Please be aware that Vinland’s residential program has implemented a policy for the Management of Stimulant Medications (controlled substances) for patients with ADHD.
Purpose: To provide guidance on the use of stimulant medications (e.g., Vyvanse, Adderall, Dexedrine, Ritalin, Methylphenidate, and other similar stimulants) in patients with ADHD, while promoting safe, effective treatment and maximizing engagement in therapeutic programming.
Policy:
- Initiation of Stimulants:
- Stimulants will not be initiated for residents during their stay in the program.
- Although stimulants may improve attention and concentration, initiating these medications in the residential setting has been associated with:
- Preoccupation with medication availability, which can interfere with therapy participation and skill development.
- Potential diversion or misuse by residents
- Interpersonal tension among residents, including resentment from those not receiving the medication.
- To support residents with ADHD symptoms, clinicians will prioritize non-stimulant alternatives (e.g., Strattera, Wellbutrin, Guanfacine) and therapeutic strategies to manage attention, impulsivity, and behavioral regulation.
- Continuation of Pre-Existing Prescriptions:
- Residents who arrive with a valid prescription for a stimulant from an outside provider who is aware of their admission and drug of choice may continue the medication as prescribed.
- Residents may reinitiate a previously prescribed stimulant through their ongoing provider with proper medical coordination including the provider knowing about the admission to treatment and the drug of choice.
- Residents will not be started on a new stimulant prescription from a new provider whom they located or saw during their stay in the program.
- Therapeutic Considerations:
- Clinicians will focus on skill-building to manage ADHD symptoms without reliance on stimulants, including:
- Organizational and time management strategies
- Mindfulness and attention-training exercises
- Behavioral interventions to reduce distractibility and impulsivity
- Group and individual therapy sessions will be adapted to support engagement for residents with ADHD, ensuring equitable access and inclusion without requiring stimulant medications.
- Clinical Monitoring:
- Staff will monitor residents for behavioral or emotional difficulties related to ADHD and document interventions and outcomes
- Non-stimulant medications will be prescribed and monitored according to standard clinical protocols.
Rationale: While stimulants may benefit some residents, the risks of diversion, preoccupation with medication, and interpersonal challenges outweigh the potential benefits within the residential program. This policy ensures safety, promotes equitable treatment, and maximizes therapeutic benefit while providing appropriate ADHD symptom management.