 Treatment for ADD/ADHD
At Campus Health
All requests for prescriptions for medications to treat ADD/ADHD are handled through Counseling and Psych Services (CAPS). CAPS cannot perform diagnostic assessment or initiate first-time medications for ADD/ADHD, but once you are clearly diagnosed with ADHD and stabilized on a medication, a CAPS Psychiatrist can usually provide prescriptions for continuing refills of your medications.
Note: You MUST provide the full documentation required by CAPS, related to both the diagnosis and prior medication treatment BEFORE you can obtain ADHD medication prescriptions at CAPS.
How does one typically get evaluated for ADHD and subsequent medication treatment?
There is tremendous variability in how this diagnosis is made in different settings. Some students have had a full evaluation and others were simply started on medications by their pediatricians or other health providers with minimal evaluation or monitoring.
A self-administered test on the internet is unreliable and insufficient to diagnose ADHD. Not all concentration problems are due to ADHD. Many students who have undiagnosed learning disorders have been told they have ADHD. Anxiety, depression and sleep deprivation, even mild, are actually the most common causes of distractibility and poor concentration in young adults. An accurate diagnosis and ethical treatment requires a thorough evaluation. Additionally substance use can impact cognitive functioning.
A thorough evaluation, leading to an accurate diagnosis of ADHD involves the clinical input of all three sources below:
1. Neuropsychological testing: a battery of several different tests, typically administered by a licensed psychologist, is administered to assess specific aspects of a person's cognitive functioning. Some students may have been evaluated earlier in their school career by a school psychologist. (The names of Psychologists in Tucson who do this type of neuropsychological testing can be obtained from the CAPS Clinical Care Coordinator) AND
2. Structured Clinical interview: an interview performed by a psychologist or other health professional to assess whether a person’s history of symptoms seems compatible with a diagnosis of ADHD. Corroborating information may also be requested from people in your life who have observed your academic performance (for example, parents or teachers). An interview alone is not considered an adequate basis on which to make a diagnosis or referral for medications AND
3. Psychiatric Evaluation: a clinical interview with a psychiatrist, who will integrate the information provided by the neuropsychological testing, review your symptoms, rule-out other potential causes (like mood or anxiety disorders), and assess the usefulness of medication as a form of treatment .
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Can I be tested for ADD/ADHD at CAPS?
No. CAPS does not currently have the staffing to perform the testing needed to establish a diagnosis of ADD/ADHD.
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Can I have my ADD/ADHD medication prescribed at CAPS?
All ADHD medication evaluations at Campus Health are done through CAPS. If you were adequately diagnosed AND treated for ADHD at any time in your life before coming to college, we will need to see documentation of how and when that diagnosis was made, before we can evaluate you for obtaining medication. The documents that we need are:
1) Full Neuropsychological Testing report: a report from the clinical or school psychologist who did the testing. If you have never had this kind of testing, or cannot locate the report you will need to have this testing done prior to requesting treatment at CAPS AND
2) Written documentation of medication stability from your prescribing physician: only students who are currently stable on their ADHD medications will be considered for obtaining a prescription for their medications at CAPS. We need notes, or a summary letter, from the physician who was prescribing your ADHD medication, indicating the history of what you were prescribed, your response to the medications, and an indication of your stability on those medications for six months preceding your visit to CAPS.
A CAPS psychiatrist will review these materials, and decide whether it is appropriate to meet with you in order to receive prescriptions for your ADD/ADHD medications through CAPS.
If you were just started on medications shortly before you came to CAPS you will be asked to see an off campus provider until you meet the above criteria.
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What if I think I have ADD/ADHD but have never been evaluated before?
Unfortunately we do not currently have the staffing to do neuropsychological testing at CAPS. If you feel that you have symptoms of ADD/ADHD we can refer you to clinicians in the Tucson area who can perform the neuropsychological testing needed. If testing indicates a diagnosis of ADD/ADHD, we could also refer you to a community-based psychiatrist who could work with you to find the right medication. Once you have been stabilized on a medication regimen by that psychiatrist, you can transfer your care to a psychiatrist at CAPS by bringing in the documentation described above.
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Would a CAPS psychiatrist ever refuse to prescribe my ADD/ADHD medication, even if I have provided all the requested documentation?
Yes. Our mission at CAPS is to promote health, wellness and safety.
If we have concerns that a student is abusing or selling his or her ADHD medication we will refuse to prescribe. Most ADHD medications are amphetamines. Amphetamines can be purchased “on the street,” are often abused in college settings, and can quickly escalate to addiction.
ADHD medications should not be used with other mind-altering substances, including alcohol or marijuana (not to mention cocaine, ecstasy or pain-killers). We have a zero-tolerance policy for students with ongoing substance abuse problems who seek ADHD medications. We may require random urine drug screens (UDS) on any student who is prescribed ADHD medications if we have concerns about concurrent substance abuse.
Additionally, a CAPS psychiatrist might refuse to prescribe ADD/ADHD medications is if they feel, based upon their clinical judgment, that the prior diagnosis is incorrect. Many other problems can cause symptoms that might resemble, but not be, ADHD.
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The waiting list for these appointments out in the community is at least a month. What am I supposed to do?
ADHD is not an acute condition that requires emergency or immediate treatment. It does not "flare-up", and generally starts during childhood. If you have made it to college without a diagnosis, it is likely that any symptoms you might have are probably mild. Sometimes the more rigorous academic demands of college make the symptoms more problematic than they might have been in high school. Waiting one month for an evaluation is not an unreasonable time-frame. ADHD is a chronic condition, and it is important to keep a long-term view of the problem. Maintaining regular study habits, minimizing alcohol use, and making sure that you are paying attention to sleep and dietary habits are especially important!
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I never had ADHD before but I think I might have “adult onset ADHD”
A diagnosis of ADHD generally includes evidence that goes back to childhood. It may be possible that the symptoms were not previously severe enough for ADHD to be suspected or diagnosed, especially in cases where attention issues existed without notable hyperactivity. Many other conditions, such as anxiety, depression, sleep issues, substance use issues and other life stressors can cause problems with focus and concentration. Adequate testing and clinical evaluation, as described above, should be able to confirm the diagnosis of ADHD.
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Are there other treatments for ADHD that I should consider?”
If you are uncomfortable with taking medications or you have another medical condition which contraindicates the use of the medications that are commonly prescribed for ADHD, you should consider the use of other techniques that may assist you. Cognitive, behavioral and meditative techniques, along with exercise, biofeedback and other educational interventions might prove helpful in managing your symptoms. Additionally, there are other non-stimulant medications that have proven to have some benefit in addressing the symptoms of ADHD. Feel free to consult with a CAPS provider to discuss this further.
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