Ritalin is traditionally used by people who have concentration problems. For these people, the drug does a lot of good. But Ritalin is being bought off-label by non-prescription users to aid in study and as a party drug, and few of these users know about its side effects and contra-indications.

Ritalin is traditionally used by people who have concentration problems. For these people, the drug does a lot of good. But Ritalin is being bought off-label by non-prescription users to aid in study and as a party drug, and few of these users know about its side effects and contra-indications.

ADHD/ADD users

A child sits in a room, one wall covered in 10 television screens. But the child doesn’t know which screen to concentrate on and doesn’t absorb anything. On Ritalin, however, the child is able to focus on one screen at a time, ignoring other distractions. This is how one doctor describes the effects of Ritalin on a person with AD(H)D. Ritalin is a central nervous system stimulant originally prescribed to children who had been diagnosed with Attention Deficit (Hyperactivity) Disorder (AD(H)D).

The symptoms: Difficulty concentrating, lack of attentiveness, fidgetiness, impulsiveness and sometimes hyperactivity. Today, concentration problems are recognised in adults, too, and are better accepted than they were 20-odd years ago. As a result, Ritalin is being prescribed to adults to help them concentrate.

Third-year Rhodes student, Michael Glover, has been on Ritalin since he was a child. “Without it I’m distracted in the extreme and can’t assign my concentration to one particular thing for a sufficient length of time."

""Background noises and other distractions no longer compete so tenaciously for my attention. Generally, the medication placates me, in the sense that I feel composed, rather than restive and volatile. Without Ritalin, I would have to work twice as hard and still wouldn’t achieve the marks I now produce.”

Michael’s not the only one. Third-year student, Audrey*, says she has a love-hate relationship with the drug, but that ultimately she can’t survive without it: “I take it to help me concentrate. I find it difficult to start work, and get easily distracted afterwards. "Ritalin helps me to focus on one thing.”

Aubrey took Ritalin every day while she was at school and experienced unpleasant side-effects, as well as changes in her behaviour. “I hardly ate. I had a massive loss of appetite – food no longer was appealing. It became almost gross -looking. "I would forget about time, days and people. I’m sure I could go a whole week without saying more than 10 words.” Aubrey now uses Ritalin less frequently, as well as taking a decreased dosage.

Ritalin has had a big impact on Dave Morrison, who is doing his Master’s in Biochemistry. He has been using Ritalin since his second year. “When I started using Ritalin, all my marks improved by 20% and I suddenly had the ability to do maths and accounts. I never had the ability to do that before,” he says.

Ritalin consists of Methylphenidate and is a central nervous stimulant, which acts on dopamine, the "happy" neurotransmitter in the brain. This affects the reward response section of the brain, which gives a person positive feedback in what they’re doing, which in turn increases concentration in the task. It also promotes long-term memory formation.

The sellers and the buyers

Some students have taken to buying and selling Ritalin. Jonathan* is a second-year student who has ADD. “I sell about half of my Ritalin each month, and then I use about a quarter for going out and a quarter for work,” says Jonathan. “I sell it to make a bit of extra money, but I mainly just sell to people I know and I often give some away, because I know people enjoy it.”

James*, a third-year student, buys Ritalin to help him work and study. Sometimes friends share their pills with him and other times he buys from people with prescriptions. “It is quite prevalent. Sometimes it’s very hard to get hold of. But there’s a surprising number of students who take Ritalin at Rhodes. "A lot of people refuse to sell it, though.”

Audrey has ADD and has been using Ritalin since she was a child. When she was first approached by a friend to give her some, she refused. Since then, she has sold some of her prescription, but uses most of it herself: “At the time, my family were going through some troubles and the extra money helped me a bit,” she says.

Selling prescription medication without a license is illegal, however. “It’s essentially the same thing as drug-dealing,” said local doctor, Dario Berenisco. “You can’t sell medication without being a pharmacist,” he said.

Both Dr Berensico and another Grahamstown doctor, Dr X (who preferred not to be named) admit that it is very easy to trick doctors into giving out Ritalin prescriptions, because there is no test to determine whether or not a person has AD(H)D. The doctor has to make a decision, based on what a patient tells him.

Berenisco says psychological testing, alongside a doctor’s consultation, would be advisable, but that this is out of reach of most people, in terms of costs and waiting time.

The performance enhancers

Many students have become wise to the fact that Ritalin aids concentration and buy it from friends and other Ritalin “dealers” to increase their focus while working on assignments and studying. “You have a lot of energy and it allows you to focus very well,” says third-year student, James*.

James first tried Ritalin in first year, when a friend suggested that he try some before one of his exams. He’s been using it since then, but only to do assignments and while studying for exams.

Rhodes University’s Dean of Students, Dr Vivian de Klerk, is aware of and concerned about this use of Ritalin. “I believe that students who do not take any performance enhancers get a realistic sense of their own competencies, and they learn coping skills which will stand them in good stead later in life. They can be confident that they will be able to maintain these levels when they join the workplace and face a range of new and demanding stresses,” de Klerk says.

But asked if he thought Ritalin provided him with an unfair advantage over other students, James said, “In my case, I really struggle to focus and get work done, whereas other people find it very easy. I don’t think it’s for me to say whether it provides an unfair advantage or not.”

Although James feels he really needs something to help him concentrate, he has built up a significant tolerance and is worried that he is developing a dependency on the drug. “For what I used to be able to do using 40mg, I now need 90mg. I struggle to work without it these days, because I’ve become so accustomed to using it to work. "It worries me, because I want to take my studies further. I don’t want to be doing my Master’s thesis having to sniff Ritalin.”

Grahamstown doctor, Dr X (who preferred not to be named) pointed out that people with addictive personalities could let their use of Ritalin get out of control. Dr X said seven percent of women and nine percent of men suffered from concentration problems. If a person found that Ritalin helped them, then they were probably in this statistical bracket, he said.

Berenisco is adamant that Ritalin should be prescribed and monitored by a doctor, no matter how safe or unsafe it is. “There are certain people in whom it can be very unsafe. Epileptics, for example, people with high blood pressure, people who’re using other medications. For them, it is a potential problem,” said Berenisco.

Recreational users

Ritalin’s use as a party drug is increasing. Samuel is a third-year student who has only ever used Ritalin recreationally. “Usually I’ll use Ritalin when I’m with friends and we feel like a bit of a pick-me-up before going out. "I could have had a long and exhausting day and still go out that night, full of energy and willing to talk with anyone,” he says.

Most recreational users of the drug open the capsules and crush up the little balls into a fine powder, which they snort in the same way that cocaine is snorted. “Snorting it allows the effects to kick in right away, and they are also considerably stronger than if you were to swallow the pill. It produces quite a high; a euphoric feeling and a desire to socialise. "When you swallow the pill, you don’t get quite the same rush,” says Samuel.

Snorting of the drug, however, isn’t the only similarity Ritalin has to cocaine. Both are amphetamines and release certain stimulating neurotransmitters from the brain. It’s known by some as 'kiddy-cocaine', or as “cocaine with a PG rating”, a phrase popularised by the series, House.

Samuel has tried cocaine, and he comments on the similarities and differences between the two: “It was pretty similar to Ritalin, albeit a hell of a lot more expensive. I think cocaine has more of the euphoria that only large amounts of Ritalin can induce. They both make you more focused and energetic. However, cocaine is quite a lot more intense.”

Berenisco was surprised to hear about the recreational abuse of Ritalin, although he pointed out that there was a huge amount of potential for abuse in any medication used incorrectly. “It does have stimulant effects, as does coffee, as do caffeine tablets that you buy over the counter. So, I think it’s a bit of a con, just because it’s Ritalin,” he says.

De Klerk said she had no information regarding the recreational use of Ritalin. “We cannot police the minutiae of the daily lives of all our students. They are adults, and must make their own decisions. "This means they must also live with the consequences of any bad decisions which they may make.”

De Klerk says that the university talks to students about the dangers of drugs and alcohol during Orientation Week, but that they are not planning to design a campaign specifically around the use of Ritalin. “If the university makes too much fuss about the issue, it may well plant a seed in the minds of some of our students who had not previously contemplated trying the drug out,” she says.

It’s not all fun and games, however. As with other drugs, there is a come-down as the drug starts wearing off. “You slowly start to feel uncomfortable and less sociable,” says Samuel. “In addition to that, you start to feel tired and worn out.”

The drug also leaves users unable to sleep for a long period of time after taking it, and users have reported feeling shaky, moody, agitated and they get headaches. “It’s a horrible feeling,” says Samuel, “almost like you’ve just realised something terrible has happened, that same sinking feeling.”

Dr X says, “The dangers are that it is a mind-altering drug. It’s a stimulant. It’s combined with other stimulants like the Red Bull and the caffeine. It’s compounded by the alcohol.”

Both Dr X and Berenisco point out that selling Ritalin and using it without a prescription is illegal. De Klerk also commented on the illegality of buying and selling the drug: “If the University becomes aware of whom the culprits are, they will be charged or handed over to the police for investigation,” she says.

*Names changed to protect identities

Students who want to find appropriate ways of dealing with stress, anxiety and difficulties in concentration can discuss these difficulties with a psychologist at the Counselling Centre. Contact 046 603 7070 to make an appointment.

Side effects

The following are side-effects experienced by the Ritalin users, or mentioned by the doctors in this story: •Insomnia •Depression •Moodiness, agitation •Loss of appetite •Weight loss •Headaches •Difficulty reaching orgasm •Feeling confused, muddled or socially awkward •Heart palpitations •Dry mouth and extreme thirst •Lethargy

Potential dangers

Ritalin is dangerous for people with the following conditions: •Diabetes •Thyroid problems •On other medication •Depression •Prone to addiction •Epilepsy •High blood pressure •Tics or tourettes •Heart problems •Liver problems •Pregnant •Bipolar disorder

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