Ritalin Addiction: Signs, Symptoms, and Treatment

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Ritalin (methylphenidate) is a prescription central nervous system (CNS) stimulant. When used as prescribed, Ritalin is an effective medication to treat attention-deficit/hyperactivity disorder (ADHD).^{1, 2, 3, 4} It typically is prescribed if behavioral interventions for ADHD prove unsuccessful.⁵ However, there exists growing concern about Ritalin’s patterns of use and potential misuse.^{6, 7} Thus, Ritalin addiction is a serious concern—one that you should know the signs and symptoms of to assess if you need treatment.

In this article:

• Signs and Symptoms of Ritalin Addiction
• Who is at Risk for Ritalin Addiction?
• How to Treat Ritalin Addiction

Signs and Symptoms of Ritalin Addiction

Ritalin addiction is a chronic condition characterized by compulsive use despite negative consequences. Since Ritalin is a prescription stimulant, an addiction to this medication is referred to as a stimulant use disorder, per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

If you or a loved one exhibits two or more of the following signs and symptoms over a period of 12 months, this may indicate a diagnosis of Ritalin addiction:⁸

1. Ritalin is taken longer and in higher amounts than intended or prescribed
2. Efforts or persistent desires to reduce Ritalin use do not have intended results
3. Much time is spent in getting, using, or recovering from effects related to Ritalin
4. Strong cravings or desire to use Ritalin
5. Responsibilities at work, school, or home go unfulfilled due to Ritalin use
6. Continued use of Ritalin despite how it negatively affects social or interpersonal relationships
7. Previously valued activities are ignored or abandoned due to Ritalin use
8. Ritalin being taken in places and at times that are physically dangerous
9. Recurring Ritalin use even in the face of known problems it causes to your physical or psychological wellbeing
10. Tolerance built to Ritalin, which manifests either as reduced effects of the same amount of the drug, or as a need for more Ritalin to induce the desired effects
11. Withdrawal symptoms

Symptoms of Ritalin Withdrawal

Withdrawal from stimulants such as Ritalin can result in several symptoms and side effects. Normally, if you stop using Ritalin after developing an addiction, you will feel a dysphoric mood or general sense of unhappiness, unease, or dissatisfaction. If this is accompanied by at least two of the following symptoms within several hours to several days after stopping Ritalin use, you may be undergoing withdrawal:^{8, 9}

• Inability to sleep
• Daytime sleepiness despite getting good sleep
• Nightmares that are vivid or unpleasant
• Slowed movement or thought processes
• Paranoia
• Agitation
• Fatigue
• Increased appetite
• Depression
• Irritability
• Poor concentration
• Cravings for the drug

Is Ritalin Addictive?

Yes, Ritalin can be addictive if you misuse it, especially by snorting or injecting it. Ritalin has been shown to induce euphoria in individuals who take it in doses larger than prescribed.^{2, 7} This is caused by an increase in dopamine signals in the brain, activating the reward system of the brain. When you misuse Ritalin and experience a dopamine rush, your brain “learns” that it should keep repeating this behavior to repeat the pleasurable feeling. In this way, repeated Ritalin misuse can increase the potential for dependence and addiction.^{10, 14}

Dependence and addiction are very probable when misusing any Schedule II controlled substance, such as Ritalin. These controlled drugs have a high potential for misuse, often causing severe physical and psychological dependence.^{4, 11} Significant numbers of participants in nonrandomized studies reported experiencing withdrawal from methylphenidate.⁷

Recently, some in the addiction science community have noted their concerns about Ritalin’s use to address ADHD in preschoolers.⁶ They have stressed the need for research to see if such use can develop into substance use disorder (SUD) later in life. However, recent studies have shown that stimulant medication used to treat ADHD does not increase the risk of SUD development later in the life of the person with ADHD.^{2, 12, 13} In fact, studies have shown that untreated ADHD can result in the development of SUD later in life.¹⁴ Properly applying Ritalin to treat children with ADHD can reduce their chances of misusing substances in adulthood.¹⁴

Who is at Risk for Ritalin Addiction?

Several risk factors may increase a person’s risk of Ritalin addiction and misuse. Studies have shown that nonmedical prescription stimulant use is common among college students.^{16, 17, 18} It is also correlated with academic strain among these college-aged adults. Thus, Ritalin addiction can form in college students who use it instrumentally to study or enhance their productivity.¹⁶

In particular, low grade-point averages and poor academic self-efficacy are strong indicators of potential stimulant misuse.^{17, 18} Those who believe strongly that Ritalin will enhance their academic performance also are at increased risk of misusing stimulants.¹⁸ Ritalin’s common association with combatting ADHD could contribute to its use in this capacity.

However, among younger age groups, this academic association does not exist. Rather, eighth­– and tenth-grade students who misuse other substances in social or recreational settings were found to be at significantly greater risk of stimulant misuse. These substances include:¹⁶

• Alcohol
• Tobacco
• Marijuana

Why is Ritalin Misused?

While Ritalin is used to treat ADHD and even narcolepsy, misuse can occur. Long-term trends from 2002 to 2021 indicate an overall significant decrease in the misuse of Ritalin among eighth–, tenth–, and twelfth-grade students. However, it remains misused among these same age groups.¹⁹

Rising diagnoses of ADHD have caused a concurrent rise in Ritalin’s medical use, thus increasing its availability.²⁰ Additionally, emergency department visits spiked significantly between 2005 and 2010, especially among adults aged 18 years or older.²¹

Prescription stimulants such as Ritalin often are misused to induce a rush, or an acute feeling of euphoria.²² They also are known to suppress appetite, which can be a dangerous perceived benefit for young adolescents who have body dysmorphic disorder (BDD) or who are otherwise uncomfortable in or unhappy with their body appearance.²¹ Some may misuse prescription stimulants to elicit enhanced alertness in ways contrary to their prescription or without any medical diagnosis.²¹

Finally, as discussed, Ritalin and other prescription stimulants are misused to enhance academic performance, often without a prescription.

How to Treat Ritalin Addiction

While further research is actively being supported and conducted on this subject, there exist no FDA-approved medical treatments for addiction to prescription stimulants. However, behavioral therapies address cravings, prevent relapse, and help you overcome relapse if it does happen. These behavioral therapies are known for their efficacy in treating stimulant and Ritalin addiction:¹

• Contingency management (CM)/motivational incentives: In CM, your therapist uses positive reinforcement to encourage abstinence from Ritalin or other stimulants. For example, they might establish a reward system, which can redirect your brain’s reward circuit away from Ritalin use.
• Matrix model: This model informs you about addiction and relapse, as well as self-help programs. Your therapist functions as a teacher and coach who directs and supports you, but never in a confrontational or parental fashion. Therapy sessions are designed to promote your self-worth, better your self-esteem, and reestablish your personal dignity.
• 12-Step facilitation therapy: These therapy sessions promote abstinence by actively engaging you in self-help groups. Acceptance, surrender, and active involvement are three key ideas that permeate the 12-Step program. You will be taught to recognize that drug addiction is a chronic disease that you cannot control, learning to rely upon a higher power and fellowship to help you get on the path to recovery.

How to Find Treatment

Ritalin addiction can affect you and those around you. If you or someone you know has an addiction to Ritalin, treatment is available. Call 800-681-1058 (Who Answers?) to learn from a treatment specialist about your options and the ideal treatment program for you.

Resources

1. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).
2. National Institute on Drug Abuse. (2014). Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide.
3. U.S. Library of National Medicine. (2022, January 1). Methylphenidate. MedlinePlus.
4. Center for Substance Abuse Treatment. (2019). 2018 National Survey on Drug Use and Health. Rockville (MD): Substance Abuse and Mental Health Services Administration (US).
5. Centers for Disease Control and Prevention. (2021). Attention-Deficit/Hyperactivity Disorder (ADHD).
6. National Institute on Drug Abuse. (2015). NIDA 2015 Strategic Plan: RFI Comments on Public Health.
7. Storebø, O. J., Pedersen, N., Ramstad, E., Kielsholm, M. L., Nielsen, S. S., Krogh, H.B., Moreira‐Maia, C. R., Magnusson, F. L., Holmskov, M., Gerner, T., Skoog, M., Rosendal, S., Groth, C., Gillies, D., Buch Rasmussen, K., Gauci, D., Zwi, M., Kirubakaran, R., Håkonsen, S. J., Aagaard, L., Simonsen, E., & Gluud, C. (2018). Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents – assessment of adverse events in non‐randomised studies. Cochrane Database of Systematic Reviews, 5(CD012069).
8. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association Publishing.
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10. National Institute on Drug Abuse. (2020). Misuse of Prescription Drugs Research Report.
11. Drug Enforcement Administration Intelligence Division. (2022). Controlled Substance Schedules.
12. Humphreys, K. L., Eng, T., & Lee, S. S. (2013). Stimulant medication and substance use outcomes: a meta-analysis. JAMA Psychiatry, 70(7), 740–749.
13. Davis, C., Cohen, A., Davids, M., & Rabindranath, A. (2015). Attention-deficit/hyperactivity disorder in relation to addictive behaviors: a moderated-mediation analysis of personality-risk factors and sex. Psychiatry 6(47).
14. Volkow, N. D., & Swanson, J. M. (2008). Does childhood treatment of ADHD with stimulant medication affect substance abuse in adulthood? The American Journal of Psychiatry, 165(5), 553–555.
15. Siefried, K. J., Acheson, L. S., Lintzeris, N., & Ezard, N. (2020). Pharmacological Treatment of Methamphetamine/Amphetamine Dependence: A Systematic Review. CNS drugs, 34(4), 337–365.
16. León K. S., Martínez, D.E. (2017). To Study, to Party, or Both? Assessing Risk Factors for Non-Prescribed Stimulant Use among Middle and High School Students. Journal of Psychoactive Drugs, 49(1), 22-30.
17. Teter, C. J., McCabe, S. E., Boyd, C. J., & Guthrie, S. K. (2003). Illicit methylphenidate use in an undergraduate student sample: prevalence and risk factors. Pharmacotherapy, 23(5):609-17.
18. Looby, A., Beyer, D. L., & Zimmerman, L. (2015) Non-medical prescription stimulant use: Investigating modifiable risk factors. Addiction Research & Theory, 23(2), 143-147.
19. Johnston, L. D., Miech, R. A., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2021). 2021 Overview: Key Findings on Adolescent Drug Use. Monitoring the Future: National Survey Results on Drug Use 1975−2021. National Institute on Drug Abuse.
20. Davidovitch, M., Koren, G., Fund, N., Shrem, M., & Porath, A. (2017). Challenges in defining the rates of ADHD diagnosis and treatment: trends over the last decade. BMC Pediatrics, 17(218).
21. Center for Substance Abuse Treatment. (2013). Emergency Department Visits Involving Attention Deficit/Hyperactivity Disorder Stimulant Medications. The DAWN Report. Rockville (MD): Substance Abuse and Mental Health Services Administration (US).
22. National Institute on Drug Abuse. (2018). Prescription Stimulants Drug Facts.