ADHD Assessment and Substance Use

 

Completing cognitive testing under the influence of any substance, especially those being used at high doses or those that are used for long periods of time, can impact your cognitive testing results. Taking a prescribed medication for ADHD during cognitive testing may also mask some of your attentional issues.

In the best-case scenario, someone would not be using non-prescribed substances when completing cognitive testing and would also not use a stimulant medication 48 hours prior to their designated testing session. There are cases, however, where this is not possible.

 

If you are using prescribed or non-prescribed substances, please see the guidelines below:

  • If you are being treated for a mental health condition apart from ADHD with a prescribed medication (e.g., mood, anxiety or other mental health condition), we can proceed with cognitive testing. We will simply take note of your current pharmacological treatment.
  • For the use of prescribed medications for the treatment of ADHD: There are different types of ADHD medication, including short-acting and long-acting stimulant medication, and non-stimulant medication. Because different medications work in different ways, we advise you to speak to your family physician about their recommendation regarding whether you should stop taking your prescribed ADHD medication 48 hours prior to your cognitive testing session or not. During cognitive testing, once again, we will take note of your current pharmacological treatment as part of your assessment and proceed with this in mind.
  • If you are using cannabis or a derivative, alcohol and/or other non-prescription drugs, the diagnostician will have reviewed the pros and cons of proceeding with cognitive testing with you. If the use of these substances is very limited and not long-standing, it is likely the diagnostician will have suggested you proceed with cognitive testing and will have confirmed the importance of not using substances at least 48 hours prior to cognitive testing. If you are using a substance regularly and/or have been using a substance for an extended period of time, it is not recommended that you cease using substances for cognitive testing without the aid of the appropriate medical and psychological support. This is especially important with certain types of substances, including alcohol, as decreasing use can be associated with significant withdrawal effects. In these cases, it is recommended that this be discussed with the diagnostician as well as your primary physician.

 

In terms of the usefulness of your testing results if you are using substances, please review the following:

As indicated earlier, completing cognitive testing under the influence of any substance can impact your cognitive testing results (this includes substances that are being used regularly but not immediately before cognitive testing).

For example, if you are using cannabis daily and complete cognitive testing, some of the assessment results may be due to the impact of chronic cannabis use rather than to something else (e.g., ADHD). Or if you are taking a stimulant medication, and your physician has advised you to continue its use prior to cognitive testing, the medication may help you do better than you would if you were not taking this medication.

In each case, you may still proceed with cognitive testing at the discretion of the diagnostician. We will take note of your current pharmacological treatment or substance use as part of your assessment. We will then assess the possible influence of these substances on your performance in the context of all other sources of diagnostic and assessment information, and come up with the most likely explanation for the reported attention and concentration difficulties.

Please note that you will have the opportunity to discuss your specific medication or substance use with the diagnostician you will be working with. Please feel free to reach out to the primary diagnostician if your appointment has already been scheduled and you have additional questions about your next steps.

 

Please note that all recommendations related to the use of prescribed medication or the use of or non-prescribed substances will include a request that you consult with your physician prior to making any suggested changes.