DEA Drug Fact Sheet: Methylphenidate

Methylphenidate (methyl-alpha-phenyl-2-piperidine-acetate hydrochloride) is a central nervous system (CNS) stimulant that has been marketed in the United States since the 1950s.

Introduction

For many years, Ritalin® (immediate release (IR) product) was the only brand-name product available. In recent years, other IR, extended-release (ER), and long-acting (LA) methylphenidate products have entered the market.

• Trade Names: Ritalin® (IR, LA, and SR), Concerta®, Metadate® (CD and ER), Methylin® (IR and ER), and Focalin® (IR and ER).
• Primary Use: These products are primarily prescribed to children for the treatment of attention-deficit hyperactivity disorder (ADHD).
• Global Usage: The United States is the main consumer, accounting for about 69 percent of global medical use in 2011.

Licit Use

Methylphenidate is used almost exclusively for the treatment of ADHD. While there is evidence for its short-term efficacy in pharmacotherapy for ADHD, it is noted that:

• Attentional improvement is not diagnostic of ADHD.
• There is no diagnostic test that can confirm an ADHD diagnosis.
• Recent data suggests some children are diagnosed and treated with methylphenidate without meeting full diagnostic criteria.

Chemistry and Pharmacology

Methylphenidate is a CNS stimulant. It has a high potential for abuse and produces pharmacological effects similar to those of cocaine and amphetamines.

• Psychological Effects: At high doses, it produces a “rush” or euphoria that is sought after by abusers.
• Research Findings: Clinical studies have shown that humans cannot distinguish between the effects of methylphenidate and cocaine when both are administered intravenously.

Methods of Abuse

Abusers typically use the drug via the following methods:

• Oral Ingestion: Swallowing tablets.
• Intranasal: Crushing tablets and snorting the powder.
• Intravenous: Dissolving the powder in water and injecting it.

Effects of Abuse

The effects of methylphenidate abuse include:

• Short-term: Increases in blood pressure, heart rate, and body temperature; feelings of euphoria; and loss of appetite.
• Long-term/Chronic: Severe psychological dependence, tremors, and muscle twitching.
• Psychotic Episodes: High-dose “binge” use can lead to psychotic episodes, paranoid delusions, and hallucinations similar to amphetamine psychosis.
• Injection Risks: Complications can arise from the insoluble fillers used in tablets, which do not dissolve and can block small blood vessels, causing serious damage to the lungs and retina.

Illicit Distribution and User Population

• Source of Abuse: There is no clandestine production of methylphenidate; diverted pharmaceutical products are the only source for abuse.
• Methods of Diversion: Obtained through fraudulent prescriptions, “doctor shopping,” pharmacy theft, or from friends/associates with legitimate prescriptions.
• User Population: While a wide spectrum of the population abuses the drug, the primary abusers are individuals younger than 25 years of age who often use it as a study aid or to party.

Control Status

Methylphenidate is a Schedule II substance under the Controlled Substances Act, indicating it has a high potential for abuse and may lead to severe psychological or physical dependence.