ADHD: Is Ritalin a Cool Drug?

Literally hundreds of adults have come up to me at ADHD conferences, book signings, ADHD support group meetings, or other public events and begun what back in the ’60s we used to call a “speed rap.”

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With pleasure drugged, he almost longed for woe, And e’en for change of scene would seek the shades below.
— Byron: Child Harold, Canto 1, st. 6

One theory of why there’s such an explosion of ADHD has more to do with the proliferation of the diagnosis among adults than it does among children.

Children often report they don’t like the way Ritalin or other stimulant medications make them feel, or are resentful about having to take anything at all. Particularly after the first few months when the newness of the experience has worn off, it’s just another thing to have to remember. Children also simply appreciate that it often helps them do better in school.

But among adults, although these same responses are common, another response occurs with alarming frequency.

Literally hundreds of adults have come up to me at ADHD conferences, book signings, ADHD support group meetings, or other public events and begun what back in the ’60s we used to call a “speed rap.”

The person talks so fast that they barely can keep up with their own words. They smile widely, have great urgency and intensity, and often bounce up and down while talking. They have absolute certainty that they’re saying the most important words ever uttered in the history of humankind, and that their insights are mind-boggling and world-changing. They believe the person they’re talking to is hanging on their every phrase.

In my experience, being on the receiving end of these speed raps, sometimes it’s amusing; more often than not, though, it’s annoying to the other people who want a book signed or have a question to ask. The last time I spoke to a convention for adults with ADHD, I encountered at least two or three speed-rappers an hour throughout the day. One fellow even paused in mid-sentence of a mind-numbing discourse about the state of American politics (he’d stopped me in the hall to share his insights about “Bill Clinton’s ADHD”) to throw down his throat a half-dozen yellow 5 mg. tablets of Ritalin.

“How much of that stuff do you take?” I asked.

“Not much,” he said. “Only about a hundred-fifty milligrams a day.” While this may seem like an eye-popping amount of stimulant to take (normally, adults and children begin at 5 to 20 mg./day), there has been quite a bit of discussion lately about the value of such high doses of methylphenidate (Ritalin), Dexedrine, or methamphetamine. No doubt some folks require such high doses, or have built up a tolerance that makes them less dangerous. If nothing else, the spectrum of humanity varies widely in its neurochemistry.

But there’s also a problem here: some of these people have gone from unhappy and dysfunctional to bubbling and dysfunctional. While from the inside it may seem like an improvement to them, follow-up discussions with many reveal that they experience black depressions when they “crash” from their high levels of drugs. Therefore, some are also on antidepressants such as SSRIs or benzo drugs. And most distressing, very, very few are receiving any sort of psychotherapy or learning new life skills to help them become more functional with or without medication.

Several psychiatrists commonly on the ADHD speaking circuit have shared with me similar observations. A small but measurable subgroup of adults really enjoy the buzz they get from stimulants and, whether they’re ADHD or not, they’re using an ADHD diagnosis to maintain access to these substances.

This certainly wouldn’t be the first time a drug drove the diagnosis of mental conditions (rather than the other way around, as one would normally expect). Sigmund Freud found cocaine so psychologically liberating that for several years he prescribed it to nearly all his patients, as well as taking it himself. Until the darker side of the drug revealed itself to him, Freud believed it facilitated the cure of conditions ranging from depression to sexual dysfunction.

When I was a college student in the 1960s, we all knew of several area physicians who’d willingly prescribe stimulant “diet pills” (typically methamphetamine or dextroamphetamine) for anybody as much as ten pounds over the norm. We used them as study aids: they were, after all, the same stimulant drugs now used to treat ADHD. The availability of stimulant drugs drove an epidemic of overweight diagnoses. And this wasn’t just limited to college students in Michigan. Housewives and young women across America discovered diet pills in the ’60s, leading to an entire American subculture of middle-class drug-users chronicled in books and movies of that era such as Valley of the Dolls.

It’s impolitic to say that people take drugs simply because they enjoy them, but it’s a widespread fact of life. Look at the millions of Americans who take nicotine in the form of tobacco, a drug which when taken as directed often leads to death. Alcohol is another recreational drug of our culture. The way that over-the- counter and prescription drugs are pushed on TV (we’re the only country in the developed world that allows prescription drugs to be advertised to the public), it’s easy to understand how the average raised-on-television American might think there’s a pill to solve virtually every problem.

With the stimulant drugs used for ADHD, there’s a substantial grain of truth to the notion that they solve a problem. Benzedrine was first promoted in the 1930’s by the infamous Dr. Bradley as the “miracle mathematics pill,” and thousands of college students took it to improve their test scores. Dr. Bradley himself advocated its use in public elementary schools.

Dexedrine and Benzedrine were routinely given by the U.S. military to pilots from the late 1930s until the practice was mentioned on CNN during the 1990s Gulf War and then discontinued because of the adverse publicity. These drugs do measurably enhance performance, at least over the short term.

So here is another possible reason why so many people are visiting the doctor (and now hooking up with telemedice doctors who advertise on TV) to inquire about having ADHD. Stimulant drugs produce an enjoyable sensation and make some people more proficient — at least over the short term — at their work or studies.

A study on drinkers of coffee found that nurses who consumed more than two cups of coffee daily were less likely to commit suicide than those who consumed fewer than two cups. Although this study was flawed in several significant ways (it didn’t look at personality factors which may be common to non-coffee-drinkers and suicidal people, for example, or between coffee-drinkers and non-suicidal people), it may indicate that there’s some benefit in taking stimulant drugs on a regular basis. So the societal and medical solution to this situation may be twofold:

First, consider that the drug may be driving the diagnosis, and look for other ways people can find satisfaction in life without using Ritalin, amphetamine, or other stimulants. These would include the standard psychotherapeutic strategies of examining life situations, relationships, interpersonal strategies, work, etc., and looking for better alternatives or ways to change. Many of these are outlined in other articles here on HunterInAFarmersWorld.com.

And second, perhaps we should reconsider the role that Ritalin and other stimulants play in our society, and the level of restriction attendant to them. While the first strategy implies using less of these drugs, we may also find that there should be more use of them, particularly the naturally-occurring compounds such as caffeine, Yerba Mate, and Gingko.