Concerta Addiction and Abuse: Signs, Symptoms, and Treatment

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Concerta, a brand name for methylphenidate, is a prescription stimulant used to manage the symptoms of attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. Concerta is a safe and effective medication when taken as prescribed, but misuse and abuse can have many harmful effects, including tolerance, physiological dependence, and addiction. Knowing the signs and symptoms of Concerta addiction can empower you to seek to treatment for yourself or someone you care about.^1,2

Signs and Symptoms of Concerta Addiction

Concerta is a commonly abused prescription stimulant. The reasons someone may misuse this medication vary but may include:

For its euphoric or rewarding effects
To stay awake longer to study or work
To improve focus and concentration
To stay awake to party or drink alcohol for a longer period

People who misuse Concerta may take it without a prescription, mix it with alcohol, take higher or more frequent doses than prescribed, or use it in a way other than directed (e.g. snorting or injecting). Injecting or snorting this central nervous system (CNS) stimulant, which causes the drug to reach the brain much more rapidly, can speed up the development of Concerta addiction.

Physical Signs of Concerta Abuse

If you are concerned that someone you know is struggling with Concerta addiction or abuse, you may notice some of the following physical signs of a Concerta high:^1,2,3

Teeth grinding
Performing repetitive tasks
Stomachache
Headache
Dizziness
Nausea
Lack of appetite
Poor nutrition and weight loss
Seizure
Stroke
Enlarged pupils
Increased body temperature
Dehydration

Signs of intravenous Concerta use include:⁴

Track lines
Collapsed veins
Puncture marks
Abscesses
Cellulitis
Circular scars

Signs of intranasal Concert abuse include:⁴

Irritation of the nasal mucosa
Nose bleeds
Perforation of the nasal septum

Psychiatric Signs

Someone who is addicted to Concerta will likely experience psychiatric symptoms due to Concerta abuse. These psychiatric signs of a Concerta high may include:^1,2

Anxiety
Panic attacks
paranoia
Hallucinations
Delusions
Disorientation
Confusion
A manic-like state
Violent and erratic behavior

You may also notice that your loved one seems depressed and lacking energy. This can occur when they are going through Concerta withdrawal, which occurs when they abruptly stop taking this prescription drug.⁴

Behavioral Symptoms of Concerta Addiction

Concerta addiction, or stimulant use disorder, is a pattern of compulsive Concerta use regardless of negative consequences. Common behavioral symptoms of Concerta addiction include:⁴

Taking larger or more frequent amounts of Concerta than intended
Spending a great deal of time obtaining and using Concerta, as well as recovering from its effects
Failing to fulfill major role obligations due to Concerta use
Failing to quit Concerta use despite attempts to do so
Neglecting previously enjoyed hobbies and activities in favor of Concerta use
Continuing Concerta use despite physical or psychological issues caused or worsened by use
Continuing Concerta use despite occupational or social consequences caused or worsened by use
Using Concerta in physically hazardous situations

Who Is at Risk of a Concerta Addiction?

Anyone who misuses Concerta has the potential to develop Concerta addiction; however, some people may have a heightened risk due to environmental and genetic risk factors, such as:^5,6,7

History of abusing other substances
History of mental health disorders
Family history of substance use disorders
Childhood trauma
Poor impulse control
Chronic stress
Lack of parental supervision
Early aggressive behavior
Neighborhood violence
Lack of economic opportunity
Racism

Although risk factors increase the likelihood of substance abuse and addiction, there are also many protective factors that reduce the risk factor’s impact. These include positive self-image, self-control, parental involvement, availability of after-school programs, academic competence, and strong neighborhood attachment.^6,7

Before starting Concerta treatment, it’s important to tell your doctor about your substance abuse history. They may recommend therapy for your ADHD as opposed to an addictive medication like Concerta.⁸

How to Treat Concerta Addiction

Concerta Detox

The first step on the continuum of care for Concerta addiction is professional detox, which involves a set of interventions aimed at managing Concerta withdrawal. Detox can occur in several settings and may include medical care or may follow a social detox protocol.

Medical detox offers 24/7 care from a team of nurses and doctors, assuring your comfort and safety throughout the withdrawal process. Although there are no medications approved by the Food and Drug Administration (FDA) for the management of Concerta withdrawal, the medical team will still provide medications to address various symptoms.

Conversely, a social detox setting may involve around-the-clock care if it’s an inpatient program, but you won’t receive any medical care. Instead, these detox programs focus on interpersonal support to help you get through Concerta withdrawal. If you experience a medical emergency at a social detox program, they will be able to transfer you to a hospital for treatment.

One of the most dangerous Concerta withdrawal symptoms is that of profound depression and suicidal thoughts. If you are experiencing suicidal ideation after quitting Concerta, it’s important to enroll in an inpatient program that is experienced in providing comprehensive psychiatric support.

Once you are stabilized and the Concerta has been flushed from your system, your detox team will refer you to a Concerta addiction treatment program where you can learn effective coping strategies, relapse prevention skills, and emotional regulation skills, which will help you to live a substance-free life.

Inpatient and Outpatient Care

Concerta addiction treatment occurs in two main settings: inpatient and outpatient. Inpatient treatment involves living at the facility for the duration of the program, which may last anywhere from 30 to 90 days, and sometimes even longer, if needed. You receive around-the-clock care and a myriad of treatment modalities, such as:

Psychotherapy
Behavioral therapy
Group counseling
Family therapy
Drug education classes
Support group meetings

Inpatient Concerta addiction treatment is the most intensive level of care and offers patients an opportunity to jumpstart their recovery in an environment free of distractions or drug-using triggers. Often, these treatment facilities are located in peaceful, serene environments, such as by the beach or in the mountains. Every inpatient program has a different treatment approach or philosophy—from faith-based treatment and holistic care to luxury rehab and executive treatment—so it’s important to do your research when comparing Concerta rehabs.

Conversely, an outpatient Concerta rehab involves living at home and attending treatment sessions at a center. These programs offer more flexibility for someone who wants to continue working, attending school, fulfilling other obligations while recovering from a Concerta addiction. Outpatient programs range in intensiveness, from standard outpatient involving just a few hours a week of care to partial hospitalization programs (PHPs) that involve several hours per day of therapy and counseling and serve as a bridge between inpatient and outpatient.

The type of treatment setting for Concerta addiction depends on the level of severity of the addiction. If life functioning isn’t significantly impaired, outpatient therapy could be a possibility for you. If your addiction is more severe, a residential rehabilitation or inpatient program may be a better fit.

Therapies for Concerta Addiction

Although every rehab is different, most will utilize evidence-based therapies for stimulant use disorder, such as:^3,9,10

Cognitive-behavioral therapy (CBT) has been shown to be effective in treating SUDs. CBT involves identifying the emotions that lead to Concerta misuse, and the thoughts that lead to those emotions. By working to alter your thought processes, you could be more in control of your emotions and, in turn, not be as inclined to use Concerta to cope.
Motivational enhancement therapy (MET) works to help you sort through conflicting feelings you may have about Concerta use and get you closer to taking action to reduce or stop use. Nowadays therapists tend to integrate various styles into their work rather than using just solely one.
Contingency management is a type of behavioral therapy technique that involves rewarding abstinence with prizes, or vouchers that can be exchanged for goods and services.

Aftercare and Ongoing Support

Recovery is a lifelong process, which means that the work doesn’t end once you’ve completed an inpatient or outpatient treatment program. Many people benefit from ongoing support or aftercare that can help build upon the skills they learned in rehab or help them transition from treatment back to everyday life where there may be many triggers and stressors.

Common aftercare options include:

Narcotics Anonymous (NA)
SMART Recovery
Sober living homes
Step-down care (PHP or outpatient treatment)
Individual therapy

If you are concerned about your misuse of Concerta, or that of a loved one, call 800-681-1058 (Who Answers?) for 24/7 help. One of our treatment support specialists can assist you.

Resources

Morton, W.A. & Stockton, G.G. (2000). Methylphenidate abuse and psychiatric side effects. Primary Care Companion Journal of Clinical Psychiatry, 2(5), 159-164.
US Food and Drug Administration. (2007). Concerta®.
Iles-Shih, M. (2017). Treatment of stimulant use disorders [PowerPoint slides]. The University of Washington.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Sinha, R. (2008). Chronic stress, drug use, and vulnerability to addiction. Ann NY Acad Sci, 1141, 105-130.
Substance Abuse and Mental Health Services Administration. (n.d.). Risk and Protective Factors.
National Institute on Drug Abuse. (2011). Preventing Drug use among Children and Adolescents (In Brief): What are risk factors and protective factors?
National Institutes of Health. (2019). Methylphenidate. US National Library of Medicine.
Substance Abuse and Mental Health Services Administration. (2020). Treatment of Stimulant Use Disorders. SAMHSA Publication No. PEP20-06-01-001 Rockville, MD: National Mental Health and Substance Use Policy Laboratory.