You Suspect Your Patient’s Parent is Using His Medication

You have an adolescent patient with attention-deficit/hyperactivity disorder and prescribe Adderall for him. You become aware that one of your patient’s parents is demonstrating increasingly strong mood swings, is more anxious and irritable, reports an inability to fall asleep and stay asleep, and has had quick weight loss. You also become aware that this parent frequently calls for medication renewals for her child because she says she spilled the medications into the sink when she opened the container, the pharmacy dispensed fewer pills than ordered, or the family will be out of town on vacation when the renewal is due.

You are also concerned that the patient’s symptoms are not controlled well in the school setting, and he also reports that his mother does not give him his medication every day.

You suspect that your patient’s mother may be taking his Adderall. Now what can you do?

First, address your concerns with your patient’s mother. Be calm, understanding, and open. Expect a range of responses from her, from adamant denial and anger at being accused of stealing the medications to her revealing that she has been taking the medication in her desire to be the “perfect mother” because the Adderall gives her the “energy to get everything done.”

If she admits to taking the Adderall, the next step is to ask why and attempt to understand her motives so that you can decide whether further actions are needed. Here are some risk management points to consider:

As with all prescribed medications, you have the responsibility to educate the patient and parents on the purpose, side effects, and appropriate monitoring to ensure that the patient is getting the medications and treatment recommended. You also have the responsibility to monitor the patient’s use of the prescribed medications and the renewal process to promote safe patient care. ■

This information is provided as a risk man-agement resource and should not be construed as legal, technical, or clinical advice. This infor-mation may refer to specific local regulatory or legal issues that may not be relevant to you. Con-sult your professional advisors or legal counsel for guidance on issues specific to you. This ma-terial may not be reproduced or distributed without the express, written permission of Allied World Assurance Company Holdings, AG (“Al-lied World”). Risk management services are pro-vided by or arranged through AWAC Services Company, a member company of Allied World.