Recently the College of Physicians and Surgeons of BC (CPSBC) developed and published guidelines for safe prescribing of drugs with potential for misuse and diversion. These guidelines were developed for the prescribing of opiates, through a lens of addiction. Unfortunately ADHD stimulant medications were also included in these guidelines. While CADDAC and CADDRA applaud guidelines for opiates, yearly urine drug screening and/or pill counts for patients receiving ADHD medication have no benefit and have not been implemented by other provinces. If a physician suspects their patient, any patient, has an issue with addiction, protocols for this are already in place. Including ADHD stimulant medication in these guidelines is unnecessary, ill-informed and will deter the treatment of ADHD in British Columbia.
What will this mean to those being treated for ADHD?
From now on, those receiving ADHD medication will be required to present themselves with 24 hours’ notice to a designated lab for a yearly routine drug screen. This drug test will screen for opioids, amphetamines (found in ADHD amphetamine medication), and THC (found in cannabis). Screening cannot be done for Methylphenidate based medication. Other drug screens can be requested as well. The patient will be given a special sample bottle, must go into a room without their wallet or coat and produce a sample. Alternately, or in addition to urine tests, physicians are being asked to conduct random pill counts requiring the patient to bring in the prescribed pills for counting on a specific day.
In addition, physicians will now be unable to prescribe stimulant medication used to treat ADHD with anxiety medications (benzodiazepines) or sedative hypnotics used to treat sleep problems. And certain pain medications will not be prescribed to a patient taking stimulant medication.
As well as the stigmatization and shaming of patients with ADHD and their families this will result in a decline in the number of family physicians and paediatricians willing to prescribe stimulant medication. These guidelines promote the perception that prescribing stimulant mediation is a problem with similar risks to prescribing opiates. There is no data or research to back up this perception. We have already seen a steep decline in the number of stimulant ADHD medications being prescribed in BC resulting in more untreated ADHD. The resulting side effects and socioeconomic costs of untreated ADHD have been well documented.
An added result of these biased guidelines will be increased costs to BC healthcare for unnecessary tests and additional physician visits. For additional details access BC Advocacy
What can you do about it?
- Write a letter to: Dr. Heidi Oetter Registrar, College of Physicians & Surgeons of British Columbia, 300 669 Howe Street, Vancouver, BC V6C 0B4
- Meet with your MLA or write a letter to your MLA
- Write a letter to the editor of your local or regional paper