ADHD and Behavior Management

Here's an email I got that was quite challenging. Any ideas?

I just signed up for your program and then left town for a few days so I have not heard or read everything about this program. I currently use a check mark system with rewards so I am wondering if your program is a duplicate of what I am currently using. My question I have for you....I have 2 severely ADHD students in my classroom. One is well maintained on a patch, but recently family was trying to go back to a daily pill and the room was disasterous because the pills were not working and this one child was very defiant and beligerant. The student was eventually sent to the office and sent home, but to the question....

How much can I/should I/hold these ADHD students responsible for when their medication is forgotten or for whatever reason not working? They are extremely disruptive, but truly have no control over the tics, movement, noise, etc. that comes about when unmedicated. Do they get the same treatment as another child who is usually controlled but acting out, or is ADHD this severe treated as an "illness" (turrets, epilepsy, etc that are dependent on meds to control themselves). Please let me know your thoughts.....I feel my room is managed well on a normal basis, but when these ADHD students are "off" it throws everyone into a spin.

Any thoughts?

Darren