NCAA: Case study on new medical exceptions process

Effective August 1, 2009, the NCAA began requiring stricter documentation procedures for student-athletes seeking a medical exception to allow the regular use of a medication that contains a banned substance.

Stimulant medications commonly prescribed to treat Attention Deficit Hyperactivity Disorder (ADHD), such as Adderall and Ritalin, are among banned substances for which a medical exception for a positive drug test may be granted, provided a student-athlete’s institution presents documentation that those substances have been prescribed by a physician and is supported by a clinical assessment for educational or health reasons.

In order to process a medical exception for a banned stimulant, an institution must be prepared to submit documentation at the time of confirmation of a positive drug test. Otherwise, the student-athlete will be ruled ineligible until the requisite documentation is provided.

Under the stricter application of medical exceptions, documentation for stimulants prescribed to treat ADHD must include evidence that the student-athlete has undergone a clinical assessment to diagnose the disorder, is being monitored routinely for use of the stimulant medication, and has a current prescription on file.

“The NCAA supports the appropriate use of stimulant medication necessary to assist student-athletes who have been diagnosed with ADHD,” said Mary Wilfert, NCAA associate director of educational affairs.

She added that stricter application of the medical exception policy for stimulant drug treatment for ADHD was put in place to assure that medical necessity for the use of stimulants was well documented, and student-athletes were appropriately being monitored by a physician while using these drugs.

“This is a shared responsibility between the member institution and the national office to assure that the sports medicine staff is fully informed and can appropriately advise and respond to student-athletes using these medications,” said Wilfert.

So how has your athletic department handled these new requirements?

We asked Julie Campbell, University of Denver’s director of sports medicine, the same question. Campbell and the DU staff implemented a five-step plan that has worked well for them. While each institution may go about it a bit differently, DU’s plan presented below may provide you with a few fresh ideas as your institution gets used to the new medical exception requirement:

1. Last fall we began an educational campaign for all returning student-athletes. This included education on the reasoning behind the new medical exception process and what is required of a student-athlete taking a banned stimulant for ADHD.

2. Over the summer, we e-mailed all student-athletes who either disclosed they were on meds or were identified on their health history packets as taking banned stimulant meds. They were informed that they needed to contact their prescribing doctors and/or psychologist/psychiatrist to complete the necessary paperwork.

3. We created a cover letter and Exception Form for the students to provide to the respective medical professional.

4. The student-athletes were informed that they would not be cleared for athletic participation until all documentation was received and approved. This way we could ensure that no athlete tested positive per the NCAA without the necessary medical documents in place prior to testing. Using participation as leverage was a great motivator and provided results.

5. We also negotiated a discounted rate for ADHD testing on campus and used the Student-Athlete Opportunity Fund for payment with any students who needed testing and couldn’t afford the test.

This proved to be very effective. Our educational campaign included all coaches and they understood that the student-athletes wouldn’t be cleared for participation without the required documentation. They were instrumental in helping to ensure their respective student-athletes submitted the information.

Our buy-in and compliance have been excellent. This program has been extremely successful.