Prescribing Stimulants via Telehealth Can Save Lives.
KEY POINTS:
The DEA has decided to extend telehealth prescribing.
1 in 10 children has ADHD.
Limiting the prescription of stimulants via telehealth is a major concern.
Individual, family, and group therapy are crucially important for adolescents with ADHD but there are times when rapid access to stimulants is lifesaving.
Children who are prescribed stimulants are no more likely to develop substance use issues than children with unmedicated ADHD.
Telehealth has provided a long list of benefits to adolescents and families with ADHD.
The DEA’s decision on telehealth and stimulants:
The DEA’s announcement that it will extend telehealth prescribing flexibilities for controlled substances (including stimulants) is a welcome start to ADHD Awareness Month.
Why is this important for patients with ADHD?
Nearly one in ten children in the U.S. has a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). Reflecting wider inequities in healthcare, it’s a diagnosis that is more common in black, non-Hispanic children. At Bradley Hospital, the nation’s first specialist pediatric psychiatric hospital, these teenagers fill our inpatient beds and ever-growing wait lists. More than a quarter of children in our intensive programming have a diagnosis of ADHD.
What is ADHD?
ADHD is a complex diagnosis. Very frequently it presents alongside:
other mood disorders
learning disabilities
substance use issues
Early ADHD treatment and diagnosis changes, and even saves, lives.
This is why the DEA’s recent decision to limit prescribing of stimulants via telehealth is so concerning.
How do stimulants help ADHD symptoms?
Impulsivity is a key symptom of ADHD. It’s also a leading risk factor for suicidality. The recent rise in suicidality among teenagers is alarming: recent CDC data shows that ten percent of high school students have attempted suicide and 22% have seriously considered suicide.
Stimulants are the most common medication used to treat ADHD. Individual, family, and group therapy are crucially important for adolescents with an ADHD diagnosis, but there are times when rapid access to stimulants is truly lifesaving. Despite concerns about addiction, evidence shows that children with ADHD who have been treated with stimulants are no more likely to develop substance use issues than children with unmedicated ADHD.
How has telehealth helped patients with ADHD?
Telehealth has been one bright spot in the otherwise bleak landscape of children’s mental health. Forced into providing virtual care by the pandemic, we found that it had huge and unexpected benefits as mentioned below:
The data we gather suggests that children show improvement at similar rates to children in our in-person care.
Families told us that “being virtual was magical” and eliminated much of the hardship and stress involved in attending in-person care at the hospital.
Telehealth has enabled us to expand our unique continuum of care throughout the New England region and into Florida.
Psychiatrists from Arizona to Baltimore now provide therapy and prescriptions for medication to children living in counties where there may be no access to child and adolescent psychiatrists.
The promise of telehealth for individuals and families is the ease and convenience of accessing care, wherever you are.
In many parts of the country, the wait for an in-person appointment with a pediatrician can be weeks long. Coupled with a national shortage of stimulants because of manufacturing delays, this only makes it harder for vulnerable patients to get the medication they need.
Families in rural areas who are already least able to access care would have struggled most if telehealth prescribing had been scaled back, as seemed likely earlier this year.
The promise of telehealth at a systemic level is that it can ease the load for an overburdened workforce in areas of provider shortage. Pediatricians tell us constantly how they are straining to cope with the increased workload relating to children’s mental health, and how little their training equips them for the task they face. Requiring an in-person evaluation to prescribe stimulants would have made things worse for a primary care workforce under pressure.
For the teenagers we care for, access to ADHD medication really is a matter of life and death. We are so pleased that the DEA’s decision to extend flexibilities is in line with national concerns about addressing the mental health epidemic that our young people are facing.
DISCLAIMER:
The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment.
If you or your child are in crisis or experiencing mental health problems please seek the advice of a licensed clinician or call 988 or Kids Link in Rhode Island.
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