Letters to the Editor
Re: Characteristics of Methylphenidate in a University Student Sample
Dear Editor: The article entitled “Characteristics of Methylphenidate in a University Student Sample,” by Barrett and others, was quite interesting and highly informative (1).
There have been several studies regarding methylphenidate abuse in university settings, especially in the US; however, very little about statistics regarding intranasal and intravenous use are present in the literature. The statistics about intranasal and intravenous use are highly important in light of the dramatic rise in methylphenidate abuse in the last 15 years.
Several studies have shown that there are similarities between cocaine and methylphenidate in their ability to block dopamine transporters, especially when taken intravenously. Some researchers postulated that the shorter effects of cocaine might account for its potential to be heavily abused (2).
A similar study done at the University of Michigan by Teter and others (3), in which a sample of 2250 students was studied, appears consistent with Volkow and others. The interesting finding, though, was that 79% of those who abuse methylphenidate started taking it during college, while 19% started in high school. Methylphenidate users accounted for only 2% of the students studied.
Other US college surveys have shown much higher prevalence. A survey at the University of Pennsylvania showed that almost 9% of undergraduates used someone else=s prescription medications, most of which were methylphenidates. Another survey showed that 16% of students at a small liberal arts college reported having tried methylphenidate recreationally and that 12.7% reported having taken it intranasally. A more recent survey in 2002 involving students at the University of Florida showed that 1.5% used ritalin recreationally in the 30 days prior to the study (4).
Barrett and others mentioned that prescription diversion was the primary source of methylphenidate use in this sample; however, other sources are prevalent. Methylphenidate is one of the 10 most frequently stolen controlled medications, although this may not necessarily be the case regarding college students. The popularity of the drug among college students could also be attributed to the competitive nature of colleges. The drug has been linked with some students’ desire to excel in a competitive academic environment, because it helps them to stay focused through periods of fatigue.
Several studies have reported how best to curb methylphenidate abuse. In addition to the suggestion put forth by Barrett and others, other researchers have suggested methods such as alternative pharmaceutical delivery systems that are not easily manipulated for injection or inhalation and the use of centralized prescription databases. We believe education would be one of the most effective ways to address this problem in a university setting, especially if, as suggested by Barrett and others, prescription diversion is a major source of access to methylphenidate. Education would be helpful in cases where only the person given the prescription, and not whoever eventually abuses the drug, is advised of the risks and benefits.
References
1. Barrett SP, Darredeau C, Bordy LE, Phil RO. Characteristics of methylphenidate in a university student sample. Can J Psychiatry 2005;50:457–61.
2. Volkow ND, Wang GJ, Fowler JS, Fischman M, Foltin R, Abumrad NN, and others. Methylphenidate and cocaine have similar in vivo potency to block dopamine transporters in human brain. Life Sci 1999;65(1):7–12.
3. Teter CJ, McCabe SE, Boyd CJ, Guthrie SK. Illicit methylphenidate use in an
undergraduate student sample: prevalence and risk factors. Pharmacotherapy 2003;23:609–17.
4. The Higher Education Center for Alcohol and other Drug Prevention. Recreational use of ritalin on college campuses. Available: www.edc.org/hec/pubs/factsheets/ritalin.html. Accessed 2005 July 27.
Adegboyega Oyemade, MD
Minesh Patel, MD
New York, New York
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