Suppose you’d like to test Ritalin, how would you get hold of it?

Media coverage and academic discourse on Neuro-Enhancement seem to suggest that smart drugs are at everyone’s disposal when required. But is it really that easy to dope one’s brain? How do people get hold of smart drugs if they feel the desire to enhance or just nosily want to give it a try? Some reflections on the situation in Austria.

There are several online forums in German language discussing how to get enhancement drugs, mostly Ritalin. A user at mygully.com, for example, tells the online-community that he/she is unemployed and experiences problems in writing and handling daily routines. As valerian did not work he/she wants to try Ritalin (1). Another forum user attends school and asks yahoo-members for help to get Ritalin: “please let me know if you have some pills left;) and please no unnecessary comments like that it´s illegal,:D thanks ;)” (2). 

The vast majority of online communities is hardly helpful and expresses deep concern about such brazen acts. Usually the advice is to go and see a doctor. “Vice Germany” published the article “The rocky road to Ritalin” by Trude Wagner, a journalist who tested if she could get a Ritalin-prescription (3). She resumed: “Buying Ritalin on black markets is expensive and making a doctor prescribe it is difficult, at least if you are an adult who has passed A-levels and got along without smart drugs so far.”

Black markets for smart drugs also were a concern to the experts we interviewed during the reconnaissance phase of the NERRI project. There are rumors about sources on the web (especially the deep web), online-pharmacies and dubious mail-order businesses. At least in Austria these warnings are taken seriously and experts of a recent Delphi panel on addiction addressed this as a main issue to prevent drug misuse (4). Similarly, both the Austrian Chamber of Pharmacists and Austrian customs are firmly aware of illegal trafficking with pharmaceuticals. One might wonder whether this is an Austrian issue. In fact, the Ministry of Finance reported that in 2011 detentions by Austrian authorities accounted for about 1/3 of all detentions of medical products in the EU (in 2007 it was even 50% of all detentions) (5). One of our interviewees suggested that pharmaceutical companies incur severe losses by product-piracy and counterfeiting. Viagra-fakes, for example, flood black markets and profit margins are said to be higher than with Cocaine. 

Little is known on the situation with Ritalin. Forum-users sometimes report that they get the pills rather easily from-a-friend-of-a-friend-of-a-friend of an ADHD-patient, who doesn´t take the prescribed pills. Others say that they make use of an online-source. Allegedly prices range from 304 Euros for 90 pills (20mg) (3) to 1 Euro per 10mg pill (6). Considering the prices and difficulties on black markets, asking a doctor to prescribe Ritalin may be a good alternative. But does that really work?

Trude Wagner, the already mentioned “Vice”-journalist checked out online ADHD self-tests (7) and on that basis made up a plausible story for her doctor. However, instead of Ritalin her German doctor prescribed vitamin pills. Probably the same would have happened, if Ms Wagner had come to see an Austrian practitioner. As the Austrian Federal Ministry for Health states in its 2013 report on ADHD, a prerequisite for an ADHD-diagnosis is that the symptoms first appear before the age of 7 (8, p. 12). For adults, there is no drug approved for ADHD treatment in Austria. ADHD drug therapy of adults is permitted only as a follow-up to a treatment that has started before the age of 18 (8, p. 18). The report expresses concern about the rising number of methylphenidate prescriptions and mentions a need for alternative therapies and better trained experts, especially when it comes to children (9, p. 24).

Finally, another quite peculiar aspect of opportunity structures for Ritalin in Austria shall be mentioned. In Austria there are many different health insurance providers. If Trude Wagner would work in Austria as a freelance-writer, she probably would have signed up with the health insurance for the self-employed. According to a report of the Association of Austrian Social Insurance Institutions (10, p 18 - 20) persons insured with this provider are less likely to be treated with psychotropic drugs than others. Given the small chances to get hold of a Ritalin prescription, Trude would probably either turn to black markets or give vitamins another try. 

So, how do those curious about Ritalin get hold of it? There seem to be considerable differences in opportunity structure due to national regulation regimes, differential access to information, age, occupation etc. How is the situation in your country? Give us a note!

 

Notes:

(1) see: http://mygully.com/thread/372-ritalin-herbekommen-2177590/ (20. 2. 2014)

(2) see: http://de.answers.yahoo.com/question/index?qid=20120311121551AApQZuY (20. 2. 2014)

(3) Vice-Germany: http://www.vice.com/de/read/the-rocky-road-to-ritalin?utm_source=vicefb (20. 2. 2014)

(4) Uhl, A.; Schmutterer, I.; Kobrna, U.; Strizek, J. (2013): Delphi-Studie zur Vorbereitung einer "nationalen Suchtpräventionsstrategie mit besonderem Augenmerk auf die Gefährdung von Kindern und Jugendlichen". Bundesministerium für Gesundheit, Wien.

(5) Produktpirateriebericht 2012, Bundesministerium für Finanzen, Wien, März 2013; https://www.bmf.gv.at/zoll/produktpiraterie/PP-Bericht_2012.pdf?3vtn20

(6) see: http://forum.suchtmittel.de/viewtopic.php?t=11085 (20. 2. 2014)

(7) see for example: http://www.adhs-studien.info/adhs_selbsttest.html; or http://www.selbsthilfegruppe-wunderkind.de/ads,selbsttest-ads-erwachsene,86.html (20. 2. 2014)

(8) Bundesministerium für Gesundheit: AD(H)S. Aufmerksamkeits-Defizit/Hyperaktivitäts-Störung Bericht; Wien, 2013 http://www.bmg.gv.at/cms/home/attachments/2/6/4/CH1419/CMS1376911007121/adhs-bericht.pdf

(9) Recommendations are based on Kooij S.J.J. et al. (2010): European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry and Vavrik K. et al. (2005): Konsenspapier "Standards zur Diagnostik und Therapie der Aufmerksamkeitsdefizit- Hyperaktivitäts- Störung- AD(H)S im Kindes- und Jugendalter".http://www.docs4you.at/Content.Node/Spezialbereiche/Entwick_Sozialpaed/ADHS_Standards_zur_Diagnostik_und_Therapie_Vavrik_2005.pdf (20.2.2014)

(10) Hauptverband der österreichischen Sozialversicherungsträger, GKK Salzburg (2011): Analyse der Versorgung psychisch Erkrankter. Projekt "Psychische Gesundheit", Abschlussbericht; Wien/Salzburg; http://www.hauptverband.at/mediaDB/948928_Bericht_160611-Endfassung.pdf (20.2.2014)