For the first time, the NCAA Study of the Substance Use Habits of College Student-Athletes will include questions about the use of medications designed to treat Attention Deficit/Hyperactivity Disorder (ADHD).

The study, conducted every four years, is designed to identify areas that need additional attention from the NCAA and its Committee on Competitive Safeguards and Medical Aspects of Sports (CSMAS). Survey results will be released in 2005.

Attention Deficit Disorders (ADD) and ADHD are neurological conditions that manifest themselves through developmentally inappropriate attention skills, a lack of impulse control and hyperactivity. Stimulants used to treat ADHD and ADD are banned by the NCAA, the World Anti-Doping Agency (WADA) and the U.S. Anti-Doping Agency.

However, student-athletes who can demonstrate a medical need for the substances can be granted a medical exception by the NCAA once they test positive for the drugs. To be considered for a medical exception, a student-athlete using stimulant medications for ADD or ADHD must inform the sports medicine staff, so that if and when a student-athlete tests positive for the stimulants, the institution has prior notice of the medical condition and can assist in requesting the medical-exception review.

Michael Krauss, team physician for Purdue University and a member of the CSMAS, said without this medical need, stimulants can be perceived as performance-enhancing drugs, so special medical documentation of a student-athlete's ADD or ADHD diagnosis is required.

In athletes without the condition, the stimulants could provide an extra rush of adrenalin, a boost to alertness and/or increases in heart rate and blood pressure, Krauss said. Those effects aren't necessarily found in student-athletes diagnosed with ADD or ADHD.

"People with ADD have deficits in concentration and task completion," Krauss said. "If you had a rush of adrenalin, you could be focused on one thing. The stimulants provide the ability to focus and complete tasks."

CSMAS member Donald Kaverman, athletics director at Southeast Missouri State University, said he believes student-athletes should not be penalized for something out of their control.

"The NCAA is composed of member higher education institutions and, as an organization, needs to be sensitive and responsive to the needs of individual student-athletes," he said. "The fact that a student has ADHD should not preclude them from seeking appropriate treatment and participating as an intercollegiate athlete."

The committee decided to include questions on the survey to determine the incidence of ADHD and the specific medications used by students with this diagnosis to provide baseline information about the number of students using the drugs. Krauss suspects the number is growing as more and more young people are diagnosed with the disease.

"I certainly think these drugs are more commonly used than they were," he said.

Also, the issue is gaining more attention as it becomes evident that ADD and ADHD do not always disappear as a young person matures into adulthood as was once believed.

Krauss said he doesn't believe the stimulant use creates any advantage for student-athletes diagnosed with either condition.

The NCAA medical-exception protocol directs student-athletes to consider non-banned medications first. But in the case of ADHD medications, the CSMAS has determined that a new non-stimulant treatment for ADD and ADHD in adults has not been demonstrated to provide the same effectiveness as the stimulant medications do for young adults. The committee's recommendation is that the decision to use either medication be made in consultation with the student-athlete's physician.

Athletes who have been diagnosed and are being treated for ADHD are not exempt from being drug tested and must undergo testing for all banned substances at both the NCAA and international levels.