Stimulants are medications used to treat attention-deficit/hyperactivity disorder (ADHD). ADHD is a common condition affecting up to 7% of children and up to 4% of adults. The main symptoms are usually problems focusing or paying attention, frequent fidgeting and restlessness, and troubles with impulse control. ADHD is treatable and most people will eventually find a treatment (stimulant or nonstimulant) that works well for them. It may seem strange to use a stimulant for ADHD, but stimulants are the most frequently prescribed medication for this condition. They work by stimulating the parts of the brain needed for focused attention. Some commonly used stimulants include amphetamine mixed salts (ADDERALL and generics), dextroamphetamine (DEXEDRINE and generics), lisdexamfetamine (VYVANSE), and methylphenidate (RITALIN, BIPHENTIN, CONCERTA, and generics). Stimulants do not work for everyone. They also require careful monitoring as they can cause side effects. As well, stimulants are controlled substances and there are numerous laws and regulations regarding how they are prescribed. One reason these regulations exist is that stimulants have a high street value and can be desired by people who misuse substances.

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The patient/guardian agrees:

1. To fill prescriptions only at one pharmacy (unless specifically approved to be switched by psychiatrist). Staying with one pharmacy makes monitoring your progress easier for all involved.

2. To receive stimulant prescriptions from only one healthcare provider (except in emergency situations, where I will inform my healthcare provider as soon as possible).

3. To report any side effects arising from the medication. These side effects can often be managed by adjusting the dose, adjusting the time of day the medication is taken, or changing to a different formulation. 4. To reliably attend appointments with the practitioner.

5. To take stimulants only as prescribed (i.e. not to change the dose without the consent of your healthcare provider). This means that early refills will NOT be authorized.

6. To safely store the medication. The best approach is to use a lock box and to not keep stimulants where others might see or have access to them. If stimulants are lost, stolen, or spilled, they will NOT be replaced. (With apologies, but we must be like the bank and money in this regard).

7. To not share, lend, or sell this stimulant medication to any other person.

8. To periodic urine drug tests at the discretion of the healthcare provider (including coming in for random screens).

9. To periodic pill counts at the discretion of the pharmacist (including coming in for random counts).

10. To be seen at least every 3 months to monitor these prescriptions.

11. To explore non-stimulant related treatments for ADHD as recommended by your healthcare provider.

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Breaking this agreement may mean that your healthcare provider will stop prescribing this stimulant. Please be advised that you will be discharged from the practice if you violate these controlled substance rules or if you use any illegal drugs.  If outside sources or relatives report that you are abusing substances you will also be discharged from the practice. 

 

This Informed Consent and Treatment Agreement is to help keep you safe and help your healthcare provider comply with standard best practices.

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