Concerta (Ritalin) Abuse Signs and Treatment Options
Concerta is a long-acting form of the generic drug methylphenidate, which has more commonly been known as Ritalin. Concerta is the new form of the medication that contains the same active ingredient as Ritalin.
Concerta is a synthetic Schedule II medication, according to the Drug Enforcement Administration, which is commonly and effectively used to treat attention deficit hyperactivity disorder (ADHD) in children, teenagers, and young adults. It has also been prescribed to treat narcolepsy.
Potential for Abuse or Addiction
As a prescription stimulant, Concerta is designed for long-term relief of ADHD and narcolepsy symptoms. The medication works over a period of 12 hours, allowing the person with the prescription to take less medication, which is less disruptive to their daily routine. About 22 percent of Concerta is released into the body soon after ingestion, while the remaining 78 percent is released slowly over the next half-day.
This stimulant drug is also a target for abuse and addiction. The drug increases the activity of dopamine, one of the neurotransmitters that can produce happiness, excitement, and pleasure in the brain. Concerta acts similarly to cocaine and amphetamines in that it releases dopamine and blocks the uptake of this neurotransmitter.
In 2006, Concerta was believed to have less abuse potential than Ritalin, because of the drug’s delayed action and long-acting formula. Medications with timed releases do not flood the body with all of the drug at once, and a low dose acting on the brain can produce mild effects but does not produce intense euphoria. However, as Concerta prescriptions have grown in popularity and Ritalin prescriptions have declined, the timed-release stimulant has shown that it is not invulnerable to abuse. It is, in fact, often preferred among people struggling with prescription stimulant abuse.
Since Concerta is a long-acting medication, there is a higher dose of stimulant in each prescription dose compared to most dosages of Ritalin. People who abuse Concerta typically bypass the time-release aspects of the medication by crushing and snorting, or mixing with water and injecting, the pills. Large doses can also be ingested orally to get an initial “high.”
People who abuse Concerta typically bypass the time-release aspects of the medication by crushing and snorting, or mixing with water and injecting, the pills.
Who Is at Risk for Concerta Abuse, and How Does It Start?
Because Concerta, and similar prescription stimulants, are prescribed for very specific disorders like ADHD and narcolepsy, the individuals who receive these prescriptions are not likely to become addicted to, or chronically abuse, these drugs. However, teenagers and young adults have the highest risk of any age group for abusing these drugs. Children and young adults with Concerta prescriptions have reportedly sold their prescriptions to classmates for nonmedical purposes. These age groups take stimulant drugs like Concerta to study all night, to feel smarter or more capable, or for the recreational euphoria sometimes achieved by ingesting large doses of the drug.
Methylphenidate has also been chronically abused by parents, especially mothers, who take prescriptions from their children. The drug makes the person feel like their performance is enhanced, and they often feel less tired. For parents who struggle with feeling overwhelmed, whether they have a history of substance abuse problems or not, these euphoric effects can become very addictive.
Some people abuse stimulants, including Concerta, in order to lose weight. People who struggle with co-occurring eating disorders and substance use disorders take Concerta or other stimulants to suppress their appetites and sometimes to provide sustained energy for intense workouts.
Signs of Concerta Intoxication and Abuse
Signs of intoxication on methylphenidate and side effects include:
- Appetite suppression
- Impaired judgment
- Painful, prolonged erections
- Impairment of voluntary movement
- Excessive repetition of meaningless tasks or movements
- Muscle twitches
- Irregular heartbeat
- Insomnia or other sleep problems
- Pupil dilation
- Raised blood pressure
- Nausea and vomiting
- Agitation, irritability, anxiety, restlessness, or paranoia
- Sweating or fever
- Problems with circulation in extremities
- A skin crawling sensation, including formication
Symptoms of Concerta overdose include:
- Extreme agitation
- Dangerously increased body temperature
- Seizures or convulsions
- Loss of consciousness
- Heart palpitations, heart attack, or stroke
- Cardiovascular problems
It is very important that a person suffering from a drug overdose, whether from Concerta or anything else, receive immediate medical attention. Always call 911 in the event of an overdose.
Long-term Effects of Concerta Abuse
Long-term side effects include chronic insomnia, increased anxiety, and similar effects to those experienced by people struggling with amphetamine abuse. In some cases of continued, long-term Concerta abuse, the person could experience toxic states resembling paranoid schizophrenia, with symptoms that include fear, psychosis, and hallucinations.
Personality changes due to consistent negative feelings can occur. These symptoms include anxiety, aggression, mood swings, restlessness, or depression that did not exist before. More dangerous but less common symptoms are cardiovascular problems. Long-term abuse, especially at high doses, can raise blood pressure and heart rate enough to cause heart problems, arrhythmia, heart attack, or stroke.
According to the DSM-5, there are 11 psychiatric conditions that are long-term side effects of amphetamine abuse. These conditions can be induced either by illegal amphetamines or by abuse of prescription drugs like Concerta. These psychiatric conditions include:
- Anxiety disorder
- Bipolar disorder
- Depressive disorder
- Psychotic disorder
- Sleep disorder
- Obsessive-compulsive disorder
- Sexual dysfunction
- Intoxication and intoxication delirium
These conditions can be experienced during withdrawal from long-term abuse of Concerta or other stimulants. The conditions should subside two weeks after the last stimulant dose, but they should be monitored during the withdrawal process by a medical professional to prevent relapse, harm to self, or harm to others.
People who become physically dependent on or addicted to Concerta often experience withdrawal symptoms if they attempt to stop taking this medication. Withdrawal symptoms include:
- Anxiety, mood swings, or irritability
- Appetite and weight changes
- Difficulty concentrating or thinking clearly
- Cravings for Concerta
- Difficulty with motivation related to work, school, or hobbies
- Exhaustion or fatigue
Withdrawal symptoms begin one to two days after the last Concerta dose, and subside, for the most part, after 10 days to two weeks. Psychological withdrawal symptoms like cravings may continue for a longer period of time.
Treatment Options for Concerta Abuse
There are no specific medications that can help taper or reduce withdrawal symptoms related to stimulant abuse, including Concerta addiction or abuse. However, working with a doctor to detox from Concerta means that the individual receives medical oversight and help overcoming some of the most intense withdrawal symptoms, should they occur. Psychiatric medication in small doses can help to manage depression, anxiety, or psychiatric disorders related to stimulant abuse. Over-the-counter painkillers or anti-nausea medications can manage some of the physical withdrawal symptoms.
A complete rehabilitation program should follow detox. Ending the body’s physical dependence on Concerta is the first step to overcoming addiction, but the following steps address the issues that led to the substance abuse and the process of building a sober life in recovery. The psychological aspects of addiction must be addressed to find the root of the problem and to develop healthier responses to stress.