IV Drug Use of Methylphenidate
In this study, “Prevalent Intravenous Abuse of Methylphenidate Among Treatment-Seeking Patients with Substance Abuse Disorders: A Descriptive Population-Based Study,.” published in the Journal of Addiction Medicine, 2015 we learn that IV use of methylphenidate (Ritalin) is very high. You can read the study here…
As a Pediatrician who treats about 1000 children with ADD (Attention Deficit Disorder) or ADHD (Attention Deficit Hyperactivity Disorder), and a board certified addictionologist who treats IV drug users, this study is a wake up call to all physicians and parents. The rates of ADD and ADHD have been on the rise for decades. In the US, we have reports of ADD and ADHD now affecting as many as one in five boys (20%). This same group of teenagers is at highest risk for drug use and abuse.
The study, done in Iceland, looked at 108 adult IV drug users admitted for inpatient treatment, to assess the prevalence of IV methylphenidate (MPH) abuse. They found IV MPH was the most commonly abused substance (65%) and for 1/3 of them, it was the first IV substance ever abused. Those with drug use that started in the past 10 years, MPH was the first drug they injected in 42% of addicts.
Diversion of medications, where the person obtains the medication (in this case ADD or ADHD medications) and then sells them on the black market, has been a growing problem. I see this in my addiction clinic where the medications Suboxone or Buprenorphine that are used to treat opiate addiction, may then be sold so the addict can buy heroin, and or make money from the sale of the Buprenorphine.
Physicians need to be aware of the abuse potential of MPH and amphetamine-dexamphetamine (Adderall) and for those at risk for IV drug use, I would recommend, if you must treat the ADD or ADHD, that you use Vyvanse (lisdexamfetamine dimesylate) which must be swallowed and digested to have any effect. Parents and concerned significant others, if your ADD or ADHD loved one might be abusing their prescription, you should hold the medication and watch them take it.
While this is a small study and was done on a very particular high risk group in Iceland where the drugs available for abuse might differ from other parts of the world, I think the wide availability of MPH should put us all on high alert for abuse or diversion of MPH.