Colleges and university are cutting back on their involvement with ADHD, primarily due to abuse of the psychiatric medications — stimulants like Ritalin — prescribed to treat the disorder. Students — whether they are malingering the symptoms or actually have it — are prescribed a drug to treat ADHD (sometimes from different providers in different states), then sell a few (or all the) pills on the side. Profit!
Now universities are becoming wise to the epidemic nature of the problem, as some studies have suggested up to a third of college students are illicitly taking ADHD stimulants.
This might help curb the abuse problem, but will it also make it harder for people with actual ADHD to receive treatment?
The short answer is, yes, of course. Students with a pre-existing diagnosis of attention deficit or attention deficit hyperactivity disorder will still often be able to get their prescriptions filled while at school. The university just doesn’t want to do the diagnosing of ADHD any longer.
I’ve long wondered at the wisdom of universities getting into the ADHD business in the first place. University counseling centers generally shrug off long-term treatment of serious mental illness. So it’s never been clear to me why they were comfortable prescribing medications for ADHD.
The New York Times notes — in a well-written take on this issue by Alan Schwarz — that the changes are sweeping campuses throughout the country:
Lisa Beach endured two months of testing and paperwork before the student health office at her college approved a diagnosis of attention deficit hyperactivity disorder. Then, to get a prescription for Vyvanse, a standard treatment for A.D.H.D., she had to sign a formal contract — promising to submit to drug testing, to see a mental health professional every month and to not share the pills. […]
The University of Alabama and Marist College, like Fresno State, require students to sign contracts promising not to misuse pills or share them with classmates. Some schools, citing the rigor required to make a proper A.D.H.D. diagnosis, forbid their clinicians to make one (George Mason) or prescribe stimulants (William & Mary), and instead refer students to off-campus providers. Marquette requires students to sign releases allowing clinicians to phone their parents for full medical histories and to confirm the truth of the symptoms.
“We get complaints that you’re making it hard to get treatment,” said Dr. Jon Porter, director of medical, counseling and psychiatry services at the University of Vermont, which will not perform diagnostic evaluations for A.D.H.D. “There’s some truth to that. The counterweight is these prescriptions can be abused at a high rate, and we’re not willing to be a part of that and end up with kids sick or dead.”
Not everyone is convinced:
“If a university is very concerned about stimulant abuse, I would think the worst thing they could do is to relinquish this responsibility to unknown community practitioners,” Ms. Hughes [CEO of CHADD, an advocacy organization] said. “Nonprescribed use of stimulant medications on campus is a serious problem that can’t just be punted to someone else outside the school grounds.”
She has a point. The 2010 suicide death of Kyle Craig, who abused Adderall prescribed by his local physician at home and not by the university he attended, suggests the problem is more wide-ranging than perhaps some university officials understand.
However, this sort of effort on the part of Fresno State is amazing and should be applauded:
And in a rare policy among colleges, students receiving prescriptions to treat A.D.H.D. must see a Fresno State therapist regularly — not for a cursory five-minute “med check” but for at least one 50-minute session a month.
Psychotherapy required for ADHD treatment? Nice — finally an institution that listens to the research and understands that medications are, for most, not a life-long answer.
I think that, by and large, this is a measured response to a very serious problem of stimulant abuse among college students. Students have long enjoyed free healthcare on campus, with counseling an additional free service they receive. But student counseling centers mostly refer students with serious, ongoing mental health or mental illness to local providers in the community — they’re simply not well-equipped to treat people with such concerns. I see no reason why ADHD should be an exception.
What this does for the colleges that are mostly getting out of the ADHD business is to limit the overall amount of prescriptions floating around for these stimulant meds. That should drive down supply, drive up prices, and make it less attractive as a “study” option for students without ADHD.
As for the students who actually have attention deficit disorder? I think they will still be able to get the treatment they need. Having seen people at community mental health centers, I know that if there’s a will, people will find a way to pay for mental health services.
Read the full article: Colleges Tackle Illicit Use of A.D.H.D. Pills