Raised On Ritalin Of Politics And Pills Lobby, Drug Makers Push To Deregulate Ritalin
A national group supported by drug companies helped Ritalin’s popularity skyrocket in the ‘90s.
Now it’s trying to make the drug even easier to get.
But critics say Ritalin, a stimulant used to control hyperactivity and attention problems, could become more open to abuse if the push to deregulate it succeeds.
CHADD, which stands for Children and Adults with Attention Deficit Disorders, is a powerful lobby in Washington, D.C., and the most popular education and support group for parents of children with the disorder.
National membership in CHADD has grown from 20,000 members in 1993 to about 35,000 members and more than 600 chapters today. It was formed in 1987.
The group’s biggest political coup has been convincing the U.S. Department of Education to include children with attention disorders in special education programs.
In 1991, the agency changed its regulations to recognize the disorder as a disability. Since then, the number of kids on Ritalin has mushroomed.
Initially, educators fought the change because they thought it would cost them even more money to provide services and would burden them with additional staffing needs.
“Schools’ attitudes have changed tremendously,” said James Swanson, a University of California researcher.
Looking to solve classroom behavior problems and help students achieve, more educators now refer children to doctors.
As a result, “Good diagnosis has increased and misdiagnosis has increased,” he said.
Now CHADD is petitioning the Drug Enforcement Agency to remove Ritalin’s stigma of being classified as dangerous as cocaine and morphine.
Supporting the change are some professional organizations, including the American Academy of Neurology and the American Psychiatric Association.
CHADD members have sent thousands of letters to the DEA asking it to ease restrictions on the drug by moving it out of a category reserved for dangerous narcotics like morphine and cocaine.
That would make it easier to fill prescriptions and eliminate the production ceiling now on Ritalin, allowing unlimited manufacture of it.
Now, patients have to visit their doctor every month for a new prescription. The change would allow five refills in six months, as in the case of prescription drugs such as codeine and steroids.
“It does not have the abuse potential of heroin,” said Wade Horn, chairman of CHADD’s federal affairs committee who launched the petition last fall.
“I’m not saying put it in Flintstones vitamins and say ‘Go at it.’ I’m saying write a prescription good for three refills,” Horn said.
As much as $300,000 of CHADD’s nearly $2 million budget comes from the pharmaceutical industry. CibaGeigy Corp., the makers of Ritalin, recently paid for a CHADD informational video.
Both Ciba-Geigy Corp. and MD Pharmaceuticals Inc., the maker of the generic form of Ritalin, downplay the impact that deregulation would have on their profits.
“Our position is that we’re supportive of any efforts that will ensure we can manufacture enough to meet the medical needs,” said Ciba-Geigy spokesman Todd Forte.
Ciba-Geigy experienced a temporary U.S. shortage in 1993 because of the quota restrictions. When CHADD learned of the pending shortage, it mobilized members and bombarded the DEA with telephone calls.
At the time, the DEA was reviewing Ciba-Geigy’s request for a higher production ceiling. The agency denied it delayed the request, raised the ceiling and issued a press release saying it actually “worked to expedite the review process.”
Horn said he “will not accept a penny” from Ciba-Geigy for the campaign to ease Ritalin restrictions, to avoid accusations that the drug company bankrolled it.
Ritalin is not one of Ciba-Geigy’s major products, although the Swiss-owned company sold about $100 million worth of it in 1994. The drug has greater importance for MD Pharmaceuticals, whose generic version claims about 65 percent of sales in the United States.
“You’re looking at a market that’s continued to grow at a rate of 32 to 35 percent every year for the past five years,” said Mark Bursack, director of sales and marketing for MD Pharmaceuticals.
In its 1994 annual report, the company announced plans to build another plant in anticipation of doubling production.
When CHADD members write the DEA, they typically claim that ADD is a biological disorder, although research is inconclusive on that point.
“One letter we got today has narrowed it down to the frontal lobe of the brain,” said Howard McClain, DEA chief of the drug and chemical evaluation section.
Horn accused the DEA of deliberately delaying action on CHADD’s petition, but McClain said it’s actively being reviewed. The next step is a review by the Food and Drug Administration.
No timetable has been set for that review.
The DEA’s primary concern is Ritalin’s potential for abuse.
Horn doesn’t buy that argument.
“Show me the data” on Ritalin abuse, he said. “I’ve been asking the DEA for a year. Show me and I’ll shut up and go away.”
McClain admitted the data is limited. The agency is still collecting information, he said. “We don’t know how much it’s being abused.”
He does have anecdotes - a Virginia teenager who died from snorting the drug at a party in April and a school nurse arrested in March for stealing more than 500 Ritalin pills from students.
In the Northwest, such stories are rare.
Kootenai County juvenile prosecutor Barry Black has had a couple of cases of students distributing Ritalin to friends. Boise police report half a dozen instances of kids snorting or selling Ritalin in the last several months.
Police in Spokane and Post Falls say they never come across Ritalin abuse.
The small incidence of abuse can be attributed to tight DEA controls, agency officials said.
Idaho’s oversight of Ritalin and other abusable drugs is more stringent than most other states.
Now every Ritalin prescription in Idaho is entered into a computer database reserved for dangerous substances. The data provides the state with a monitoring tool.
But the lone data entry clerk for the Board of Pharmacy is overwhelmed. More than half her entries are for Ritalin and she’s months behind.
If the DEA loosens restrictions on Ritalin, the Board of Pharmacy likely will drop it from the program, officials said.
Though the prospect raises concerns, Horn said not to worry.
“Do you believe all the academies would support this petition if by passage we would have Ritalin houses next to crack houses in the cities?”
, DataTimes ILLUSTRATION: Graphic: Production continues to rise
The following fields overflowed: CREDIT = Susan Drumheller Staff writer Staff writer Carla K. Johnson contributed to this report.