Biology 103
2003 First Paper
On Serendip

Energetic, rowdy, animated. These adjectives, often used in describing the routines and milieu of the child, are now not as accurate as they once were. Words such as focused, calm, and attentive can be applied more readily. The differentiating characteristic between these two groups—methylphenidate.

A central nervous system (CNS) stimulant, methylphenidate—more commonly known as Ritalin—is drug prescribed in the treatment of Attention-Deficit/Hyperactivity Disorder (AD/HD) ((1)). AD/HD, by definition, is "developmentally inappropriate behavior, including poor attention skills, impulsivity, and hyperactivity" sustained for more than 6 months, appearing usually during childhood2 ((2)). Figures estimate an approximate 3-5% of children are affected by the disorder. Differing views, however, exist about the legitimacy of the majority of these diagnoses. In light of this, the object of this assessment is to examine the bodily and societal implications of methylphenidate.

The need for Ritalin and other CNS stimulants arises from a decreased amount of dopamine—a hormone closely linked to the motivational process((3)). A deficiency of this hormone can lead to difficulty in focusing and agitated behavior, among other traits1 ((1)). Methylphenidate, serving as a stimulant, augments the release of this hormone. The resulting state is similar to that after caffeine, on a milder scale, or amphetamines1 ((1)). This attribute can lead to the somewhat addictive nature of the drug.

"Ritalin, Ritalin, seizure drugs, Ritalin. So goes the rhythm of noontime for Mary Jane Kemper, nurse at Donald McKay School in East Boston, as she trots her tray of brown plastic vials and paper water cups from class to class, dispensing pills into outstretched young palms"4 ((4)). This scene, taken from a New York Times article, is steadily becoming a commonplace background. In recent years, the number of children diagnosed as AD/HD has increased drastically—more than four million children5 ((5)). Statistics behind the disorder are rather shocking:

- "The use of medication to treat children between the ages of 5 and 14 also increased by approximately 170 percent."

- "The number of preschool children being treated with medication for ADHD tripled between 1990 and 1995."

- "The number of children ages 15 to 19 taking medication for ADHD has increased by 311 percent over 15 years."

- "The U.S. produces and consumes about 85 percent of the world's production of methylphenidate". 6 ((6))

Simply, the trend demonstrates an increasing diagnosis and treatment rate of AD/HD. The affect, in turn, is a sizable circulation of methylphenidate.

Controversial theories and incongruous studies present two perspectives on the long-term impact of methylphenidate use. The National Institute on Drug Abuse (NIDA) has been pursuing further studies to determine whether AD/HD can lead to increased risks of substance abuse and addiction. Two theories, examine the study using differing catalysts for addiction—medications used in the treatment of AD/HD and the disorder itself7 ((7)). The former follows along the premise that over time the brain becomes somewhat desensitized to the stimulant. With time, a greater quantity is required to achieve the rewarding properties of the medications. The long-run implications can dictate dependence.

Conversely, recent studies from Harvard Medical support the theory that by treating cases of AD/HD through medication, the risk of substance dependence would be reduced by eighty-four percent7 ((7)). One, however, must question the accuracy of the original diagnosis (as misdiagnoses for AD/HD is not uncommon), the size of the sampling group, as well as the long-term affects—mentally and physically.

Amidst a generation familiar with AD/HD—be it directly or indirectly, the effects ripple through society. Scenes, such as the one described earlier, demonstrate the ever-present fixture of "Wonder Drugs" in our society. As a diagnosed generation leaves the supervised clutches of elementary school, they bring with them the knowledge, usage, and prescriptions for methylphenidate. Whether it is the enterprising high school student looking to make a "quick buck", a college student looking for a means to pull an "all-nighter", or the young adult looking for an inexpensive release, the line between medicinal and recreational use is obscured.

This recreational use recalls a time earlier with the frequent use of cocaine and other amphetamines in the 1960s and 1970s. The definitive characteristic shared between the three substances is the fact that the body cannot distinguish among them8 ((8)). "But unlike cocaine, which garnered a name as a social drug used at clubs and parties, Ritalin tends to be taken when people are alone and want to squeeze more hours out of the day"8 ((8)).

AD/HD has become a cultural phenomenon of sorts—provoking issues surrounding the legitimacy of the disorder, as well as the secondary problems resulting from the treatment. Inescapably, our society has changed as a result. Is this for the better, as recognition and treatment allow children to engage in life with a greater ease? Alternatively, have these pharmacopeias led to a societal demise? Is it acceptable to engineer chemically a balanced and happy child?

References

1)Methylphenidate, National Institute on Drug Abuse information sheet,
2)3) Methylphenidate works by increasing dopamine levels, BMJ General Medical Journal article,
4) For School Nurses, More Than Tending the Sick, New York Times,
5) Wonder Drug Misused ABCnews.com,
6) Statistics confirm rise in childhood ADHD and medication use, Education-World statistical information,
7) Medications Reduce Incidence of Substance Abuse Among AD/HD Patients, NIDA journal article,
8) Ritalin Abuse Spreads to Adults The Gazette (Montreal),


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