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Methylphenidate (Ritalin) Addiction and Treatment
People who have been prescribed Ritalin to treat narcolepsy or ADHD have not been shown to develop tolerance to its treatment effects, but people who misuse the drug can develop tolerance to the effects they are looking for.5 Ritalin is a Schedule II substance, meaning it has a high potential for abuse.2,5
People who use Ritalin regularly in high doses can develop physical dependence.5 Those who misuse the drug and become psychologically dependent may undergo drug cravings.5
Misusing prescription stimulants may lead to the development of a stimulant use disorder.6,8 Based on 2017 surveys, it was estimated that about 572,000 Americans ages 12 and up had a substance use disorder involving prescription stimulants in the past year.9
Signs that an individual may be suffering from a methylphenidate use disorder include:8
- Often taking methylphenidate for a longer time or in larger amounts than intended
- Persistently wanting to or unsuccessfully trying to decrease or control methylphenidate use
- Spending a lot of time getting, using, or recovering from methylphenidate
- Craving methylphenidate
- Having problems fulfilling important responsibilities at school, work, or home due to regular methylphenidate use
- Continuing using methylphenidate even though it is causing or worsening trouble with relationships or other social issues
- Stopping or decreasing important activities because of methylphenidate use
- Using methylphenidate repeatedly in dangerous situations
- Continuing using methylphenidate even when knowing that it is likely causing or worsening a physical or psychological problem
- Experiencing tolerance and/or withdrawal
The short-term effects of Ritalin are similar to those of amphetamines, with the effects largely dose-dependent.5 Short-term effects from low doses may include the following:5
- Wakefulness/decreased sleep
- Decreased appetite
- Increased alertness
- Irregular or fast heartbeat
- Nausea and vomiting
- Skin rash
Short-term effects from high doses may include the following:5
- Large pupils
- Raised blood pressure and heart rate
- Anxiety and restlessness
The long-term effects of Ritalin misuse are like those of amphetamine, and can include anxiety and trouble sleeping.5 Those who use the drug at high doses daily may also experience a toxic state similar to acute paranoid schizophrenia.5
The long-term effects of Ritalin misuse are like those of amphetamine, and can include anxiety and trouble sleeping
Recurring abuse of prescription stimulants may also cause anger or paranoia and, at high doses, may lead to cardiovascular problems, such as stroke.4
Symptoms of Overdose
A person can overdose on prescriptions stimulants like Ritalin, and overdose symptoms may include the following:1,3,6
- Fast or irregular heartbeat
- High blood pressure
In addition to those symptoms, there is a risk of experiencing heart issues from Ritalin, including heart attack and circulation failure.1,6
If you think you or someone else may have overdosed on methylphenidate or another drug, call 911 immediately.
Inpatient vs. Outpatient?
Suddenly stopping or decreasing regular use of prescription stimulants like Ritalin may produce withdrawal symptoms—including tiredness, depression, and altered sleep patterns—that could be uncomfortable and challenging for someone to deal with alone.4 If you are struggling with a substance use disorder (SUD) involving Ritalin, SUD treatment can help. If you’re having trouble deciding between inpatient and outpatient rehabilitation centers, it’s important to understand what each type of facility provides.
In an inpatient rehab center, you will live at the facility. At some facilities, you may be able to obtain round-the-clock care from experienced medical professionals as you go through the detox process.
Outpatient treatment options can also be immensely helpful, though they do not provide the same level of supervision and typically involve less treatment time than treatment programs carried out in an inpatient or residential setting.
Are Rehab Centers Private and Confidential?
All of your medical records and other protected health information must be kept private and secure by health care providers according to federal law.10 Substance use rehabilitation programs are a form of medical treatment, and your records will be kept private.
Most programs are also under additional privacy regulations that forbid them from sharing any information that would identify a person as having a substance use problem, past or present, or as participating in the program. Aside from specific exceptions, the patient must provide written consent for information to be shared, specifying who it can be shared with.11
Substance use rehabilitation programs are a form of medical treatment, and your records will be kept private.
How Long Does Inpatient Rehabilitation Last?
There is no set length of time for successful rehabilitation in a rehab program. Each individual in treatment often progresses at different rates; suitable treatment durations are influenced by patients’ needs and problems, such as the severity of the SUD and any significant medical or concurrent mental health issues for which the patient is being treated.12,13 Many programs recommend a minimum of 28 to 30 days of treatment, but this can often be extended to a longer treatment program if needed, such as 60 or 90 days. Long-term residential communities may offer treatment for six to twelve months.13 Rehabilitation should last as long as the patient needs it. Research shows that most individuals with addiction require 3 months or more of treatment (not necessarily inpatient) to markedly reduce or stop drug use.13
What Happens During Treatment?
Individual assessment is a necessary foundation for good patient care. An assessment should include a medical history, psychiatric history, social history, physical exam, and mental health evaluation to determine the patient’s specific treatment needs. If the assessment determines that withdrawal management is needed, assessment should be followed by detoxification. Other core components of treatment may include: 7
- Counseling and therapy—group and/or individual.
- Monitoring of substance use.
- Case management.
- Peer support/self-help groups.
- Aftercare planning/continuing care—aftercare focuses on maintaining recovery after a treatment episode; such efforts could include things like alumni programs, regular outpatient therapy, and support group participation.
Additional services may include: 7
- Medical and/or psychiatric treatment for any significant co-occurring medical or mental health issues (including ADHD).
- Career and/or educational services
- Family services
- Housing and/or transportation help
- Financial services
- Legal assistance
Cognitive-behavioral therapy (CBT) and contingency management, and possibly other behavioral therapies as well, can effectively help treat people addicted to prescription stimulants. CBT helps change the person’s drug-use behaviors and expectations and can help them cope with stress and triggers. Contingency management provides small rewards for healthy behaviors such as staying abstinent.6
If you think the time for treatment is now, take the first step. There’s a lot to think about, and you probably have many questions about methylphenidate (Ritalin) misuse and how to overcome it. You don’t have to be 100% sure before you reach out for help – contact someone who can help answer your questions and help you decide what to do next.
- Interventions. You may have a loved one who is struggling with a Ritalin addiction that threatens to destroy his or her life. An intervention may help him or her take the first step toward recovery. You may have thought of staging an intervention but did not know how to go about doing so. Interventions can be effective tools, but they should be carefully organized as they can backfire if planned poorly. A mental health professional or professional interventionist can help arrange a beneficial intervention and possibly even facilitate it.h
- Treatment methods. Different treatment programs may use different treatment methods. You should choose a program that you’re comfortable with. Someone who’s interested in alternative therapies may be interested in a holistic program. Someone with strong religious beliefs may benefit from a religious or faith-based program. There are non-12-step or non-spiritual programs as well.
- U.S. National Library of Medicine. (n.d.). Methylphenidate.
- SAMHSA: Hughes, Arthur., Williams, Matthew R., Lipari, Rachel N., Bose, Jonaki; RTI International: Copello, Elizabeth A.P., Kroutil, Larry A. (2016). Prescription Drug Use and Misuse in the United States: Results from the 2015 National Survey on Drug Use and Health. NSDUH Data Review, 1-72.
- S. National Library of Medicine. (2019). MedlinePlus: Methylphenidate.
- National Institute on Drug Abuse. (2014). DrugFacts: Stimulant ADHD Medications: Methylphenidate and Amphetamines.
- Center for Substance Abuse Research. (2013). Ritalin.
- National Institute on Drug Abuse. (2018). DrugFacts: Prescription Stimulants.
- Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine (6th ed.).
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5thEdition). Arlington, VA: American Psychiatric Publishing.
- Substance Abuse and Mental Health Services Administration. (2018). Results from the 2017 National Survey On Drug Use and Health: Detailed Tables
- S. Department of Health & Human Services. (2017). Your Rights Under HIPAA.
- Susan Awad. (2013). American Society of Addiction Medicine. Confused by Confidentiality? A Primer on 42 CFR Part 2.
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): How long does drug addiction treatment usually last?
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Types of Treatment Programs.
- May Clinic. (2017). Intervention: Help a loved one overcome addiction.