner when required to be seated or quiet, fidgeting and squirming constantly, trouble waiting for a turn, being easily distracted by things going on around them, impulsively blurting out answers to questions, often misplacing school assignments or toys and seeming not to listen even when directly addressed. (Gibbs, 1998) These traits must be exhibited for at least six months to be considered indicative of ADD. This is where the problem with Ritalin begins. These traits


are common in many children, and some ore often used to define childhood. At what level are these characteristics to be considered abnormal? This is left to the doctor’s discretion. Doctors however have different ways of measuring the symptoms of ADD and one doctor’s oppinion can vary greatly from another’s. Without chemical tests, we have no way of knowing if a person is really afflicted with ADD.


In order to better classify ADD and prevent doctors from using the diagnosis to sum up every patients problems, the APA has developed a standard process which doctors should follow to determine whether or not a patient has ADD. First, the parents of the child in question must be interviewed to decide the circumstances under which the child exhibits the symptoms. (Livingston, 1997) The interview is also used to ascertain a complete developmental, medical and family history of the patient. (Livingston, 1997) Then the physician must observe the child numerous times to “elicit his view of the problem” and to screen the patient for other disorders that may be