STUDENTS POPPING RITALIN TO STAY ALERT

Drug is prescribed for attention deficit

Pop the Ritalin and hit the books.

That's the reality for thousands of university students returning to
classes this week at McGill and Concordia, staff doctors and counselors
say.

The students, many from Ontario and New England, are using the prescription
stimulant like never before to help them focus on their work - or simply
get high.

The cost to them is minimal; under the Quebec government's drug plan or the
university student unions' own policies, Ritalin is covered by insurance.

In some cases, McGill officials suspect, the students are selling the pills
to other students, who get a ``buzz'' from the drug to stay awake while
they study.

The campus users are the newest wave of a phenomenon that has seen Ritalin
prescriptions almost quadruple in Quebec in the last five years among
children, adolescents and, increasingly, young adults.

A study by the Montreal-based drug research firm IMS Canada found that
Quebec prescriptions of methylphenidate (sold under the brand names Ritalin
and PMS-Methylphenidate) grew from 47,000 in 1992 to 179,000 last year. The
vast majority are prescribed to children and adolescents, mostly boys.

The drug has been around since the 1960s, and is used along with various
kinds of therapy to treat a learning disability called attention-deficit
disorder. People who have the disability, which is sometimes combined with
hyperactivity, have trouble concentrating and are easily distracted.

In the last five years, as the children who used it grew up and more new
cases were diagnosed, Ritalin has become more common among adults. Now
it's big on campus. And that worries university officials.

``The problem with Ritalin is that anybody who takes it is going to
concentrate better - it's like a strong cup of coffee; it has this focusing
effect on almost everyone,'' said Dr. Norman Hoffman, director of
mental-health services for students at McGill.

``The danger is, we're seeing a lot of kids who are addicted to it, and
it's becoming a major street drug at McGill now,'' he said in an interview.
``Kids used to take speed 20 years ago, or caffeine pills; now they're
taking Ritalin.''

Of McGill's 20,000 students, between 5 and 10 per cent - anywhere from
1,000 to 2,000 - are using Ritalin to help them study, Hoffman estimated,
based on anecdotal evidence from students who pass through his practice.

At Concordia, there may be even more: perhaps 15 per cent of the 25,000 who
study there - more than 3,700 young adults, according to the university's
disabled-students' services office.

``It's only over the last two years that we've been hearing about this,''
Hoffman said. ``Our concern is the possible health risk - depression,
psychosis - associated with taking Ritalin.''

Taken two or three times a day, the drug mildly stimulates the central
nervous system. For students who have trouble concentrating and juggling
their assignments, it works wonders.

``Overnight there was a change, and I'm not exaggerating,'' said``Mary''
(not her real name), a 34-year-old McGill graduate student, who started
taking Ritalin 18 months ago and now takes it four times a day.

Before she started ``I was almost thrown out of the master's program at
McGill,'' she said yesterday. ``Now I'll be finishing with honours in
May.''

It's not just that the pills help her concentrate, she said.

``You're able to keep organized. You don't have a sense of the wheel
spinning all the time, where you've got five million things happening and
you never remember from one minute to the next what to do. You become a
very different person.''

In Mary's case, the prescription appears to have been apt. But university
physicians and counselors say attention-deficit disorder has been
mistakenly diagnosed in thousands of other students. In some cases,
especially with out-of-town freshmen coming straight from high school,
they're simply having trouble coping with the isolation from their families
and the lack of structured work time, the staff say.

``They enter university, and because there are different demands, they
don't do as well - and they start to wonder why that is, so they get
assessed,'' said Dr. Pierre-Paul Tellier, director of McGill's campus
medical clinic.

For some, that means a rigorous evaluation by psychiatrists and
psychologists. But for others, the ``assessment'' is simply a quick
consultation in a general practitioner's office.

After that, they walk out with a prescription for Ritalin in their hand -
and the temptation to abuse it.

Asked Tellier: ``Are people exposing themselves to Ritalin when they don't
really need it, to get a high or to be able to stay awake when they're
studying? It appears so.''

Some students use their diagnosis to explain away their bad marks to
skeptical professors.

Some use it to get special treatment - a chance to write exams privately,
for example - then sell their prescription to other students.

``It's the faculty who are the skeptics,'' said Leo Bissonnette,
co-ordinator of services for disabled students at Concordia. ``That
hard-nosed faculty person says `Prove it to me. You look normal; you're
just a little nervous. What the story here?' ''

Joan Wolforth, director of McGill's office of student disabilities, has
seen a few questionable cases pass through her office. It's part of the
trend in diagnoses of adults with attention-deficit disorder - some aren't
really ``disabled'' at all.

``It's changed,'' she said in an interview yesterday. ``Four or five years
ago, I didn't have any students with ADD. It's been one of those steady
growth areas, not just at McGill but right across North America.''

Many of the students come from Ontario and New England, where ``there seems
to have been a much greater push on diagnosis than I've seen in Quebec,''
Wolforth said.

Misuse of Ritalin ``is a real concern,'' she added. In one case she
handled, the student increased his dosage so much ``he became totally
dysfunctional, very jittery - you know, like (the effect of) four dozen
cups of coffee.'' In another case, a student admitted giving some of his
supply away to another student.

There's a simple way to solve the problem of Ritalin abuse, experts
believe: don't prescribe it when it isn't needed. Indeed, if doctors took
better care before misdiagnosing ADD, fewer students would be using the
drug, Hoffman said.

At McGill's mental-health clinic, ``we see lots of kids with concentration
problems, and the vast majority of time it's due to an emotional problem of
one sort or another - stress, depression, anxiety,'' he said.

``A small per cent of the time it's due to what seems to be a true
attention-deficit disorder.

``Unfortunately, it's very easy to look past the more complex problem and
just prescribe a pill.''