After seven days, most individuals will begin to experience a relative return to normal functioning, some symptoms one may experience are:
Concerta is a medication that is primarily prescribed for the treatment of attention deficit hyperactivity disorder (ADHD). Concerta is the extended-release version of the drug methylphenidate, whereas its cousin drug Ritalin is the immediate-release form.
In addition, college graduates who are employed in high-pressure positions, such as management positions or stockbrokers, commonly abuse Concerta. Most often, users are Caucasian males under the age of 30.
The most common form of abuse for Concerta and similar drugs consists of grinding up the pills and snorting the powder. This behavior results in the person experiencing a quicker onset of the psychoactive effects of the drug, and in many cases, it leads to individuals using far more of the drug than would normally be used for prescribed purposes. The drug is most often obtained from dealers who sell it illegally, or it is stolen from individuals who have a prescription for it.
There is a documented withdrawal syndrome for stimulant medications. The primary symptoms that occur during withdrawal from stimulants are psychological. The American Psychiatric Association (APA) lists the formal diagnostic criteria for stimulant withdrawal as consisting of:
The symptoms that the individual displays must result in severe distress or impairment in everyday functioning. In addition, the symptoms cannot be better explained by some other medical issue (e.g., a thyroid problem), some other mental health issue, or the use of drugs or alcohol. A withdrawal syndrome specifically occurs when one stops using a particular drug.
Concerta has a relatively short half-life in both the immediate-release and extended-release forms, but individuals who abuse the drug may retain it in their system a bit longer. However, in general, the withdrawal timeline from methylphenidate or Concerta can be expected to occur over the following course:
Individuals who have consistently abused Concerta with other drugs of abuse may have more lengthy and complicated withdrawal syndromes, particularly if they habitually used Concerta with alcohol or other prescription medications like narcotic pain medications. It is also important to understand that there is a lot of individual variability in the presentation and length of any withdrawal syndrome. The symptoms listed by APA and the timeline listed here are general guidelines that are based on the experiences of most individuals.
An individual who experiences withdrawal from Concerta will most likely experience at least two of those symptoms but may experience others as well. For instance, there are reports in the literature of some individuals experiencing muscle cramps, mild tremors, and even issues with psychotic-like behavior, such as mild hallucinations or paranoia; however, these symptoms are rare.
The withdrawal syndrome associated with stimulant medications like Concerta is not generally accepted as potentially dangerous in most cases. However, there is always the possibility that in rare cases some individuals will have extreme reactions. For instance, some individuals who are emotionally unstable may become very upset during withdrawal, and this may lead to potential accidents, issues with poor judgment, or self-harming actions. Other individuals may give into cravings during the withdrawal process and may binge on Concerta and/or some other drug, leading to an overdose.
Because there is an increased probability that an individual will relapse during the withdrawal process, and in rare cases, some individuals may engage in activities that can be harmful as a result of going through withdrawal, it is always preferable for individuals who have used Concerta medicinally or abused the drug for more than a few weeks to seek professional help when attempting to stop use. A consultation with a psychiatrist who specializes in addiction medicine or an addiction medicine physician is highly recommended. Most addiction treatment programs will either offer medical detox services or can refer clients to an appropriate treatment facility.
The withdrawal syndrome for any drug or medication can be managed by way of a physician-assisted withdrawal management program. A program to assist with withdrawal from stimulant medications will consist of the physician monitoring the individual’s symptoms and potentially administering a number of medications to control symptoms like fatigue, lethargy, depression, and cravings, as well as any other symptoms that may appear (e.g., nausea). The physician and other medical professionals will monitor the individual closely and slowly taper down the use of these medications as the person goes through the withdrawal process. With a tapering approach, the withdrawal process takes longer; however, the person experiences very minor symptoms or no symptoms at all. This significantly reduces the potential for relapse and prepares the individual for therapy.
Simply going through the withdrawal process for any drug, including Concerta, is not a sufficient approach to dealing with a substance use disorder. It has long been recognized that individuals need to be enrolled in a formal addiction treatment program that includes withdrawal management, medical management of other issues, therapy, social support groups, and other interventions as needed for the individual. For the vast majority of individuals, this requires a long-term commitment to living life without drugs or alcohol. Just going through withdrawal and not formally addressing the issues underlying addiction makes relapse incredibly likely.