The protocol for refilling ADHD medication prescriptions has changed in some states, where it is now required to take a drug test to obtain the refill. Agave ADHD Coach Vida Carey walks us through her own experience with the new protocol and shares insights about how to navigate these unsettling situations.
February 2023, Vida Carey, ADHD Coach @ Agave Health
Have you ever had to take a drug test to get your ADHD meds refilled? That was my reality this a few weeks ago. I have been on Adderall for my ADHD for the last six years. I ran out of my meds right before Christmas and wasn’t able to get in to the doctor until this week. I went through the standard protocol of the in-person 15 minute doctor appointment. The PA checks my vitals and then states, “A nurse will be in with your paperwork and your drug test.” At my questioning look she goes on, “Oh, we are changing the protocol. You now have to take a drug test and sign an anti-abuse contract. You only have to sign the contract one time but we will need the drug test every month you come in for your med refill.” What could I say but, “Okay,” I really needed my medicine.
The protocol to receive my medication has changed several times in just the six years I have been taking it. First, it was a once every three months in person appointment. Then COVID hit and it became a once a month video visit. Then it changed to a once every three months in person visit along with monthly video visits. Next, it was back to the once a month in person visit. Now, it is a once a month in person visit with a drug test. Granted I live in Oklahoma and we are behind the curve on many things but this constantly changing protocol gives me anxiety.
The stigma of the added drug test may cause many people to go untreated or under-treated.
Also, this new protocol triggered some feelings I wasn’t expecting to feel. As I read through the Opioid/Controlled Substance Therapy Patient-Provider Agreement I felt a mixture of shame and understanding on each line I initialed. I come from a family of people with addiction problems and the Opioid epidemic is crippling and real, so I understood the need for some kind of protocol and paperwork to make sure we are all on the same page with my treatment. However, having to submit to a monthly drug test makes me feel like I am untrustworthy and doing something wrong. Was I now on some watch list for controlled substances because of my ADHD meds? I have never struggled with addiction problems but was my health insurance going to see these monthly reports and classify me in some shadow banned category for healthcare?
And this is only my own experience. What about people who have struggled with addiction? Regardless of what they struggle with, they should still be able to get treatment for their ADHD symptoms. Would this protocol drive them away from receiving care because of shame and stigma?
Many healthcare clinics are starting to utilize this form of test in their treatment protocol, it isn’t just an Oklahoma thing. Temple University in Philadelphia, PA requires students to submit to a urine test in their ADHD and Stimulant Policy.
Your feelings are valid whatever they may be.
Not all, but many of the commonly used ADHD medicines are controlled substances and with things like Adderall shortages, over-prescription, and increased diagnosis of neurodivergent issues, policies will evolve and change. This is to be expected, however, for a community that receives 20,000 more negative messages than their neurotypical peers by the age of 10, the stigma of the added drug test may cause many people to go untreated or under-treated.
I am one of the lucky ones as I sit here writing this article while medicated. However, this is something the neurodivergent community will have to address together throughout the evolution of more and more regulatory protocols. If you find yourself in a similar situation, know that your feelings are valid whatever they may be. Find a support group, a counselor, a trusted friend, or reach out to an ADHD coach to help you process your feelings. We are stronger together than we are alone.
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