ADDICTION - THE RITALIN - COCAINE CONTROVERSY - COURTESY OF THE UTAH UNIVERSITY WEBSITE

Ritalin and Cocaine: The Connection and the Controversy

Ritalin is the most commonly prescribed medication for ADHD (attention deficit hyperactivity disorder). This treatment has helped thousands of people control their symptoms. But because Ritalin is a stimulant like cocaine, it may cause undesirable changes in the brain over time. It also has the potential for abuse. So what are the benefits of Ritalin, and what are the risks?
 
Ritalin

Ritalin is currently prescribed to approximately six million people in the US.
75% of these are children, with boys receiving Ritalin about four times more often than girls.

Since the mid-1950s, doctors have been using Ritalin to treat a variety of conditions including depression, fatigue syndrome and narcolepsy. Ritalin gained FDA approval for treatment of hyperactivity in children in 1961.
 
ADHD: The Benefits of Ritalin

Individuals with ADHD have difficulty concentrating, and can be hyperactive or impulsive. They also have lower levels of a brain chemical called dopamine.

Dopamine helps people control their behavior. So having the right level of dopamine in the brain is important. Ritalin increases dopamine levels, enabling ADHD kids to focus, filter out distractions, and make decisions based on reason rather than emotion.
 
Ritalin is Similar to Cocaine

Like cocaine, Ritalin is a powerful stimulant that increases alertness and productivity. Ritalin and cocaine also look and act the same. Both have a similar chemical structure, and both increase dopamine levels in the brain. They do this by blocking a dopamine transporter protein responsible for the reuptake of dopamine at the synapse.
 

Transporter



Ritalin and cocaine block the dopamine transporter, causing an increase in dopamine concentration at the synapse.



Ritalin

Cocaine
 
Is Ritalin Addicting?

Ritalin is not addictive when taken as prescribed by doctors. Why this difference between Ritalin and cocaine? Ritalin is a pill that you swallow, so the drug takes longer to reach the brain. Cocaine is taken in high doses by injection or snorting. It floods the brain quickly with dopamine, which makes it dangerous and addictive.

Unfortunately, Ritalin is quickly becoming a drug of choice for teens. It's relatively cheap and accessible. And because it's a prescription drug, it's perceived to be safe. But if Ritalin is abused (taken in high doses) or taken improperly (by injection or snorting), it can be just as addictive as cocaine. This is because drug delivery methods can influence the addictive potential of a drug.
 
Consequences of Misdiagnosis

Misdiagnosis of ADHD is a common problem that complicates the Ritalin controversy. Some say that Ritalin is now over-prescribed, and that undesirable changes in the brain may result over time.

Recent animal studies suggest that children who are mistakenly diagnosed with ADHD and treated with Ritalin may be more likely to develop depression as adults. This can be explained by Ritalin's effects on the reward pathway.

We know that Ritalin increases dopamine levels in the brain. But an unnecessary increase in dopamine during childhood may change how the brain develops. The brain may become desensitized to natural rewards like food, romance and social interactions, leading to depression.

30-50% of adolescents in drug treatment centers report abusing Ritalin.
 
Replacing Ritalin With Cocaine

ADHD children are typically taken off of Ritalin when they reach adulthood. Interestingly, these individuals seem to be more prone to cocaine addiction. Why is that? Because Ritalin and cocaine are similar drugs, it's possible that ADHD adults are unknowingly using cocaine as a replacement for Ritalin. In other words, it may be an attempt to self-medicate. Cocaine may help individuals with ADHD focus, feel calm and in control.

Kids with untreated ADHD are four times more likely than normal to abuse drugs.

Dr. Kelly Lundberg

Is Ritalin a 'gateway drug'? Studies show that proper Ritalin use does not lead to drug abuse.

Research shows that 10-30% of cocaine addicts have ADHD.
Protective Factor or Gateway Drug?

Because of Ritalin's similarity to cocaine, some believe Ritalin could be a 'gateway drug'. A gateway drug is defined as a drug that may lead to the use of other more addictive drugs. But studies show that Ritalin-takers are actually far less likely to experiment with other drugs unlike those with ADHD who are not medicated.