Four adults sit around a small table in a dimly lit room, faced with a problem. The first is named The Psychiatrist, the second is The Scientist, the third, The Salesman, and the fourth is named The Ignorant.
The Psychiatrist sighs, “Kids these days, their minds move from thought to thought faster than their restless legs move up and down, and they just cannot seem to focus!” What could possibly be causing this anxiety, unregulatable emotions, and inability to concentrate for long periods?
The Ignorant exclaims, “It must be the phones; of course it is the phones! Those youngsters spend far too much time glued to the screen.” The Ignorant is steadfast. The other adults chant with their objections. “One has to consider the artificial food colouring in their favourite childhood cereal, the bisphenols in the cans that hold their food,” The Scientist proclaims. The Psychiatrist goes further, “Do not forget about the increased workload, lack of job opportunities and constant bombardment of war and tragedy on the news and the disassociation that follows to cope.” The Salesman ponders. “But there are exceptions?” he cautiously queries.
The Psychiatrist sighs, “Yes, of course there are exceptions. Some of these kids, who will grow into adults, have ADHD. A genuine medical condition that requires treatment to tackle everyday life.” The Scientist adds with a nod of the head, “Of course, that is why I have created a pill that will regulate the symptoms of ADHD and can be prescribed by The Psychiatrist.” The Psychiatrist interjects, “But how will one know the difference between a child with ADHD, a slightly hyper yet neurotypical child, and a child faking the symptoms to get to the pill? How will we know to whom to prescribe this pill?” The Businessman smiles its eerie smile and announces the plan, “We won’t.” The Ignorant is sold, and Ritalin is born.
Ritalin, the sexier name for methylphenidate, is a medication used to treat attention deficit hyperactivity disorder (ADHD) and has been prescribed for off-label use in treatment-resistant cases of bipolar disorder and major depressive disorder. Ritalin was first synthesised in 1944 by chemist Leandro Panizzon. Panizzon named the drug after his beloved wife Margarita, whose nickname was Rita, and who often used the drug to compensate for her low blood pressure.
A year later, the United States approved the medical use of this drug, and in 1957 it was sold for the first time under the name Centedrin. During the drug’s initial launch, it was used to treat a variety of conditions, such as barbiturate-induced comas, depression, and memory deficits in the elderly. It was only during the 1960s that this drug would be used to treat ADHD, a position that it continues to eagerly hold today.
Ritalin is a norepinephrine-dopamine reuptake inhibitor, which means nothing to those of us who are not studying medicine. Essentially, Ritalin is a central nervous system stimulant that increases the rate at which your nerves and brain cells interact and have a fun chat. Its winning feature is that it increases the activity of neurotransmitters in the central nervous system by blocking two neurotransmitters, norepinephrine (a stimulant) and dopamine (a neurotransmitter that affects pleasure, movement, and attention span), from being reabsorbed back into your cells after they have been released.
This is a handy little drug for those with ADHD who experience functional impairments in parts of the brain’s neurotransmitter systems. By increasing the activity in the central nervous system, it produces effects like increased alertness, reduced fatigue, and improved attention. This handy wonder drug of methylphenidate should not be confused with its best friend, amphetamine, with the sexy name of Adderall.
While methylphenidate increases dopamine by subtly blocking its reuptake, amphetamine goes straight for the nerve terminal, causing it to release so much dopamine that it essentially floods the cytoplasm, the funky liquid that fills the inside of a cell. Now that phase one, the scientific creation of Ritalin, is complete, it is time to put it on the market to see what it can do.
As a $13 billion industry, the prescription industry is the place to be, and Ritalin is increasingly bringing home the bread. The rise in ADHD diagnoses is not a distant phenomenon. Africa has one of the highest rates of ADHD diagnoses in the world at 8.5%. Research shows that over the last two decades, South Africa has had a diagnosis prevalence rate of between 5% and 10%, making it one of the most commonly occurring disorders that affect South African children and adolescents. But just because the diagnoses are high does not mean that Ritalin is an easy drug to get your hands on.
While illegal in Fiji and Russia, it holds a position as a Schedule 6 substance in pharmacies, the highest legal schedule for drugs available in South Africa. This means that Ritalin in the hands requires prescriptions from psychiatrists, a piece of paper that could cost an individual thousands of rands. Over the years, this regulation has shrunk to a hurdle, as individuals are increasingly turning to friends with their signed papers or the black market to acquire the drug.
Quintin van Kerken, the CEO of the Anti-Drug Alliance of South Africa, revealed that at least 60% of all prescriptions for ADHD medications are not being used for their associated conditions and are being distributed in schools and universities. There is a divided market that fuels this illegal industry. Some take Ritalin, hoping it will provide the same level-up that Mario receives upon running into a red mushroom during his quest to save Princess Peach.
Much like the mushroom allows Mario to grow in size and speed, students hope Ritalin will enable them to grow their grades in an increasingly cut-throat education system. These players will take the drug orally to experience a level-up of around two to four hours. However, as with most things in life, level-ups do not come for free, literally and symptomatically.
While consumers can expect a cash withdrawal, there are various other side effects and withdrawal symptoms that come with Ritalin. Side effects include nervousness, insomnia, loss of appetite, headaches, nausea and vomiting, and raised blood pressure. However, there are other players in the market. These players take the drug in the hopes of experiencing a high sense of euphoria. While certain players take the drug orally, others crush it into a fine powder before snorting it up their noses. This is done to increase the euphoric symptoms associated with the drug, allowing the drug to be released quicker into the system than with oral ingestion.
As one can imagine, the side effects of snorting something that was never meant to be snorted are undesirable, including damage to the nasal membrane, depression, rise in blood pressure, nosebleeds, fever, vomiting, psychosis, and irregular heart rate or heart failure. Those non-prescribed Ritalin ravers and high chasers remain on the lookout for signs of an overdose, which include severe twitching, delusions or hallucinations, and seizures.
Ritalin is not bad; no inanimate object can be good or bad. It is simply a thing that humans have created, used, and abused. Ritalin was born in 1944. Since then, it has helped millions of individuals with ADHD cope with everyday life, it has taken millions hostage in the hopes of achieving excellence, and it has strangled millions with the weight of addiction. In all these ways, Ritalin is what The Ignorant ordered, The Scientist produced, The Psychiatrist prescribed, and The Businessman provided.
