Ritalin Use And Abuse
The potential street value of Ritalin (methylphenidate) has become a focus of concern. The current report describes stimulant use and abuse identified by school administrators and children diagnosed with attention deficit/hyperactivity disorder (ADHD).
Five years after being identified as methylphenidate responders, 161 children with ADHD were surveyed regarding stimulant use and abuse. School principals in central Wisconsin were also surveyed.
Results revealed that no child believed prescribed stimulants could lead to abuse, nevertheless, 16 percent of them had been approached to sell, give, or trade their medication. During school hours, 44% of children and 37% of schools reported stimulants were stored unlocked. Not all schools had written policies regarding prescription drugs, and 10% permitted students to carry their own medication.
School Administrator Survey Results (N = 53*)
| Yes (%) | |
| I am aware of abuse of ADHD medication in my school (giving or selling to other students or taking in ways other than as prescribed) | 1 (1.9) |
| School staff in general believe ADHD is a medical/neurological disorder | 47 (88.7) |
| I believe ADHD medication is overprescribed by doctors in our area | 11 (20.8) |
| I and my staff are adequately educated regarding ADHD | 32 (62.7) |
| I am familiar with the double-blind assessment to determine Ritalin efficacy | 38 (74.5) |
| There is a school or district policy regarding dispensing and use of medications | 44 (83.0) |
| Sudents are permitted to carry their own medicine for ADHD | 5 (9.4) |
*Because of incomplete data, denominator ranges from 51 to 53.
Monitoring prescription usage, periodic reassessment of efficacy, and continuing education of family and school staff should be part of the multimodal treatment for this disorder.
(Musser C. Stimulant use and the potential for abuse in Wisconsin as reported by school administrators and longitudinally followed children. Dev Behav Pediatr 1998; 19(30):187-192)
COMMENT: We must tighten our procedures and heighten our vigilance knowing that Ritalin has increasing street value. School nurses should convince their principals that locked cabinets are essential. Ritalin and other controlled substances that are missing need to be reported to local police for investigation. Many districts have procedures for a weekly accounting of all meds at each school.