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Intravenous Methylphenidate Abuse: Prototype for Prescription Drug Abuse

Intravenous Methylphenidate Abuse: Prototype for Prescription Drug Abuse Abstract Data are presented from a case series of 22 patients who abused methylphenidate hydrochloride (Ritalin-SR). The abuse pattern and symptoms of toxicity were similar to that seen with cocaine hydrochloride and amphetamine sulfate addiction; yet, the morbidity and mortality seen in this case series were greater than usual for a group of patients involved in intravenous drug abuse. We describe the characteristics of the methylphenidate abuse syndrome in terms of the pharmacology of methylphenidate, the constituents of the Ritalin-SR preparation, and the disease of chemical dependence. We propose solutions to the problem of methylphenidate abuse. (Arch Intern Med. 1991;151:781-783) References 1. Franz DN. Central nervous system stimulants . In: Gilman AG, Goodman LS, Rall TW, Murad F, (eds): Goodman and Gilman's The Pharmacological Basis of Therapeutics . New York, NY: Macmillan Publishing Co Inc; 1985;586-587. 2. Martin WR, Sloan JW, Sapira BD, Jasinski DR. Physiologic, subjective, and behavioral effects of amphetamine, methamphetamine, ephedrine, phenmetrazine, and methylphenidate in man . Clin Pharmacol Ther. 1971;12:245-258. 3. Safer DJ, Krager JM. A survey of medication treatment for hyperactive/inattentive students . JAMA. 1988;260:2256-2258.Crossref 4. Jaffe JH. Drug addiction and drug abuse . In: Gilman AG, Goodman LS, Rall TW, Murad F, eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics . New York, NY: Macmillan Publishing Co Inc; 1985:550-554. 5. Nicholi AM Jr. The nontherapeutic use of psychoactive drugs . N Engl J Med. 1983;308:925-933.Crossref 6. Spensley J, Rockwell DA. Psychosis during methylphenidate abuse . N Engl J Med. 1972;286:880-881.Crossref 7. Barnhart ER, ed. Physicians' Desk Reference . Oradell, NJ: Medical Economics Books; 1988:880-881. 8. Hahn HH, Schweid AI, Beaty HN. Complications of injecting dissolved methylphenidate tablets . Arch Intern Med. 1969;123:656-659.Crossref 9. Lindell TD, Porter JM, Langston C: Intra-arterial injection of oral medications . N Engl J Med. 1972;287:1132-1133.Crossref 10. Zemplenyi J, Colman M. Deep neck abscesses secondary to methylphenidate (Ritalin) abuse . Head Neck Surg. 1984;6:858-860.Crossref 11. Waller B, Brownlee WJ, Roberts WC. Self-induced pulmonary granulomatosis . Chest. 1980;78:90-94.Crossref 12. Arnett EN, Battle WE, Russo JV, Roberts WC. Intravenous injection of talc-containing drugs intended for oral use . Am J Med. 1976;60:711-718.Crossref 13. Jeffe RB, Koschmann EB. Intravenous drug abuse, pulmonary cardiac and vascular complications . AJR. 1970;109:107-120.Crossref 14. Lewman LV. Fatal pulmonary hypertension from intravenous injection of methylphenidate (Ritalin) tablets . Hum Pathol. 1972;3:67-70.Crossref 15. Missouri Task Force on Misuse, Abuse and Diversion of Prescribed Drugs. Scan of the Month No. 4: `The Hyperactive Child.' Jefferson City, Mo: Division of Alcohol and Drug Abuse; 1984. 16. The Drug Abuse Warning Network 1986 Report . Washington, DC: National Institute of Drug Abuse; 1986. Series 1, No. (6) . 17. AMA Council on Scientific Affairs. Drug abuse related to prescribing practices . JAMA. 1982;247:864-866.Crossref 18. Wolford BB, ed. Balancing the response to Rx drug abuse . In: Summary Report of an AMA National Symposium Medicine and Public Policy . Washington, DC: (December) 1988 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Intravenous Methylphenidate Abuse: Prototype for Prescription Drug Abuse

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References (23)

Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400040119027
Publisher site
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Abstract

Abstract Data are presented from a case series of 22 patients who abused methylphenidate hydrochloride (Ritalin-SR). The abuse pattern and symptoms of toxicity were similar to that seen with cocaine hydrochloride and amphetamine sulfate addiction; yet, the morbidity and mortality seen in this case series were greater than usual for a group of patients involved in intravenous drug abuse. We describe the characteristics of the methylphenidate abuse syndrome in terms of the pharmacology of methylphenidate, the constituents of the Ritalin-SR preparation, and the disease of chemical dependence. We propose solutions to the problem of methylphenidate abuse. (Arch Intern Med. 1991;151:781-783) References 1. Franz DN. Central nervous system stimulants . In: Gilman AG, Goodman LS, Rall TW, Murad F, (eds): Goodman and Gilman's The Pharmacological Basis of Therapeutics . New York, NY: Macmillan Publishing Co Inc; 1985;586-587. 2. Martin WR, Sloan JW, Sapira BD, Jasinski DR. Physiologic, subjective, and behavioral effects of amphetamine, methamphetamine, ephedrine, phenmetrazine, and methylphenidate in man . Clin Pharmacol Ther. 1971;12:245-258. 3. Safer DJ, Krager JM. A survey of medication treatment for hyperactive/inattentive students . JAMA. 1988;260:2256-2258.Crossref 4. Jaffe JH. Drug addiction and drug abuse . In: Gilman AG, Goodman LS, Rall TW, Murad F, eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics . New York, NY: Macmillan Publishing Co Inc; 1985:550-554. 5. Nicholi AM Jr. The nontherapeutic use of psychoactive drugs . N Engl J Med. 1983;308:925-933.Crossref 6. Spensley J, Rockwell DA. Psychosis during methylphenidate abuse . N Engl J Med. 1972;286:880-881.Crossref 7. Barnhart ER, ed. Physicians' Desk Reference . Oradell, NJ: Medical Economics Books; 1988:880-881. 8. Hahn HH, Schweid AI, Beaty HN. Complications of injecting dissolved methylphenidate tablets . Arch Intern Med. 1969;123:656-659.Crossref 9. Lindell TD, Porter JM, Langston C: Intra-arterial injection of oral medications . N Engl J Med. 1972;287:1132-1133.Crossref 10. Zemplenyi J, Colman M. Deep neck abscesses secondary to methylphenidate (Ritalin) abuse . Head Neck Surg. 1984;6:858-860.Crossref 11. Waller B, Brownlee WJ, Roberts WC. Self-induced pulmonary granulomatosis . Chest. 1980;78:90-94.Crossref 12. Arnett EN, Battle WE, Russo JV, Roberts WC. Intravenous injection of talc-containing drugs intended for oral use . Am J Med. 1976;60:711-718.Crossref 13. Jeffe RB, Koschmann EB. Intravenous drug abuse, pulmonary cardiac and vascular complications . AJR. 1970;109:107-120.Crossref 14. Lewman LV. Fatal pulmonary hypertension from intravenous injection of methylphenidate (Ritalin) tablets . Hum Pathol. 1972;3:67-70.Crossref 15. Missouri Task Force on Misuse, Abuse and Diversion of Prescribed Drugs. Scan of the Month No. 4: `The Hyperactive Child.' Jefferson City, Mo: Division of Alcohol and Drug Abuse; 1984. 16. The Drug Abuse Warning Network 1986 Report . Washington, DC: National Institute of Drug Abuse; 1986. Series 1, No. (6) . 17. AMA Council on Scientific Affairs. Drug abuse related to prescribing practices . JAMA. 1982;247:864-866.Crossref 18. Wolford BB, ed. Balancing the response to Rx drug abuse . In: Summary Report of an AMA National Symposium Medicine and Public Policy . Washington, DC: (December) 1988

Journal

Archives of Internal Medicine – American Medical Association

Published: Apr 1, 1991

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