The intent of this report is to alert physicians to the rare possibility of intranasal methylphenidate abuse in chemically dependent adolescents treated for ADHD and to the possibility of group methyphenidate abuse at special education schools where many adolescents may be treated with stimulant medication. The information reported in this case shows that the treatment of childhood ADHD with methylphenidate did not contribute to subsequent alcohol and drug abuse. The abuse and dependence on methylphenidate developed after alcohol and marijuana abuse had begun. The case data should not influence clinical decisions of the use of methylphenidate in ADHD children and adolescents who do not abuse alcohol or drugs. 9 references