DEA Warns of Ritalin® Abuse; Drug Manufacturer's Contributions to Advocacy Group Investigated

PRESCRIPTION DRUGS March 1996

The Drug Enforcement Administration (DEA) is warning that teenagers are abusing Ritalin®, a drug used to treat Attention Deficit Disorder (ADD) in children (Laura Sessions Stepp, "A Wonder Drug's Worst Side Effect," Washington Post, February 5,1996, p. A1; Laura Sessions Stepp, "Ritalin: 'In the Wrong Hands, A Dangerous Medication,'" Washington Post, February 5, 1996, p. C5).

Washington Post reports say students obtain pills for $1 to $5 per pill from other teens who have prescriptions for the drug. They then ingest the pills or crush them into a powder that they snort. Called "Vitamin R," "R-ball," or "the smart drug," use of the drug by children and teenagers without ADD causes short, intense periods of high energy. In large doses, Ritalin® can cause seizures, psychosis, or stroke. The DEA attributed several deaths to abuse of the drug.

"We have always had some problems with [methylphenidate] abuse and traffic. But it has never been pervasive because there never was much available. ... That situation [has begun] to change radically," said Gene Haislip, head of the Drug Enforcement Administration's drug diversion unit.

Ritalin®, the brand name of the drug methylphenidate, is prescribed to about 2.4 million children diagnosed with attention deficit disorders to help them concentrate. The drug is manufactured by the Ciba-Geigy Corporation.

According to the University of Michigan Monitoring the Future survey, non-prescription use of methylphenidate doubled among high school seniors between 1993 and 1994. The DEA said there were 1,171 emergency room admissions attributed to use of methylphenidate in 1994, a slight increase from 1993.

Todd Forte, a spokesperson for Ciba-Geigy, said news accounts have overstated the problem. "The reports ... appearing in the media [are] isolated events. The abuse speaks more to society's problems than to the medication."

News about abuse of Ritalin® comes at a time when the relationship between Ciba-Geigy and an advocacy group for people with ADD is under investigation (Karen Thomas, "Ritalin® Maker's Ties to Advocates Probed," USA Today, November 16, 1995, p. 14D).

The United Nations and DEA say Ciba-Geigy has contributed almost $1 million to Children and Adults with Attention Deficit Disorder (CHADD) between 1991 and 1994, possibly compromising CHADD's ability to help those with ADD. In a document resulting from the year-long probe into CHADD's finances, DEA warned that the contributions are "not well-known by the public, including CHADD members that have relied upon CHADD for guidance."

"A lot of people don't know Ritalin® is like cocaine," DEA diversion control head Gene Haislip said. "That doesn't mean don't use it. ... It can be very dangerous and must be treated with respect. Obviously, it was not under surveillance." He called the relationship between Ciba-Geigy and CHADD an "unhealthy co-mingling of medical and commercial interests."

Both Ciba-Geigy and CHADD argue there is nothing wrong or unusual about the contributions. "We see it as an ethical responsibility to give back to the community," said Todd Forte, a spokesperson for Ciba-Geigy.

CHADD says it does not promote use of Ritalin®, but does mention it in the context of treatment options for those with ADD. "In our literature, you will not find that CHADD markets methylphenidate or Ritalin® other than in the context of overall treatment programs for children with ADD," said Harvey Parker, one of the founders of the organization.

CHADD has petitioned DEA to reschedule Ritalin® from schedule II to schedule III in order to make it less expensive and more available. Parker said that when that petition was filed, CHADD had not been aware of abuse of Ritalin®. Recently, CHADD established a project to examine the problem of abuse by children and adults. DEA sent their report about Ciba-Geigy's contributions to CHADD to the Department of Health and Human Services and is waiting for a response before reclassification decisions are made.