THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Thursday, March 7, 1996 TAG: 9603070421
SECTION: FRONT PAGE: A1 EDITION: FINAL
SOURCE: BY LORRAINE EATON AND MIKE MATHER, STAFF WRITERS
LENGTH: Long : 185 lines
It's flowing through the veins of children being admitted to emergency rooms across the country. It's glorified in the lyrics on a gold record album. And it's being used illegally by some young people in Hampton Roads.
Ritalin, the brand name for methylphenidate, is a drug increasingly prescribed to treat children with attention deficit and hyperactivity disorders, known as ADD or ADHD. On the streets it's hailed as ``Vitamin R,'' and young people are using it to study harder and better, or just to get high.
``It's pretty widely abused,'' said one Norfolk Academy student. ``There are so many people that take Ritalin anyway (who are) my age and older, they're free with their prescriptions. People just say, `Hey, can I have one of your Ritalin?' ''
In the past five years, the amount of Ritalin legally prescribed to teens and adults has increased 600 percent, according to the Drug Enforcement Agency. Annually, the United States uses five times more methylphenidate than all other countries combined. Since 1987, Virginia's consumption of methylphenidate has been above the national average. From 1987 to 1994, consumption rose by nearly 120 percent.
Ritalin is a Schedule II drug, in the same classification as opium and among the strongest drugs available.
Federal researchers estimate that as many as 5 percent, or 2 1/2 million, of the nation's school-age children take Ritalin regularly. In people with attention deficit and hypertension disorders, Ritalin has a calming effect and heightens concentration. In those without one of the disorders, the drug works like a stimulant. It can be addictive and it can be fatal.
Two deaths in the past year have been attributed to Ritalin abuse, one in Mississippi and one in Roanoke, where a teen died of a heart attack last spring after snorting the drug off a stove top at a party. The soccer player was attending a community college and had plans to transfer to a four-year school.
``The dangerous belief they (illegal users) have is that it is safe because it is manufactured by a drug company and prescribed by a doctor,'' said Dr. Robert C. Morrow, a Norfolk physician and medical anthropologist who is an assistant professor at Eastern Virginia Medical School.
Hundreds of local students are administered the drug at school, where distribution of methylphenidate is tightly controlled. The procedure is the same as for all prescription drugs, except bee-sting kits.
In most local school districts, the medication, in the original container, must be handed directly from the parent to the school nurse, who keeps it under lock and key. Lines form at the nurse's office when pupils come in for their midday dose, which is given under strict supervision. The nurse hands the medicine to the student and watches him or her take it.
Students found carrying the drug, even if it is prescribed to them, can face either long-term suspension or expulsion. This fall, three students - one each in Norfolk, Portsmouth and Chesapeake - have been disciplined in Ritalin-related incidents. Last year, a Virginia Beach student was disciplined in relation to the drug. Suffolk schools reported no Ritalin-related cases. Last year, parents at Norfolk Academy received letters alerting them to potential misuse of the drug.
Despite the supervision, Ritalin is being used by those without a medical need. Police say they have seen a direct correlation between the rising number of Ritalin prescriptions and the rising number of Ritalin abuse cases.
``There's a big market for it,'' said a Maury High School student.
Here and across the country Ritalin pills are being sold illegally for between $1 and $15 a tablet. That represents a significant mark-up from the prescription price of between 25 and 50 cents a pill.
The illegal use of Ritalin has garnered the attention of the state police, who devote a dozen agents to investigate prescription-drug fraud and abuse in Virginia. Local police departments, however, said they generally don't have the resources to devote to pharmaceutical fraud, and none contacted had any statistics on Ritalin problems.
``We have made arrests, and we have seen an increase in pharmaceutical diversion,'' said Tommy Gladson, state police senior special agent ``Ritalin is a drug of abuse, and it is being abused. My gut feeling is Ritalin is a tremendous problem.''
Gladson and Morrow have teamed to study the local use of Ritalin - Gladson from the police perspective and Morrow from the medical side.
For teens with ADD or ADHD, symptoms include inability to concentrate for long periods and inability to sit or remain still. Many parents have said the drug has helped problem children become productive students.
But when Ritalin is swallowed or crushed into powder and snorted by those without the disorder, the drug mimics the effects of cocaine - loss of appetite, frenetic energy, heightened pulse and blood pressure. It has been used for decades as a stimulant. In fact, in ``The Electric Kool-Aid Acid Test,'' Tom Wolfe's 1968 nonfiction account of the drug subculture, college-age youths pop Ritalin like candy.
Today, older teens and college students seeking a cocaine substitute have found that the drug gives a similar high at a lower cost. Also, there's less risk in obtaining the drug because it's dispensed from medical professionals instead of street dealers. And, police admit, users know law-enforcement efforts are focused more on illegal street drugs than on Ritalin.
Even pop culture has extolled the drug:
``Ritalin is easy
Ritalin is good''
- from the Foo Fighters hit song ``This is a Call.''
Locally, dozens of students said that they have at least heard of the drug acceptable on the party circuit where it is either taken orally or snorted.
The growing popularity of the drug among young people in South Hampton Roads mirrors the rise in national statistics.
Between 1993 and 1994, the estimated number of times that the drug was mentioned during emergency-room visits by people age 6 to 17 soared from 245 to 815, a 232 percent increase, according to the national Drug Abuse Warning Network. And the University of Michigan's ``Monitoring the Future'' study of 2,500 high school seniors found that the illegal use of the drug more than doubled between 1993 and 1994. In the same study, Ritalin rose sharply as a drug of choice - from 7.8 percent in 1993 to 16.6 percent in 1994 - for seniors who said that they had used amphetamines in the past year. The figure dipped slightly to 14.3 percent for the class of '95.
Despite strict controls, local young people say that Ritalin is easy to get. Youths give it away or sell it. And there are other avenues. A Norfolk Academy student said that teenagers also try to get a steady supply by convincing their parents that they have ADD, and then deliberately skewing their behavior during tests to check for the disorder.
However, the idea that there is a single test for the disorder is a teenage myth, said Dr. Daniel T. Walter, a psychologist who practices in Portsmouth and Norfolk. To make a diagnosis, Walter said, doctors rely on many things - including IQ tests, observations of reaction times, academic history, family medical history and information from parents and teachers.
``It is not possible to carry that subterfuge all the way through the diagnostic process,'' said Morrow, the Norfolk physician whose speciality is preventive medicine.
An intense pressure to perform academically to get into a ``good'' college is driving some young Ritalin seekers. And an ``F'' on the ADD test doesn't stop some from getting what they want. One Virginia Beach teen knew of a student who failed the test for ADD. But still believing she has the disorder, the girl now ``shares'' a prescription with a friend.
``She thinks it helps her study better,'' the student said.
The drug is also being abused on college campuses, including some in Virginia. A Hollins College student said that Ritalin is quite common at Hampden-Sydney College, an all-male school that Hollins women often visit.
``People use it all the time; they sell it for $1 a pill,'' she said. ``When they have tests and have to study they take it. . . . They take it before parties and after parties.''
Hampden-Sydney's campus clinic has treated no students who have taken Ritalin illegally, but students prescribed the drug have asked that their supply be kept there under lock and key, said Linda L. Martin, director of health services.
Martin said that students sometimes come into the clinic asking for the drug. ``They've moved (out of high school and) into the big time and they have trouble with focus and concentration,'' Martin said. ``They want Ritalin.''
To be diagnosed, students go through a lengthy procedure that includes evaluation by two doctors. And last spring, the college started requiring additional documentation for dispensing drugs to students with prescriptions from their home doctors.
``Something's going on and we certainly do know that the drug gets passed around,'' Martin said. But since many students get the drug from their doctors at home - totally bypassing the clinic - it is impossible to monitor.
Concern over recent reports of Ritalin abuse has prompted its manufacturer, Ciba-Geigy Corp., to take action. In the next few weeks, the company will begin distributing educational pamphlets, via pharmacists, that will warn parents about the dangers of misuse of the drug. Copies will also be given to parents to give to school nurses.
Locally, law enforcement and the medical community plan to have some hard numbers on local use and abuse of Ritalin within six months.
But people should remember that Ritalin abuse is not an island, said Don J. Shearer Jr., a certified substance abuse counselor who teaches at Old Dominion University and Paul D. Camp Community College. It's part of a much larger mass of drug abuse.
``The problem is evident with all drugs,'' Shearer said. ``Kids are changing their moods to feel good or feel bad.''
The danger in that, he said, is that experimenting with drugs is ``like the tune on a tuning fork. You are never going to get it right; you keep going back and forth.'' ILLUSTRATION: [Color Photo]
STEVE EARLEY
The Virginian-Pilot
[Ritalin]
RISING RITALIN
Graphic
KEN WRIGHT
The Virginian-Pilot
SOURCE: DEA
KEYWORDS: DRUG ABUSE RITALIN by CNB