Stimulant Medication Policy

1. Scope

This policy applies to all patients receiving short-acting and long-acting stimulant medications at Rockwise Medical. Particular focus is on short-acting formulations due to higher diversion potential.

2. Assessment Before Initiation

• Confirm diagnosis according to accepted clinical guidelines (e.g., ADHD, narcolepsy).
  
  

• Conduct a thorough medical and psychiatric history, including:
  
  

• Baseline vital signs and weight; ECG if cardiovascular risk present.
  
  

• Discuss risks, benefits, and alternatives with the patient/caregiver.

3. Prescription Guidelines

• Short-acting stimulants: prescribe smallest effective quantity (e.g., ≤30-day supply).
  
  

• Prescription frequency:
  
  

  • Initial: often weekly to monthly follow-up recommended.
    
    

  • Maintenance: review every 3 months; consider longer intervals if stable.

• • Short acting stimulants will be prescribed with weekly dispensing or shorter at the discretion of the treating physician
    
    

• No automatic refills; require office visit or telehealth follow-up to renew.

• Long-acting formulations are preferred and will be trialed prior to initiating short-acting stimulants unless there is a documented clinical rationale for starting with short-acting

4. Safeguards

• Patient Education:
  
  

  • Expected to maintain appropriate storage (locked, out of reach of children or roommates)
    
    

  • In no way must you share or sell stimulant medication
    
    

• Prescription Monitoring:
  
  

  • We will check NL prescription monitoring program (Pharmacy network) before initiation and at each refill as mandated by the government
    
    

  • We will document rationale for dose changes
    
    

• Monitoring for Misuse:
  
  

  • We may request pill counts or pharmacy refill confirmation if concerns arise
    
    

  • We may monitor for early refill requests, lost prescriptions, or requests from multiple prescribers

5. Follow-Up & Monitoring

We will monitor on an ongoing basis: 

• Efficacy: symptom tracking (ADHD rating scales, functional improvements)
  
  

• Side effects: appetite, sleep, mood, cardiovascular symptoms
  
  

• Diversion risk assessment at every visit
  
  

• Physical assessment: vitals, weight, BP, heart rate

Dr. Aaron Wiseman, Rockwise Medical

Revised: August 30, 2025

admin@rockwisemedical.com

709-979-1490