Some days it hits me like a bolt from the blue that we administer a controlled substance daily to my son. A drug that addicts have killed for – have died for. Methylphenidate, the active ingredient in his patch, produces many of the same effects as cocaine or the amphetamines.1

It was one of many reasons we were reluctant to start XBoy on meds in the first place. The side effects, like most drugs, can be frightening and it amazes me that so many kids are on ADHD and ADD drug therapies. I would think many parents would decide against it for fear of those affects.

It’s easy to forget and to take lightly the fact that we keep a dangerous and addictive drug in our home (yes, it is locked up and away from both kids), especially since it’s kept in such an innocuous form like the patch. It’s not injected. It’s not swallowed. It’s just a matter of peeling off the plastic layer and sticking it to his skin. Bu sometimes we are careless. Sometimes I find a tiny triangle of that plastic on the floor. Just the right size, and oh so tempting piece of shiny for ZGirl to pick up and put in her mouth. I don’t know how much residue is on it, but when your doctor and the drug company specifically warn to wash hands after handling, it’s enough to be measurable.

XBoy experiences many of the common side effects from the patch. When we first started the therapy, he was an emotional wreck. For example, he would cry if there were only 3 pickles instead of 4 on his hamburger. His teacher called us in to meet with her after his first week of treatment to discuss how he teary and sad he’d been recently. It was only then that we told her about starting him on the drug as we didn’t want him to have that stigma – just another kid on Ritalin. Keeping it from his teacher allowed us to find out if there was a change in his behavior without anyone suspecting why.

He has since adjusted to the dosage, and while we still find he overreacts on occasion, he’s better. Now my concern has focused from his emotional response to the physical. Last year at this time I was worried about his sudden weight gain between his 6 year check-up and the first time I took him to the ped to discuss his behavior, which was almost 10lbs in six months. The clothes I had bought for school were too tight even before he wore them once. In August I was scrambling to find him uniform-wear in husky. And by the time he was weighed by the school, he was up 14lbs to the grand total of 64lbs. He peaked at 65lbs, which we discovered when he started wrestling and had to weigh in. It was also when he started his meds. That was January.

It is the beginning of June, which means he’s been on the daily patch for a solid four months. The other day he came to me and complained that he now weighed only 58lbs after using our bathroom scale, and frankly, that scares me.

I knew he was losing weight. Pictures from last summer show a round, full face. He sported a bit of a “pot” belly in his swim trunks. He was squeezing on his favorite pair of sweatpants. Now? The belly is gone. His collar and shoulder bones are prominent. He is not gaunt, but thinned out considerably. He’s still in a normal weight range for boys his age and height, but for how long?

In the morning, when he doesn’t want breakfast – “I’m not hungry!” – it takes all my willpower not to say, “If you don’t want to lose any more weight, you’ll need to eat breakfast!” since I can only imagine that since he’s already suffering from a chemical imbalance that produces ADHD, he would be just that much more susceptible to experiencing an eating disorder of some kind or another. So I say nothing, but encourage him to at least drink a glass of milk. Paranoia is my master in parenting decisions, apparently.

It’s not like his eating habits have drastically changed. He definitely doesn’t eat as much, but the kid could really put it away a year ago and of course then I worried that he was eating too much. But I watch more carefully when he takes his plate to the sink with food still on it. I don’t grouse as much when he asks for a treat (a brownie, chips, candy, etc.) because I welcome the chance for him to put calories – even empty ones – into his body.

I worry to the point of going sleepless about what will happen in a year knowing that he will still be on meds. I worry about the future in five years; ten years from now. Many kids “outgrow” ADHD. Will he? What if he doesn’t? What long-term emotional affects will he have from a decade of stimulant use? What about the physical? I’ve had family and friends wave away my concerns like I’m making a big deal of out nothing. “Lots of kids have ADD/ADHD,” they say dismissively. I always find it funny how the ones who tell me this don’t. 

1 http://www.usdoj.gov/dea/concern/methylphenidate.html