Big transitions can be challenging for all of us. When a student with ADHD heads off to college, this can be particularly true when they suddenly need to manage their use of prescription medications on their own. Numerous studies have reported this finding and we certainly hear many clients and parents report this at CRG, too. A recent qualitative study interviewed 10 first-year college students with ADHD to explore why students struggle to comply with daily use of the ADHD medication. The article, “Adherence to ADHD Medication during the Transition to College” (Journal of Adolescent Health, vol. 60, pp. 706-713) reported five major findings.
“Transitions to independence are often abrupt and many adolescents lack medication self-management skills.” Students reported that their parents had been in charge of their medication compliance in high school, so they had not yet learned how to remember to take the medication on their own.
“Inaccurate disease beliefs, perceived academic demands, and medication side effects were reported to influence volitional nonadherence.” Besides simply forgetting to take their medication, students reported a belief that doing so should no longer be necessary since they had succeeded in getting into college. Others reported that they should only need to take their medications in the evenings while studying (which could then disrupt their sleep cycles).
“Poor self-management had perceived negative implications on school performance.”
Looking back, almost all of the participants regretted their poor academic performance during their first semester and concluded that their inconsistent use of medication (or decision to stop medication usage altogether) had a strong influence on their GPA.
“Pressure from peers to share medication was perceived as frequent and could negatively affect social functioning and adherence.” This pressure frequently increases during exam periods. Students are encouraged to keep their prescription medications in a locked box hidden from sight. Parents should talk with their young adults about how to handle the peer pressure that can be created by other students’ desire to buy a pill from them.
“Social support was expressed as a perceived need.” Students in this study expressed a desire to meet other students with ADHD, particularly older college students who had learned how to manage their needs in college. Similarly, students expressed a desire to work with campus professionals with knowledge who could help them during the transition. Only 4 of the 10 participants had registered with the Disability Services office.
College students with ADHD (or related disorders such as anxiety and depression) can utilize simple techniques to remember to take their medications. What may be a necessary first step, though, is to educate them with factual information about why these medications have been prescribed and how they can help with the increased attentional, organizational, mood and learning demands in college.