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Medication Management in College

It takes practice, so high school is the time to start

Writer: Rae Jacobson

Clinical Expert: Allison Baker, MD

en Español

Let’s be honest. One of the highly anticipated pleasures of going to college is escaping parental oversight. College is a time for kids to try out living on their own, and we want them to enjoy their new freedom.

For some kids it will be a rocky transition—there is a lot to learn about taking care of yourself, not to speak of college-level schoolwork. And for kids who are taking medication, part of being independent means being responsible for managing their meds.

The first year of college is not a good time for kids to go off medication that’s been working—because they’re careless or they’re experimenting. Making sure your child has the knowledge and preparation to maintain her own medication regimen can mean the difference between a strong start and a hard landing.

Begin early

The first weeks of college are full of new information. Just trying to remember where your classes are, let alone figuring out a totally new schedule, is a lot to handle. In short: Not the time to start figuring out how to manage medications.

Instead, help kids start building skills well in advance so that by the time freshman year arrives, the habits are old hat. “My approach starts well before college,” says Allison Baker, MD, a child and adolescent psychiatrist.

Dr. Baker recommends that beginning junior year kids start learning to manage their own medication. “When kids are comfortable and familiar with managing their own meds, including calling the pharmacy or their therapist to ask for a refill, they’re much more skillful and likely to maintain good practices when they get to college.”

Get organized

The first step is to foster independence by putting kids in charge of making sure they take their meds everyday, but with safeguards in place:

  • “To start with, I ask families to get one of those days-of-the-week pill minders,” says Dr. Baker. “Then I have the kid dispense their own medication for the week. That way parents can check to be sure the meds have been taken.”
  • Smartphone alarms are great for meds that need to be taken at a certain time of day. Use a unique tone for the reminder so it can’t be overlooked or mistaken for a call or text.
  • Make them hard to miss. “Try putting the pills right by your toothbrush,” suggests Dr. Baker. “Or by anything you know you’ll use everyday.” The harder they are to miss the easier they are to remember.

Drinking and medication

College is a time for socializing and experimentation, and a lot of the time that means parties and other gatherings where drinking is the norm. For kids who take medication that reacts badly with alcohol, this can be a serious issue. Having a conversation about making responsible choices is vital. For starters, kids need to know if their medication will make alcohol affect them more than it does other kids.

“I do a lot of education around what happens if you’re on various medications and alcohol comes in the mix,” says Dr. Baker. “I explain that some medications potentiate the effects of alcohol, which means you’ll get drunk much more quickly than your peers.”

Discuss the dangers of mixing medication and alcohol, but don’t be sensational. “Be realistic,” says Dr. Baker. “Be transparent and above board. Fear tactics don’t work. So it’s not saying ‘You can never, ever have a beer at a frat party,’ but thinking about ways they can take care of themselves and still have a college experience. ”

Drugs and dangers

Taking drugs without a prescription is dangerous for anyone, but can be even more so for kids who are already taking medications. It’s important to talk to college students about why they should not take other drugs.

Be frank and specific about the potential for harm: “Smoking pot is bad for you” doesn’t hold the same weight as “Smoking pot could cause a serious reaction with your medication in the following ways…” Having details and clear reasons to fall back on can help kids make good decisions when potentially dangerous situations arise.

No sharing: It’s no secret that some medications, particularly stimulants, are in demand on college campuses. The practice is so common that sharing or selling medication can seem like no big deal. Talk to your kids about the consequences of sharing their prescription medications. Among the big ones:

  • Taking other people’s meds can be really dangerous. Medications have different effects on different people. That’s why you need to go through a trained professional for a prescription. If someone is taking conflicting meds or has a bad reaction, they could be hurt or even killed.
  • If you are caught sharing or selling meds you could be kicked out of school or face legal action.
  • You just don’t have enough! “There is a good reason that refills are timed,” says Dr. Baker, explaining that she has a hard policy against writing refills before they’re due. “You have enough pills to last you. It helps to discourage sharing and can be a motivator to be cautious about losing or misplacing meds.”

Parental worries

According to Dr. Baker, one of the most important factors in kids feeling competent and independent on the way to college is the way their parents handle the transition.

It’s natural to feel worried when kids go off to school, especially when a kid has struggled with mental illness or learning disabilities, but parents must learn to manage their own worries about kids leaving the nest. This includes—but certainly isn’t limited to—letting kids handle their own meds.

“A lot of parents are anxious about transferring the locus of control,” says Dr. Baker. “And when parents can’t give up control, it becomes harder for kids to learn independence.” Dealing with your own fears and worries about a kid leaving for college is healthy and will have long-term benefits for both you and your child.

Sometimes that’s easier said than done, however. If you’re having a hard time letting go, try building some strategies of your own to help you through the rough patches.

Have faith

Once the car is unpacked and it’s time to say goodbye, let your kid know you have faith in his abilities. “Trust that kids don’t want to get depressed again, or fail or start having panic attacks. Likewise, they don’t want to harm someone else or get in trouble with the law,” says Dr. Baker. “Most kids are motivated to do the things they have to do to stay safe, and do well.

This article was last reviewed or updated on October 30, 2023.