University Health and Counseling Services maintains a high standard for the documentation of Attention Deficit Hyperactivity Disorder (ADHD). This is necessary to ensure accurate diagnosis, especially given the fact that other conditions can look like ADHD, that many conditions can accompany ADHD, and that there are significant side effects and the potential for abuse, misuse and/or dependence associated with stimulant medications typically used to treat ADHD.
UHCS requires that ADHD documentation is:
- up-to-date and current,
- found to clearly support an ADHD diagnosis, and
- reasonably comprehensive.
UHCS defines "reasonably comprehensive" documentation to include: appropriate psychological, neuropsychological and/or or psychoeducational testing that typically includes objective assessment of the following domains: intellectual functioning (IQ), memory, attention, executive functioning, processing speed and achievement (e.g. reading, writing, math) skills. Reasonably comprehensive documentation may also include 504 plans and Individualized Educational Plans (IEPs), provided that they are based on prior testing.
UHCS may consider older documentation to be sufficient if the original diagnosis was made based on reasonably comprehensive testing (as defined above) and if the student has been maintained continuously on ADHD medications. This will be determined on a case-by-case basis.
Please note that UHCS would not consider an ADHD diagnosis based on a clinical interview, symptom checklist, and/or trial of medications to be sufficiently comprehensive.
Documentation Review and Options
- Fax documentation to UHCS at 833.645.0872 to the attention of Dr. Michelle Romero.
- If your documentation meets the above criteria, Dr. Romero will contact you to discuss your options for treatment. These options include:
- referral to a UHCS Psychiatrist
- referral to a UHCS Primary Care provider
- referral to a psychiatrist in the community
- referral to your physician back home who has been prescribing your stimulant medication
- referral to a UHCS counselor or community counselor for behavioral management of ADHD
- If you do not have documentation or if your documentation does not meet the UHCS criteria, you will need further assessment for UHCS to prescribe ADHD medication.
- Dr. Romero will provide you with referral options for assessment in the community.
- If you decline to undergo an assessment, it is recommended that you contact your home physician to ask if s/he will continue prescribing for you while you are a student. As an alternative, referral options for psychiatrists in the community can be provided.
Information about the National Shortage of Stimulant Medications
Stimulant medications (like Adderall or Vyvanse) have been under a national shortage since October of 2022 - and the shortage is expected to continue through 2025.
What Can YOU Do?
Planning
- Please do not wait until you are out of medication to request your next prescription. Prescriptions for stimulant medications can be filled every 28 days; you should set a calendar reminder every 28 days to reach out to your pharmacy to request your next prescription.
Perseverance
- You may need to call pharmacies. This is not something your provider or other UH&CS staff can do on your behalf.
- Ask to speak with the pharmacist (rather than the pharmacy technician).
- Some pharmacists may be able to look system-wide and alert you to another location that may have your medication. They may also provide you with information regarding alternative doses, different formulations, other stimulant medications, or brand/generic alternatives they may have available. Some might also let you know what they expect their next shipment of your prescribed medication. Please be respectful and courteous when speaking with pharmacies; the shortage is not their fault.
- If you identify a pharmacy and need a new or updated prescription, notify your provider of the pharmacy information (pharmacy name, address, & phone number) in addition to information as to what is available.
- Note, that a refill request can take 1-2 business days, and the pharmacy may no longer have the medication available once the new prescription is received. Be aware that prescriptions for stimulant medications sent out-of-state pharmacies may not be filled due to regulations in the specific state.
Flexibility
- Be open to discuss alternative strategies with your provider, including taking days off from your medication.
- Consider connecting with the Academic Support Resources for Students for additional support with your academics and/or connecting with University Health & Counseling Services to discuss behavioral management strategies for ADHD.
How Can UH&CS Help?
Providers can discuss non-stimulant medications as well as alternative stimulant options. They can also assist with connecting you with a counselor to learn behavioral management strategies.
What Else is Being Done?
The DEA is working to ensure that manufacturers make their full allotment and had made changes to their quota allocation process. In July of 2023, the DEA also revised regulations to allow for patients to transfer electronic prescriptions from one pharmacy to another without going back to their provider. This request must be initiated by the patient and must be done pharmacy to pharmacy. Note that pharmacies may have their own policies and procedures in place that prohibit the transfer of controlled substances, such as stimulant medications.
Further Information:
ADHD Medication Shortage: Tips for Getting What Your Child Needs
The ADHD Medication Shortage: Here's What Clinicians Can Do for Patients
ADHD Documentation and Prescription Policy | University Health and Counseling Services