How do you respond to early refill requests for stimulants in stable patients who report lost or stolen medication?   

I do not refill stimulants when they are reported lost or stolen. When starting a treatment course of stimulants with a patient, I review a brief list of instructions and expectations. For stimulants, this includes that it is their responsibility to store and protect their medication from theft or ...

Definitely a case-by-case thing for me. In our clinic, patients sign a controlled substance agreement, and I review these parameters with them. I will often refill enough medication to get a patient to their next appointment and schedule them to come into the clinic as soon as possible. We discuss t...

For me, the key is at the onset of forming an alliance. The doctor and patient agree that stimulants are powerful tools in our armamentarium to manage the core ADHD symptoms. Emphasis on special features of this treatment modality is made at the first visit, which includes special precautions for co...

Agree with the comments, though I believe the approach should be both cautious and individualized. A thorough initial discussion and/or controlled substances contract, and more caution is often very helpful, especially with the younger adult demographic, where diversion is more common. I typically a...

I tell the patient they are entitled to "one lost stimulant prescription per lifetime." This communicates a firm boundary and a bit of helpful humor. It has served well. Vacation early-refills are infrequent in my practice, and I simply type the rationale in the e-prescription. If it requires inter...

I explain to patients when they start treatment with stimulants that they are responsible for their medications. I will not do a refill for “lost or stolen” medications under any circumstances. That results in a few requests for an exception. The occasional request is denied.

Depends upon the severity of ADHD and comorbidities. My usual answer is to wait until next due, but I can refill if in rare, genuine non-repeat cases without active family members with addiction.

I have a small private practice, and most of my patients have multiple diagnoses, including ADHD. We speak about the medicolegal aspects of stimulants throughout our work together. I’ve had no concerns about diversion, but I have had concerns about them missing doses due to having misplaced or...