July 27, 2017  Last Update: December 21, 2016, 11:10 pm

Ritalin Cures Cocaine Addiction? Nope.

Methylphenidate (Ritalin, Concerta) is a stumlant like cocaine, and more powerful. If the dosing is not controlled, it can be more addicting than cocaine.

Methylphenidate (Ritalin, Concerta) is a stumlant like cocaine, and more powerful. If the dosing is not controlled, it can be more addicting than cocaine.

A brain imaging study  comparing cocaine addicts to non-addicts suggested  that Ritalin had some effect on controlling brain function. Ritalin is the brand name prescription drug containing methylphenidate, a stimulant prescribed to treat ADHD (attention-deficit hyperactivity disorder). It is also a common “study drug”, used by students to increase attention and focus, during exams. The media is now reporting that Ritalin might be a cure for cocaine addiction.

One problem with these brain imaging studies is that they do not actually directly measure the topic they investigate. They measure blood flow, and try to rationalize how changes in blood flow (and local chemical flow) might suggest level of brain tissue activity. They then assume that cellular activity level correlates with “brain function” as we normals understand it. As imprecise as this is, the media will usually report the findings as if the scientists had made direct measures.

A bigger problem is the way the media distorts science via scandalous exaggeration. For example, for today’s media coverage of “Effects of Methylphenidate on Resting-State Functional Connectivity of the Mesocorticolimbic Dopamine Pathways in Cocaine Addiction”, CBS News published the headline  “Cocaine Addiction may be Cured by Ritalin“. They included  a dramatic photo of cocaine on a mirror parted by a razor blade, with a syringe in the foreground AND what look like three bright red Xanabars to the left (Xanax, a commonly-abused anxiety medication). Wow. That headline isn’t even close to true. At best this study showed that Ritalin effects the same brain functions as cocaine, but in a normalizing direction. At best.

At worst, this may be an attempt to divert attention away from the news that British doctors are frightened to see 3 year olds being prescribed Ritalin. They are calling for an investigation into lazy over prescribing of such drugs.

It is already well known that both methylphenidate (Ritalin) and cocaine block the dopamine transporter that normally moves dopamine between parts of nerve cells. That causes dopamine to build up (not get moved away). They are both stimulants. It is also well known that both Ritalin and cocaine can be addicting. The University describes this nicely:

Like cocaine, Ritalin is a powerful stimulant that increases alertness and productivity. Ritalin and cocaine also look and act the same. Both have a similar chemical structure, and both increase dopamine levels in the brain....if Ritalin is abused (taken in high doses) or taken improperly (by injection or snorting), it can be just as addictive as cocaine

It is also well known that Ritalin is a very dangerous drug, which many respected scientists and medical professionals consider to be just as dangerous as cocaine. Nora Volkow, the current director of the National Institute on Drug Abuse, previously showed that Ritalin is more potent than cocaine.

CBS reports that the study included “18 adults who were addicted to cocaine but were otherwise healthy and were not on any medications”. I’m going to surmise that these were students who self-reported their “addictions” as well as the fact that they were otherwise healthy. I’m not sure how well such a selection process supports the research, but it definitely doesn’t support the outlandish CBS News headline.

Also, since fMRI scans must be conducted under still conditions, how still did these “cocaine addicts” stay while being tested? How long had they waited since “last using cocaine”? I’ll also surmise that the “normal controls” used for comparison were also students (the easiest resource within reach of graduate students). Did those controls have any history of “study drug” use?

Another signal that you should be a little skeptical of the reports: the work was conducted by “a graduate student”. Had the work appeared to be scientifically valid and defensible, and also meaningful, almost certainly a faculty member would be taking credit for the work.

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Kids with untreated ADHD are four times more likely than normal to abuse drugs
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Ritalin is similar to cocaine, and can be addicting.
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Ritalin is not a cure for cocaine addiction. Don't believe outlandish headlines!
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Resources: 

  • JAMA saying Ritalin acts just like cocaine
  • UK Docs say Ritalin for 3 year olds is scary – time to investigate over prescribing
  • Abstract for “Effects of Methylphenidate on Resting-State Functional Connectivity of the Mesocorticolimbic Dopamine Pathways in Cocaine Addiction” by Anna B. Konova, MA; Scott J. Moeller, PhD; Dardo Tomasi, PhD; Nora D. Volkow, MD, and Rita Z. Goldstein, PhD in JAMA Psychiatry Journal.
  • CBS News outlandish exaggerations (Google “CBS News Ryan Jaslow placebo ” to find it)
  • University of Utah on how addictive Ritalin can be, and how people who used to take Ritalin are more prone to cocaine addiction later in life
  • NIDA Director notes Ritalin is more dangerous than cocaine

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