~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This message is from PedTalk! To reply to the group, use "" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ >From: Kramer, Kevin [SMTP:] >Sent: Tuesday, October 21, 1997 12:54 PM >To: >Subject: Ritalin for sale >I would be interested in others opinions of this. Yesterday, I got a >call from the gmom of a patient who seems reliable and she reported to >me that the uncle of one of the patients I have on Ritalin for ADHD is >selling his Ritalin and mixing it with crystal. She called to warn me >because the mom was coming in later that day. Well, sure enough she >tried to convince me that his dose wasn't enough, even though he is >doing ok in Head Start, and she came in with her neighbor who brought >her daughter in for, you guessed it an ADHD eval. Her other daughter is >also on Ritalin. Now, I have seen these kids and believe their symptoms >are legitimate, but I have opted to separate them all from the >practice. I also notified the local police dept. I would be interested >in others' opinions. I also notified the other physicians in our group >about this. Obviously, I have no proof, but didn't feel the risk >justified any further relationship with them. I also have separated the >child's cousins as they also have one child with ADHD. Kevin Kramer, >MD,FAAP I had one mom who was seeing me, another pediatrician and a child psychiatrist for ritalin refills. Her son definitely needed it, by the way. Anyways, I personally only prescribe one month's worth at a time, so as to keep a close eye on who's using more medication. This mom was timing it just right from all three docs that she was able to get away with it for several months until she made a mistake and tried to fill a script at a pharmacy she had just used. The pharmacist called me about it. I tried switching the child to Cylert, but the mom was reluctant and called me back three times in the next two days to tell me about the wild reactions the child was having; I seem to remember hallucinating was one of the reactions she listed. So, my final solution was to tell the mom I would not write her any more ritalin, but that the psychiatrist would be in charge. I notified the other doctors and the psychiatrist agreed. She left my practice on her own shortly thereafter. In your situation, there's a number of other things to do. One is to get the school caretaker to administer the ritalin instead of the mom, and talk to the teacher about the "need" for increases, instead of relying on the parent's word for it. And get the teacher of the sibling to verbally give you a report to see if the other child has ADD. Sometimes, just the intimation that you suspect something will scare these parents off. Len Leshin, MD, FAAP Corpus Christi, TX http://www.davlin.net/users/lleshin