Europe is being targeted by the drugs industry as the next major market for increasing the use of stimulant drugs such as methylphenidate (Ritalin) and dexamfetamine, a Californian doctor specialising in behavioural paediatrics warned at a recent meeting of the President's Bioethics Council.
Dr Lawrence Diller has become known in the United States as a critic of the inappropriate use of stimulants such as methylphenidate for the management of children with attention deficit hyperactivity disorder. Besides its therapeutic uses methylphenidate has also attracted non-therapeutic uses: pacifying unruly children, enhancing performance, and, as Dr Diller told the Council, “helping parents be better parents and teachers to teach better.”
But now, Dr Diller said, the use of these stimulants is beginning to expand outside the United States. In the 1990s the United States led the world in the use of these stimulants, with 90% of global use. In recent years this has fallen to 80% “That's because other countries are catching up,” he said.
Canada now uses almost as much methylphenidate per capita as the United States. Doctors in the United Kingdom currently use about a 10th of the amount per capita of methylphenidate used in the United States, and this figure is climbing, he said. Per capita stimulant use in France and Italy is about a 20th of US consumption, although methylphenidate is not yet approved for use in Italy. In Germany the use is “somewhere in between.” In Finland “only a few dozen children take stimulants.” In Australia and New Zealand stimulant use is increasing, Dr Diller said. Such stimulant use in developing countries is zero.
In the United States methylphenidate and (Adderall) methamfetamine are classified as schedule II drugs because of their addictive potential. Production records of these drugs are kept by the Drug Enforcement Agency, and the drugs must be prescribed by a doctor. Between 1992 and 2000 the production of methylphenidate went up 730% to over l4000 kg a year, while the production of amphetamines (mostly methamfetamine) increased by 2500% Over 10000 kg of legal amphetamines are produced each year in the United States, not to mention an unknown amount of illegal stimulants sold as “speed” or “crack.”
Dr Diller estimated that between four and five million children out of a total of about 80 million under 18 years of age in the United States take stimulants.
Dr Diller said that a major factor is a massive advertising campaign by the pharmaceutical industry, promoting methamfetamine to doctors and patients.
“The current boom didn't begin with the pharmaceutical industry, but it has been assisted by it,” he told the council. The current legal market for methylphenidate and similar agents is estimated to be worth $1bn (£0.6bn; €1bn) a year.
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RANDY SQUIRES/AP
hris Black, from Springfield, Illinois, who takes methylphenidate (Concerta) for attention deficit hyperactivity disorder