Ask the Experts

Managing ADHD Medication in College

College students with ADHD may struggle to manage their medications on their own. Here, Dr. Larry Silver offers advice on how to manage your prescriptions while away at college.

Your teen with ADHD will be graduating from high school soon and heading off to college. The get-ready-for-college list is long, but here are important questions to add: Have you made sure that your teen truly understands ADHD and how it affects them? Have you explained how medication helps and how to use it properly? How you effectively shifted the responsibility for taking and managing medication to them? If you answered yes, you are ahead of the game. If not, you have work to do.

If your teen runs into ADHD treatment problems at college, they should know that they can call or text you for help. But this is a short-term solution. At college, your teen should know how to solve medication problems, and talk with you only as a last resort.

If your child is leaving for a college far away from home—and your prescribing physician—share with them these key strategies for navigating the difficulties of managing mediation in college.

ADHD college medication strategy #1: Develop a medication routine.

Taking medication was easy in high school: An eight-hour capsule in the morning covered classes, and a four-hour tablet in the afternoon covered homework. This model won’t work in college. You will need to target your medication to be effective when you need it. If your son or daughter is hyperactive and impulsive, he or she may need to be on medication all day, every day. If he or she is trying to manage distractibility, inattentiveness, and executive function problems only during classes, his or her medication schedule may vary with the daily class schedule.

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On some days, your child might take an eight-hour tablet in the morning to cover classes and work time, chill out in the afternoon, and then take a four-hour pill at 8 p.m. to allow for focused study time. On other days, your college student may need coverage straight through. It’s also up to them to monitor the drug’s effectiveness and side effects, and to refill the prescription as needed. Discuss a comprehensive medication plan with your primary care provider.

ADHD college medication strategy #2: Anticipate refill needs.

Your college student must be able to monitor their own supply of ADHD medication and plan to get refills on time. There are two options: working with your family physician or using Student Health Services at college. You should explore the logistics of both.

If you decide to use your family physician, discuss it in advance. If your teen will be attending college locally, they should be able to get refills during winter and spring breaks and during summer vacation. If they will be going to school out of state, check to see whether the prescription written in your home state can be filled in the state where they are attending school. If it can’t, you will have to fill the prescription locally and mail the refill.

Using your family doctor will require logistics. Talk it over with your teen and decide how and when they will alert you that refills are needed in time to fill the prescription and ship it off.

[Click to Read: Graduation Daze: 6 Ways to Smooth the Transition from High School to College]

If you decide to use Student Health Services (SHS) to help manage the medication, your family physician will need to write a letter to SHS. Present this letter in the spring or over the summer before school starts, and make sure that SHS confirms, in writing, that it will handle the medication for your student before he heads to campus. Most college SHS departments require meeting with the student briefly when picking up a refill, so your student will have to make an appointment to get his medication.

ADHD college medication strategy #3: Take medication only as prescribed.

The prescribed dosage is the amount determined to be the most effective for your teen’s individual brain chemistry. Make sure they know that taking more won’t enhance the drug’s effectiveness. If they feel it’s no longer working, alert your doctor together.

Be sure that your college student understands how medication helps, how long it takes to start working, and how long it lasts. Learning more about how medication works and impacts the ADHD brain will help them understand why it is essential to take the right dose. Talk to your prescribing physician, or read more to inform yourself about medication dosage, and encourage your teen to do the same.

ADHD college medication strategy #4: Watch for shifting side effects.

Side effects of ADHD medication can impact your college student differently when his or her lifestyle changes — going to college is a great example of one of those changes. Arrange for a meeting with your doctor to explain potential ADHD medication side effects and what to do if new ones occur. Encourage your teen to monitor what they are feeling and take notes to help you make informed next steps.

Parents, you should be the first one your college student calls to discuss side effects in college. From there, you can help your teen decide whether to go to your family physician or to SHS for help.

ADHD college medication strategy #5: Don’t share ADHD medication. Ever.

Sharing medication is officially called ‘medication diversion,’ and it’s against the law. Plus, stimulants may be harmful to people who are not diagnosed with ADHD. Let your son or daughter know about the dangers of sharing medication so that they don’t make this ‘harmless’ mistake.

It is surprisingly common for students without ADHD to steal medication from those who are taking it. This is especially true for Adderall. You should encourage your college student to keep his or her medication safely locked in his or her room and never give it to anyone. Look into lockboxes or safes that you can fit under their bed. Some college students carry their medication with them so it’s not accessible to others.

Tell your son or daughter that if someone steals their medication, they should alert college security immediately.

ADHD college medication strategy #6: Limit alcohol consumption.

Stimulant medications amplify the effects of alcohol. The bottom line? Individuals with ADHD will get inebriated sooner. Instead of avoiding alcohol — partying is part of college, after all —drink less, which is always a good idea.

For some teens, the best advice is to not take medication when they plan to imbibe. For others, though, being off medication leads to problems — impulsive decisions or out-of-control behavior. Arrange a chat with your doctor to determine the best strategy for your teen that is both practical and safe.

Use academic breaks and time away from college to evaluate your medication management plan, and work with your college student to troubleshoot problems as you go. Thinking ahead and planning well will ensure that your time in college will be calm and successful.

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