Source:  Insight on the News, July 1, 1996 v12 n25 p39(1).
                                                                            
Title:  DEA (Drug  Enforcement Agency) restless 
about Ritalin: doctors sounding the alarm about a 
popular drug used to combat attention disorders in 
kids. 
   Author:  Joyce Price
                                                                         
    
 Abstract:  Ritalin is a stimulant and its side effects have been noted.
The consumption of Ritalin in the US went from 6 mil prescriptions in 1993 to 
10.5 mil in 1995. About 2 mil children from ages 5-12 received the drug as a 
control for ADHD during this time period. Drug abuse by teens has also been 
noted.
                                                                         
    
Doctors are sounding the alarm about a popular drug used to combat attention 
disorders in kids.

The use of Ritalin has soared 500 percent in the United States during the 
last five years and a growing number of doctors worry that the drug is 
being overprescribed.

According to Los Angeles pediatrician Lawrence H. Diller, the number of 
Americans taking the drug doubled to 2.6 million between 1993 and 1995. Most 
of them -- about 2 million -- are children ages 5 through 12 who take Ritalin for 
attention deficit/hyperactivity disorder, or ADHD, a condition marked by 
inattention, impulsive behavior and, in some cases, hyperactivity.

Ritalin, a stimulant whose generic name is methylphenidate, is related to 
amphetamine and methamphetamine and is regulated by the Drug Enforcement 
Administration, or DEA, in the same category as cocaine, 
morphine, PCP, codeine and methadone. "There has been a 
tremendous increase in consumption and prescription of Ritalin," says Itzhak 
Frank, a pediatric neurologist at North Shore University Hospital in New York, 
"and I can join the statement that not every child who is restless needs to get 
Ritalin automatically."

Both Diller and Frank note that ADHD is a 
"behavioral" diagnosis, not one based upon a blood 
						1

test or X-ray. Because of that, a physician may 
prescribe a medication "rather than addressing the 
thornier and more time-consuming issues of emotions, 
family relationships or school environment," says Diller, 
who sounded the alarm in an article in the Hastings Center Report, a publication 
that examines ethical issues in medicine.

The DEA and the U.N. International Narcotics Control Board agree there is 
cause for concern about methylphenidate. "The documentation ... directly refutes 
the assertions that methylphenidate is a benign, mild stimulant that is not 
associated with abuse or serious side effects," stated the DEA in a recent report 
on the drug. It cited 1993 U.N. statistics that found that the United States 
"produces and consumes five times more methylphenidate than the rest of the 
world combined."

The agency also referred to evidence of methylphenidate abuse, particularly 
among adolescents: "Recent trends indicate that adolescents are giving and selling 
their prescription medications, and youngsters are crushing the tablets and 
snorting the powder like cocaine."

Side effects of methylphenidate can include "dose-related increases in blood 
pressure, heart rate, respiration and body temperature, appetite suppression and 
increased alertness," according to the DEA. "Weight loss and growth retardation 
are common side effects of chronic methylphenidate pharmacotherapy in 
youngsters, although drug holidays on weekends and/or summers can usually 
compensate for these deficits. Serious side effects include facial tics and muscle 
twitching." Abuse of methylphenidate can lead to "psychotic episodes, violent 
behavior, tolerance and severe psychological dependence."

Methylphenidate should be one part of a "multimodal" treatment that includes 
remedial psychological, educational and social measures, says the DEA. "While 
most practitioners subscribe to such a multimodal approach to the treatment of 
ADHD, most children are prescribed methylphenidate chronically as their sole 
treatment."

Full Text COPYRIGHT 1996 Washington Times Corporation