Avoiding the October Surprise

Tomorrow is the first day of school for New York City students, but their older siblings and friends at college likely started classes days or weeks ago. College students who are new to campus living need to adjust to a wide array of  "self care" responsibilities. These are things that used to be done with parental support or, at least, parental awareness. They include getting adequate sleep, eating well, avoiding dangerous situations, and staying up-to-date on assignments.

One responsibility in particular can make or break a student's chance of success in college: maintaining his or her medication regime. Students who require medication, whether to treat a health condition, a mental illness, or AD/HD, have likely been taking these medications regularly, perhaps reminded by or assisted by their parents. They have parental help with obtaining prescriptions, including making appointments with their doctors, knowing about their drug plan coverage, and getting refills (in general, controlled substances - which include most medications for attention and psychiatric conditions - require that the patient be seen by the prescribing physician at least every three months), and monitoring side effects. Parents can often tell when their adolescent is not taking prescribed medications just by observing how they feel and behave.

Not infrequently, when a student arrives to begin college, they are eager to assert their independence and might decide they don't really need their medication. Or, they may have the best of intentions to continue their medication regime, but become distracted and don't follow through with taking their meds regularly.

Why do we call this the "October Surprise"? We first heard the term from a colleague who was describing a regular experience in her legal practice, when parents would call her and report that their college student suddenly was failing, or in the infirmary, or decided they couldn't handle college. Why? After some investigation, many of these students had stopped their medications as soon as they got to school. Since most of these medications don't stop working immediately, it took until late September or early October for them to be fully out of the student's system and for the student to feel the full effects of functioning without needed medication. Hence, the surprise in October.

College students may not realize that there is no opportunity for a "do over" in college. If a student fails a course, that "F" is there forever, impacting his or her GPA. I've sat with more than one set of parents who sought guidance in what they could do once their child has failed several courses and have been able to offer little solace.

Families need to begin when a student is in high school to create medical independence, but it is not too late to speak to a college student to make sure he or she has the tools to manage their medication. Students need to understand their medical or psychiatric conditions, know what medications they are taking and why, and how to keep their medication secure from those who would like to try their attention meds to "help" them study. Your student needs to understand that in addition to the legal and ethical issues involved, ADHD stimulants are called “controlled substances” because of their potential for side effects. They can do harm to individuals who are not under the supervision of a physician. Your son or daughter should know how to obtain more medication when they need it -- even if that means letting a parent know rather than making arrangements for a refill themselves.

Speaking with your student about his or her medications, the importance of taking them, and when and how to reach out for additional medication or to report problems is an important part of college readiness and can make a real difference in college success.


Photo by Sharon McCutcheon on Unsplash