No, medicating my child’s ADHD is not the easy way out

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Alternately titled:  Things I wish I knew about ADHD medication before we started medicating

I am unabashedly pro-medication when it comes to treating ADHD. I am pro-medication because it has worked for my child, in conjunction with other therapies. Nothing gets me angrier than misconceptions and myths surrounding the subjecting of medicating for ADHD.

There’s this prevailing attitude that kids aren’t allowed to be kids anymore: that parents who are medicating for ADHD are just lazy or unwilling to provide structure and discipline for their kids.

Maybe this is true. But I haven’t found any of these lazy parents. Instead, what I have found are parents desperate to see their child succeed and found medication to be a part of that.

That said, ADHD medication isn’t one magic little pill that fixes everything. Rather, ADHD meds come with their own set of unique challenges for which I definitely wasn’t prepared.

Believe me, if discipline worked…if spanking worked…if less sugar worked…if going gluten free worked…if sticker charts and visual schedules worked…then I would be thrilled to say goodbye to all the trips to CVS and hello to a bit more sanity.

Medicating for ADHD is IN NO WAY the “easy way out.” Here are some of the challenges that come along with medicating for ADHD:

The whole “controlled substance” thing is no joke.

If you use stimulants to treat ADHD, you need to know that most of these medications are classified by the federal government (at least in the US) as Schedule II controlled substances because of their high risk of addiction and substance abuse.

This doesn’t mean that kids who take ADHD medications will turn into drug addicts, although people will tell you this.

What this does mean is that there are a lot of restrictions in place for who can receive these medications, how they get them, and when they can have them filled.

This means that you have to show an ID every time you pick up the medications for your child. This – by far – is the least of your hassles, but still worth mentioning.

This means that there’s no extras for oopsies. If you or your child loses or misplaces the medication, you are screwed until your refill date.

This means that you might find yourself taking apart a car booster seat to dig medication out of it because it was dropped.

This means that if you are using a liquid stimulant, and you spill it, you are screwed until your refill date. Even if you are at the CVS pharmacy counter and the pharmacist sees you spill it. #truestory #askmehowIknow

This means that there are no early refills. Get used to finding the closest CVS or Walgreens when you are on vacation!

This means that the way you distribute medication between school and home (if your child takes medication at school), and you misjudge how much you need – or other things alter the schedule like your child missing school due to illness or weather – that you may have to run to school to “borrow” medication from your school stash to get through until your refill date.

Medication at school comes with its own set of hassles, but is often necessary.

We didn’t always distribute medication at school, and we don’t currently, but we have in the past. Here’s a few things you need to know about medicating at school:

There’s some paperwork.

As if you didn’t already have enough, there is paperwork that has to be taken from the school to the doctor, filled out, and then returned to school. Here in North Carolina there is a one-page form for every medication.

Medication has to be WALKED INTO the school and handed to staff personally. This might be a no-brainer to some of you, but for me it wasn’t. When Ezra was in kindergarten, I sent in a refill of medication in his backpack assuming his teacher would get it out when she got out his homework binder. But somehow between dropoff and that moment, Ezra took it out of his backpack and lost it and THE WHOLE SCHOOL STARTED FREAKING OUT because there was lost medication in a school of 800 some-odd children and it was all my fault.

The medication was thankfully located swiftly and no one died, unless you count me dying of embarrassment. Let’s just say that’s a mistake I never made again.

We will get to medication trials and changes in a minute, but any time there’s a change in medication, the school also has to be notified and paperwork updated. This means you need to get to know your school nurse well! 

School and medication also means that you have to rely on behavioral reports from your child’s teachers to get an accurate idea of how the medications are (or are not) working.

The way your child’s body reacts to the medication will change over time.

As the child grows, so does the brain. And this means that sometimes you need a medication increase, or even a change. This means frequent trips to the psychiatrist or prescribing physician. With stimulants also come weight checks to make sure the child is gaining weight appropriately.

Our son was on varying versions of methylphenidate (the active ingredient of the vilified Ritalin), but went through several increases in the last three years. Unfortunately, around the beginning of this year (2019), everything seemed to quit working. He was struggling in school, struggling with reading, and a lot to handle at home. We decided (with his psychiatrist) that it was time for a change.

Over the last two months, we have tried four other medications only to have severe sleep disturbances and an increase in anger and aggression. We went through about four weeks where Ezra only slept through the night a handful of times. I also was constantly in and out of his school trying to make sure the nurse, his special ed teacher, and his regular ed teacher were all aware of what we were changing, and why. I even wrote a 1-page letter to them documenting the saga. With some of the medications we tried he DID take meds at school, and other medications we tried were supposed to last long enough so he DIDN’T take meds at school.

After having such negative reactions to the medication switch, we switched back to the methylphenidate and are on day 3 of Focalin, which seems to finally be the “sweet spot.” (Holding my breath it stays that way!)

Which leads me to the next challenge:

Not all medication of the same ingredient is created equally.

I understood the basics of medicating for ADHD when his developmental behavioral pediatrician walked us through the options when Ezra was five. Our options have expanded since then (now that he can swallow his pills). I understood that there was methylphenidate (Ritalin) and dextromethorphan (Adderall). But much like the acetaminophen and ibuprofen of the pain-management world, it’s not as simple as one or the other.

When it comes to “extended-release” (also known as “delayed release”) medication, certain medications (such as names like Concerta, Daytrana, Focalin, Metadate, etc.) contain the same ingredients but release different percentages of the medication at different times.

I found this chart to be INCREDIBLY helpful and have referenced it a lot over the last few weeks: Chart Comparing Popular ADHD Medications.

So if one doesn’t work, there are others to try – something that was both comforting AND very overwhelming to me.

Insurance helps, but also causes headaches.

We were really blessed to have Medicaid for the first few years we were medicating for ADHD. This meant our medications were pretty much free for us. Now, the costs are much higher. We have decent health insurance, but there are still copays (upwards to $85 for a 30-day supply…and even higher for meds to which we said, “No thanks, we can’t afford that!”).

For one particular medication (Concerta) our insurance WOULD NOT PAY for the generic. We had to get the name brand, which was more expensive. I don’t know why. 

Every time you try a new medication, you have to pay. This means if you are trying a lot of medications over a short period of time (like we did recently), be prepared to shell out some money!

If you are in a good routine with medications that you know are working, using a mail-order subscription for a larger supply (such as 90 days) through your insurance company can save you some money (not to mention all those monthly or twice monthly trips to the pharmacy). It can be a bit of a jumping-through-hoops game to set up, but worth it if you can!

Using technology makes everything easier.

• MyChart: If your psychiatrist is integrated with MyChart, it’s totally worth the hassle to set up to be able to communicate quickly and efficiently. MyChart is available on desktop as well as mobile app.
• Your pharmacy’s mobile app. This makes it very easy to receive notifications about when medication was filled and can be filled again. We use CVS, and I have found the app to be really handy in knowing when medication is in the process of being filled.
• Speed dial and menu prompts: add your pharmacy’s and physician’s contact information to your favorites or speed dial, with a comma and then the extensions you also need to dial. This saves you from having to listen to ALL of the menu options every time you call.
  • Here is a more detailed explanation of this process for iPhone and Android devices.
• Track medication dosages, times, and efficacy with the multitude of medication management symptom tracker apps available:
  • Medisafe – Pill & Med Reminder
  • Pill Reminder – All in One
  • Pill Monitor: Drug Minder
  • Autism Tracker Pro

You can also go old-school with keeping a record on your own with pen and paper or using a spreadsheet. Watch this video below to see how I’ve been using iPhone screenshots to track my son’s medication progress throughout all of these changes:

Medicating your child’s ADHD can feel like a part-time job some days. This is why I say that medicating is totally NOT the easy way out for parents. If anything, it’s harder. But if it allows your child to lead a successful life and be the best version of himself he can be, then it is totally worth it.