Scouts-L Mail Archive for August of 1999: Re: Getting good medical information
Re: Getting good medical information
Ian N Ford
Sun, 15 Aug 1999 14:19:36 +0100
Hi Kelly ...
You wrote :
>I just had a real bad time where parents told me they were "weaning"
their son from Adderall. I >thought that meant no pills unless it
reached a real need. Turns out the weaning had just begun, >and by Day 5
I had a kid in withdrawal--he'd been getting 20-30 mg. per day and I
cold-turkeyed >him. Put him back on the pills and all was okay again,
With respect, surely you should have insisted on instructions about
medication in writing ? [ " A Scout leader, after obtaining all the
necessary information, can agree to accept the responsibility of making
sure a Scout takes the necessary medication at the appropriate time ...
" Guide to Safe Scouting ] I presume it was listed on his medical form
... that form, with the doctor's and parent's signature on is your
authority to possess a Controlled Drug. If it is not listed on the form
with a doctor's signature at the very least you require a container with
a pharmacy label on it bearing his name and dose. In some states it is a
legal requirement that Controlled Drugs are retained in the container in
which they are dispensed, bearing the prescription control number. It
is good practice to have documentation in the form of the prescriber's
instructions, or at least a letter from the parent, with all medication.
In the case of Controlled Drugs it is essential.
I am surprised a kid needed " weaning " off Adderall ... ADD medications
don't usually result in dependence, otherwise kids would not forget /
refuse to take their medication. " Withdrawal " refers to PHYSIOLOGICAL
effects of cessation of a drug upon which the user is physiologically
dependent. This is very unusual in the case of stimulant abusers, and in
the case of therapeutic doses for AD/HD " cold turkey" must be
exceedingly rare. It is normally associated with NARCOTIC withdrawal -
if by cold turkey you are referring to : gooseflesh, hot and cold
flushes,'flu-like symptoms, twitching and gastro-intestinal upsets. My
understanding is that the symptoms of STIMULANT withdrawal are more
likely to be lassitude and depression. " The return of AD/HD symptoms
on discontinuing medication is not a " withdrawal " phenomenon - it is
the return of the child's normal (for him) behaviour that has been
modified by medication. Think how many kids have a " medication break "
without any adverse effects other than maybe a return of the AD/HD
Did you actually mean " withdrawal " in the true sense ? You are not
just talking about a kid who comes of medication and experiences a
return of the AD/HD symptoms ? A lot of kids have a medication break
over the summer, and if you are used to them on medication for a few
hours or even for a weekend, the difference can be interesting. But that
is essentially a matter of dealing with the behavioural aspects of the
AD/HD, and that comes down to knowing the kid. I personally suggest
that parents leave their kids on medication for camp, because living in
close proximity with others, an unfamiliar routine, etc. can be quite
demanding, but if that is not to be then it just comes down to working
with that particular youngster in whatever way you can.
>You might see if you have a nurse in your unit or district commissioner
>staff, or somewhere in your district who would be willing to come out
>to parents about health forms, disclosure, confidentiality, and the
>consequences of not knowing the full story. Since they are a
>they can ask better questions than I can, and inspire a certain amount
>confidentiality. Perhaps one who has been on summer camp staff, and
>really address the needs of long-term camp. Good luck.
Hopefully as camp leader you have a good relationship with the parents,
if they are trusting you with their sprogs. There is no substitute for
PERSONAL discussion with the Scouts and their parents ... don't leave it
up to anybody else. Part of being the responsible leader for a camp is
that you take personal responsibility for the health, safety and welfare
of those kids. YOU check the medical forms, YOU are the one they need to
talk to. (Generic " you " rather than you personally.)
My own view is that even if the troop are going on a staffed Summer Camp
the leaders in charge of the trip should be trained, and SMF is a
minimum. SMF teaches basic Scouting skills and the principles of youth
protection etc., but in my view it does not cover all the skills needed
to look after the health and welfare of kids in camp. To my mind, those
are skills that are learned as an assistant attending camps with an
experienced Leader, by further informal training, and by discussion with
other leaders, such as we have in this forum.
Ian N Ford
District Committee Member, Mayflower District, Transatlantic Council BSA
Special Needs Adviser, Greenwich District (UK)
DISCLAIMER: I am not a clinician, just a social work student. The above
is based on my undergraduate psychopharmacology course and my own
reading around AD/HD. I stand to be
corrected by others more qualified.