Coordinating all aspects of care
In providing the best care for the ADHD athlete, the primary care physician must possess comprehensive knowledge of evidence-based best practices. Educate yourself about all available therapies, including behavioral management and use of psychostimulants. And become familiar with available resources and with the referral network (eg, neuropsychologist).
Acknowledgement of NCAA regulations/restrictions is vital to making treatment decisions. In light of the many regulations (both governmental and within the competitive sporting world), consider the use of nonbanned medications and behavioral therapies whenever possible. Throughout the treatment process, involve all stakeholders—parents, athletic trainers, coaches, teachers—to sustain a collaborative approach to care.
Be attentive to signs of inappropriate use of psychostimulant medication (See “Anticipating and addressing the misuse of psychostimulants” above6,37-40). However, fear of potential misuse is not justification for withholding medication, especially when a clear indication is evident. Failure to recognize ADHD as a legitimate problem puts both academic and social hurdles in the path of the student athlete. Evidence shows that adequately treating ADHD with indicated pharmacotherapy actually reduces subsequent substance abuse.41 Finally, education of every ADHD athlete on existing restrictions/regulations/requirements as posed by governing bodies (NCAA, US Anti-Doping Agency, WADA, and IOC) is imperative.
Adam E. Perrin, MD, Family Medicine Center at Asylum Hill, University of Connecticut School of Medicine, 99 Woodland Street, Hartford, CT 06105-1207; firstname.lastname@example.org