Teens Are Using Ritalin To Get High

      At 13, the girl knew precisely why so many classmates darted into the school nurse''s office in the late morning: There, they swallowed their daily doses of Ritalin pills to help them concentrate.

      That year, she was on Ritalin, too. But instead of a visit to the nurse''s office, she got her pills through the black market that operates out of school bathrooms and hallways, often for $1 to $5 a pill. And, instead of swallowing the pills, she crushed them and snorted them through her nose to get high.

      ``It''s as easy to get as candy,'' said the teen-ager, now 15, who spoke on the condition of anonymity while attending an adolescent drug treatment program in Newton, Mass.

      The candy reference is apt. Outside Watertown (Mass.) High School last week, some students called the pills, which come in blue, yellow and white colors, ``Skittles,'' a reference to the colorful miniature candy balls.

      The easy availability of Ritalin - largely from other students diverting their medical prescriptions - has public health officials worried that the drug is becoming a popular adolescent approach to tripping, not treatment.

      The state now has preliminary figures to back up officials'' fears. In a survey of 6,000 public school students in Massachusetts in the last school year, nearly 13 percent of high school students said they had used Ritalin without a prescription at some time in their lives.

      Among middle school students in the seventh and eighth grade, slightly more than 4 percent of youngsters admitted to a non-medical use of Ritalin at some time.

      Researchers can''t say if the percentages are up or down, because this is the first state study of illicit use of Ritalin. While the pills clearly don''t have the adult-like allure of marijuana or alcohol - both considered ``gateway'' drugs because they can lead to the use of harder ones - Ritalin is still a threat. Teens abuse Ritalin at rates similar to inhalants and cocaine, both highly popular substances.

      ``It''s a substantial figure,'' said Thomas Clark, a research associate at Health and Addictions Research Inc., a nonprofit health research firm that conducted the state survey. ``The number should be a wake-up call to how much prescription drugs, including Ritalin, are being used recreationally by teens.''

      At the same time, the illicit Ritalin market has another danger: Students who have a prescription for the drug to control concentration problems aren''t getting the treatment they need if they''re selling their pills. Generally, the pills must be taken every four hours during the school day.

      Few reliable national statistics exist on Ritalin use among teens, though some studies suggest anywhere from 2 to 3 percent of today''s high school students have tried Ritalin at least once in the past year. In the recent Massachusetts survey, about 4 percent of high school students said they had used unprescribed Ritalin at least once in the past year.

      These numbers come at a time when even the legal use of Ritalin is being questioned.

      Congress has held hearings on the issue, and class-action suits against the drug have been filed in several states, led by some parents and psychologists who say the diagnostic criteria for attention-deficit disorders are so broad that nearly every feisty child qualifies.

      Clearly, many children who have trouble focusing in the classroom have benefited from the drug, but there''s been a growing backlash by some parents and members of the medical establishment who say Ritalin is a pharmacological quick-fix for schools and families that don''t have time to deal with complex behavioral issues.

      With U.S. production of Ritalin at nearly 15,000 kilograms a year, an eight-fold increase from a decade ago, and about 2 million Americans on this drug (overwhelmingly children), critics say more of today''s youths need patience - not pills - to see them through their tough times.

      Still, some local teens who are aware of Ritalin''s illicit market say they have taken the drug legitimately for attention-deficit disorder and found it very helpful.

      ``I could stay focused more,'' said a 12-year-old Arlington girl while shopping last week. ``My grades improved a lot.''

      While Ritalin clearly calms many people with attention-deficit disorder - through a chemical mechanism that remains little understood - it acts as a stimulant for most people. In fact, methylphenidate, as it is also called, can produce an emotional high or a caffeine-like jolt, which many college students take advantage of at exam-cramming time.

      Drug-abuse specialists appear to be of two minds on the potential threat of Ritalin as a new ``gateway'' drug for the young. On one hand, the popularity of Ritalin seems limited by the fact that many teen-agers appear to regard it as a kind of substitute drug for their first choices, such as marijuana or Ecstacy, also known as MDMA.

      To achieve an intense high, some teens say they need to snort Ritalin, also nicknamed Rids, which causes them to worry about physical damage such as nose bleeds from snorting the drug.

      ``I''d take pot over Rids any day,'' said one 17-year-old boy, who also spoke at the drug treatment center, Sameem Associates, in Newton, Mass. ``Why ruin your nose over Rids?''

      Nevertheless, Ritalin is easy to get, especially for those who live in a middle-class suburb where families are more likely to seek treatment for attention-deficit disorder.

      New Hampshire, Vermont, and Massachusetts rank first, third and eighth, respectively, among the top 10 states for Ritalin prescriptions for every 100,000 residents.

      While marijuana, cocaine, Ecstacy and other substances require teen-agers to have underground connections to drug dealers, Ritalin''s distinction is that any child with a prescription has the potential to be a dealer. Just slip a pill into their pocket to take to school, and they have something to peddle.

      A Watertown ninth-grader said he noticed a huge difference between middle and high school. Because many high school students are entrusted with their own medicine, ``they have prescriptions, but they sell the pills.''

      Ritalin is under the tightest controls in pharmacies. In fact, federal law prohibits doctors from including refills in its prescriptions and orders cannot be phoned in, even by doctors.

c.2000 The Boston Globe