(Photo/Xinhua)

Tian Jing (pseudonym), a high-school graduate from North China, did not know what "smart pills" were when she took them for the first time. She only tried them because her mother told her they could improve her exam performance.

At that time, Tian was at the beginning of her third year in high school, and had fallen out of the top 10 in the class. In the first and second years, she had consistently been in the top five.

Two months later, Tian was back in the top 10.

But now, after finishing the national college entrance examinations, she is at the Beijing Gaoxin hospital receiving drug rehabilitation treatment, according to a report in The Beijing News on February 20.

Xu Jie, the chief doctor at the rehabilitation center, told The Beijing News that half of their patients who suffer from Benzedrine abuse started by taking so-called smart pills such as Ritalin and Concerta.

The youngest of the patients was 14 years old, Xu said, noting most Ritalin takers were under huge stress or facing serious family conflicts, thus using study or work as an outlet.

Black market

The main ingredient in these smart pills is methylphenidate, a central nervous system stimulant that is a strictly managed psychotropic medication both in China and abroad.

Methylphenidate is a mild central stimulant compared to methamphetamine, but it is still addictive. Long-term use of the drug can cause anxiety, over excitation and mania, Hua Zhendong, technical director of the China National Narcotics Control Commission national narcotics laboratory, told the Global Times on Tuesday.

Central stimulants like Ritalin and Concerta can only be prescribed by hospitals to children who are under 14 years old and are diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), Bai Hanping, an expert on adolescent psychology with the Renmin Hospital of Wuhan University, told the Changjiang Daily in June 2018.

When searching for groups related to Ritalin on social media platform QQ, the Global Times reporter found a dozen. Six groups run by the same person caught the reporter's attention, as each has more than 1,000 members.

The six sequenced groups are all named "smart pills/Ritalin/adhd."

Liu, the administrator of the six huge QQ groups selling Ritalin, told the Global Times reporter, who posed as a buyer, on Tuesday that the pills would not lead to addiction or cause any serious side effects.

"Most users lose their appetite after taking the pills, and some others suffer slight headaches, but it's not a big deal," Liu said. He said users can stop for one day every five days to avoid getting addicted.

Liu also added this Global Times reporter to a WeChat group with 35 members. According to him, all the members are taking smart pills for exams. The group is named "I Want to be a Smart Ass."

However, Hua noted that "stopping one day after five days' use would not protect users from getting addicted in the long term."

His words tally with what happened to Tian and Xinxin (pseudonym), another high-school graduate who had taken Ritalin for two months.

Tian started to lose her hair and became unable to sleep one month after taking the pills. Her mother stopped giving her the pills after one term - four to five months - after noticing her symptoms, but Tian could not stop. Without the pills, she felt sick, suffered headaches and could not concentrate.

Unknown to her parents, she started to buy pills on QQ, and became more and more addicted. The pills she bought online turned out to be ecstasy, said The Beijing News.

Smuggling problem

Liu sells Ritalin produced in the US, Pakistan and Switzerland. US Ritalin is sold at 1,400 yuan ($209) for 50 pills; Pakistani Ritalin 390 yuan for 30 and Swiss Ritalin 460 yuan for 20.

When asked how he obtained the pills, Liu said they were smuggled into China.

Hua noted that drug smuggling is actually a serious problem. The growing number of overseas purchasing agencies has made it even more difficult to carry out customs inspections of drugs, he said.

"Many sleeping pills and slimming drugs agents purchased from Japan and Thailand contain controlled substances in China. But if the agents do not declare them by name and hide them in other goods, which is usually the case, customs officials won't discover them," Hua said.

Hua called for strengthened customs inspections on drugs.

Smart pill abuse is not a problem exclusive to China. A documentary released on Netflix in March 2018 revealed how Americans were abusing stimulant medicines, including Ritalin and Adderall (dextroamphetamine), as some kind of "jet fuel."

While the exact number of abusers is hard to gauge, as of 2015, the ADHD drug industry was a $13 billion business, and is expected to reach $17.5 billion by 2020, Quartz reported in 2016. 

After stopping taking the pills, Xinxin, 18, felt like she was going to die, according to The Beijing News.