Module 3: Assessment

Lesson 4

ADHD: Safety considerations

Among adults, the potential for the following should be assessed in determining whether to prescribe a controlled drug such as methylphenidate (Ritalin®):

• Drug-drug interactions (e.g., illicit drugs, alcohol, coffee, energy drinks, colas, and drugs for comorbid conditions)
• Driving risk (Jerome Driving Questionnaire)
• Substance use/abuse
• Diversion of prescribed stimulants

Among children and adolescents, the following safety considerations should be considered:

• Drug-drug interactions (e.g., illicit drugs, alcohol, coffee, energy drinks, colas, and drugs for comorbid conditions);
• Misuse and addiction of controlled drugs and substances among family members;
• Social factors such as victimization potential  for diversion.

The Canadian Centre on Substance Abuse (2016) report on Prescription stimulants state that in 2012-2013, 1.3% of Canadian students in grades 7–9 and 25% in grades 10–12 said that they had used prescription stimulants to get high and not for medical use.

Prescription stimulants are sometimes tampered with in Canada to obtain euphoric effects which may cause blockages of small blood vessels due to insoluble fillers in the tablets, spiking of blood pressure and heart rate because of the rapid onset of effects (Canadian Centre on Substance Abuse, 2016).