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Methylphenidate Detox Guide: Timeline, Symptoms & Effects

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Methylphenidate white pillsMethylphenidate is a stimulant medication that is commonly used to treat attention-deficit hyperactivity disorder (ADHD) 1. Common brand names for methylphenidate include Ritalin and Concerta 1. Methylphenidate is FDA-approved and safe for use by children, adolescents, and adults, as long as the medication is prescribed by a doctor and taken according to the doctor’s instructions 1. However, many people abuse methylphenidate by taking it without a prescription, taking more than prescribed, taking it in a way other than prescribed, or mixing it with other substances.

When an individual with ADHD takes methylphenidate, they will experience a calming effect and will have an improved ability to focus 1. This helps individuals with ADHD complete tasks for school, work, and day-to-day living. However, for someone who does not have ADHD, methylphenidate will cause reduced appetite, alertness, and wakefulness 1. For these reasons, many people who do not have ADHD abuse methylphenidate to lose weight or focus better during study sessions 1. Methylphenidate can cause a euphoric feeling as well—an effect commonly sought by those abusing the drug via methods such as crushing and snorting the tablets or first dissolving in liquid, then injecting the drug 1.

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Habitual use and abuse of methylphenidate can lead to addiction. Because methylphenidate increases dopamine levels in the brain, it is highly addictive, especially when injected or snorted 1. Dopamine is the neurotransmitter associated with the reward pathway and it acts as positive reinforcement for continued methylphenidate abuse. Addiction occurs when a person continues to abuse methylphenidate despite negative consequences resulting from use.

Researchers have recently begun investigating methylphenidate addiction in-depth and have found some startling statistics 2:

  • When snorted, methylphenidate causes a high and other effects similar to cocaine. Methylphenidate also interacts with and influences similar chemical changes within the same brain pathways as cocaine.
  • According to the Drug Enforcement Administration (DEA), methylphenidate production has increased from 1,361 kilograms in 1985 to 10,410 kilograms in 1995.
  • According to one survey, 16% of children diagnosed with ADHD were asked to give, sell, or trade their methylphenidate medication to a person without ADHD.
  • When injected, methylphenidate can cause psychosis.

Signs and Symptoms of Withdrawal

Long-term methylphenidate abuse can eventually progress to an addiction. Once someone has developed a methylphenidate addiction, abruptly stopping or reducing use can cause unpleasant withdrawal symptoms to emerge. Someone who is experiencing methylphenidate withdrawal syndrome may have the following symptoms 3:

  • Increased appetite.
  • Insomnia or hypersomnia (excessive daytime sleepiness).
  • Vivid and unpleasant dreams.
  • Profound fatigue.
  • Bradycardia, or abnormally slow heart rate.
  • Depressed mood.
  • Anhedonia, or the inability to feel pleasure.
  • Slowed movements and thought.
  • Repetitive, purposeless movements.
  • Severe methylphenidate cravings.

If you or someone you care about is abusing methylphenidate or has a methylphenidate addiction, don’t hesitate to seek treatment. Help is available.

Methylphenidate Detox Timeline and Protocol

methylphenidate dependenceWithin a few hours to several days after quitting methylphenidate, a person with significant methylphenidate dependence will begin experiencing the signs and symptoms of methylphenidate withdrawal 3. The onset of methylphenidate withdrawal symptoms will depend on factors such as the speed of action of the methylphenidate being abused and the preferred route of use. Some prescription formulations, when taken orally, have long-acting or extended-release effects and may result in relatively delayed withdrawal symptoms when use stops. If someone regularly snorts or injects methylphenidate, the symptoms are likely to appear sooner.

Abuse of medications such as methylphenidate are relatively new public health concerns and, thus, somewhat understudied. As such, there is little in the scientific literature about how long acute methylphenidate withdrawal lasts for most people. However, acute withdrawal for other forms of stimulant addictions lasts 1–2 weeks 4.

The methylphenidate detoxification duration depends on several variables, as well. There is no exact amount of time that methylphenidate detox is expected to last and the symptoms of methylphenidate detox also vary from person to person. Your specific experience with methylphenidate detox will depend on factors such as:

  • The length of methylphenidate abuse.
  • The average dose of methylphenidate used.
  • The frequency of use.
  • Your age.
  • Physical and mental health status.
  • The presence of polysubstance abuse.
  • Your individual physiological makeup.

If you anticipate going through methylphenidate detox, consider enrolling in a formal drug detox program. A formal detoxification program is a period of medical and psychological supervision in which trained professionals observe your behavior and health as you go through this difficult time. During methylphenidate detox, it will be extremely tempting to return to methylphenidate abuse in order to curb the cravings and side effects of the detox process. However, a formal detox program will help you to complete the methylphenidate detox phase as comfortably and safely as possible so that you can begin the road to recovery from methylphenidate addiction.

Many formal drug detox programs prescribe medications to help combat unpleasant methylphenidate detox symptoms. For example, some people experience insomnia, which can be treated in the short-term with prescription medications. Formal detox programs also ensure your safety during the methylphenidate detox period. Once you have completed the methylphenidate detox phase, a formal drug detox program can help you transition to an addiction treatment program to give you the best chances for a successful recovery.

Do I Need Formal Detox?

Methylphenidate addiction affects everyone differently. While some people are able to continue functioning normally in their daily lives while abusing methylphenidate, others experience serious work, school, and social consequences. Even those who are able to maintain a high level of functioning while suffering from methylphenidate addiction can experience serious health and psychological problems during withdrawal. Although methylphenidate withdrawal syndrome is not typically fatal, it can still present with some dangerous complications.

For example, depressive symptoms can be accompanied by suicidal ideation or behaviors. A professional detox program can ensure your safety in a structured environment and provide you with around-the-clock mental health care. You can withdraw from methylphenidate in a controlled setting and receive medications to help mitigate some of the other problems related to withdrawal syndrome. Although detox is not required for methylphenidate addiction, it is still a safer alternative to detoxing alone.

Dangers of Long-term Use

Over time, methylphenidate abuse can have serious physical and psychological consequences. If you are addicted to methylphenidate and continue abusing the stimulant, some potential long-term effects may include 1,2,3:

  • Malnutrition.
  • Hostility.
  • Paranoia.
  • Hallucinations.
  • Delusions.
  • Disorientation.
  • Stroke.
  • Heart attack.
  • Intravenous effects, such as track lines, collapsed veins, blocked blood vessels, and increased risk of HIV and hepatitis.
  • Intranasal effects, such as irritated nasal mucosa and perforated nasal septum.

In order to avoid or reduce these long-term consequences, it’s crucial that you seek detox and addiction treatment.

Choosing a Withdrawal Treatment Program

methylphenidate treatmentIf you are interested in finding a professional detox program, you can choose from several different levels of care. Methylphenidate withdrawal can be treated in an inpatient or outpatient setting. The key is to choose whichever program best suits your needs. Oftentimes people who are concerned that their home situation will offer too many opportunities for relapse choose to detox in a residential setting free of triggers. Others prefer to remain in a place that is familiar with plenty of social supports around them in order to reduce as much stress as possible and focus on sobriety.

If you choose to complete an outpatient detox or withdrawal program, you will be monitored by a physician at a medical office or an outpatient care facility. Depending on your specific case of methylphenidate addiction, your doctor may recommend that you gradually taper off of the drug in order to reduce the shock to your body. You will work closely with your doctor to ensure the detox process is as comfortable and safe as possible.

During inpatient detox and withdrawal treatment, you will reside at a treatment facility. You will receive around-the-clock care and observation to ensure that there are no medical or psychological crises that arise during your methylphenidate withdrawal. Inpatient treatment may be more suitable for individuals who have been abusing methylphenidate at high doses or for long periods of time. Inpatient treatment can protect against serious medical emergencies.

Once you have completed the drug detox program of your choosing, it is highly recommended that you enter a methylphenidate addiction treatment program to fortify your recovery and maintain your long-term sobriety.

Post-Detox Addiction Treatment

Following methylphenidate detox and withdrawal, a methylphenidate addiction treatment program can help you identify the root causes of your addiction and help you establish long-term sobriety. There is always a risk of relapse, but individuals who complete an addiction treatment program after detox and withdrawal are more likely to maintain their sobriety.

There are many types of addiction treatment programs, each with its own strengths, weaknesses, and philosophies. It’s important that you explore the many different options before choosing the right substance abuse treatment program for you.

Inpatient Treatment

During an inpatient treatment program, you will live at the treatment facility in a private room, with a roommate, or in a dorm-like setting. Inpatient programs offer a controlled environment that minimizes stress and the temptation to relapse. Inpatient programs also offer around-the-clock care in case of medical or psychiatric emergencies.

Each inpatient treatment program is different. Many addiction treatment facilities offer special or luxury amenities, customized treatment plans, holistic or alternative interventions, and opportunities for friends or family to visit you during your treatment. Most offer a combination of individual therapy, group counseling, family therapy, relapse prevention classes, support groups, and aftercare planning for people to continue receiving ongoing support after finishing the program.

Inpatient treatment programs vary in price, as well. Factors such as amenities, location, and program length will determine the final cost. However, many inpatient addiction programs accept medical insurance, Medicare, Medicaid, or federal military insurance. Many other programs offer sliding fee scales to accommodate various income levels.

Outpatient Treatment

Outpatient recovery programs allow you to live at home while receiving methylphenidate addiction treatment. During outpatient treatment, you will visit your addiction treatment center daily or on a pre-determined schedule for individual counseling, group therapy, education, skill-building classes, and more. Outpatient programs may also include drug screenings and health screenings in order to give you the most comprehensive treatment possible.

Outpatient treatment is also an excellent option for people who have completed inpatient treatment and would like step-down treatment. An outpatient treatment program can help protect your sobriety while you become accustomed to living in your home environment again.

There are numerous options when it comes to outpatient treatment, including:

  • Partial Hospitalization: Here, you receive the same intensive care benefits as a hospitalization program but return home in the evening.
  • Intensive Outpatient: In this setting, you might expect to meet roughly 2–4 times per week for 2–3 hours per session for individual and group counseling.
  • Standard Outpatient Programs: Here, you may meet 1–2 times per week for 1–2 hours per session for individual and group counseling.

 

Sources

  1. National Institute on Drug Abuse. (2014).Stimulant ADHD Medications: Methylphenidate and Amphetamines.
  2. Morton, W. A. & Stockton, G. G. (2000). Methylphenidate Abuse and Psychiatric Side Effects. Primary Care Companion to The Journal of Clinical Psychiatry, 2(5), 159-164.
  3. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: American Psychiatric Association.
  4. Substance Abuse and Mental Health Services Administration. (2010). Protracted Withdrawal. Substance Abuse Treatment Advisory, 9(1), 1-8.

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