What would you do if your doctor asked you to sign a contract the next time you were prescribed medication? Or what if you were required to submit to drug testing? It's happening at some college clinics around the country.
"These are unfortunate kind of barriers for those who need the treatment," said Dr. Ted Grace, director of Student Health Services at Southern Illinois University.
Studies document rampant misuse and abuse of ADHD medication on college campuses.
One student, who asked to not share his identity, explained he didn't get his prescription until his first year of college.
"I had a bunch of friends that were on them and I had taken some of theirs and that helped me," he said.
So, he asked a doctor to write him a prescription.
"I've never sold them, but have given them away,” he said.
That's a problem. Schools are having a hard time keeping up with the demand and the expense for treatment and diagnosis. They're concerned about medical liability.
"Recently a number of campuses have announced that they will no longer prescribe stimulant medication for those students with attention deficit disorder," said Dr. Jerald Kay is with the American Psychiatry Association.
Those schools are leaving it to the student to get their meds back home or off-campus. Other schools say they'll fill prescriptions, but won't do any diagnosing. They base it on the fact that it's been diagnosed in the past."
Still, other schools are making it much more difficult for those already diagnosed, requiring them to sign a contract.
"It states they will notify us if they are prescribed medication by anyone else, if they are on any other addicting kinds of medication that wouldn't mix. They promise that they will not abuse any drugs. They promise not to share or sell their medications to roommates, and importantly they promise to follow through with therapy," Dr. Grace explained.
The contract also gives consent for periodic random drug testing.
"If we think they may be coming in to get a prescription to sell it on the street, that allows us the opportunity to determine that they're truly taking the medication,” said Dr. Grace.
Not everyone agrees these changes are all good. Ruth Hughes heads up the advocacy group Children and Adults With Attention Deficit/Hyperactivity Disorder. She's worried this stigmatizes students.
"We're making it harder and harder for them to have access to good treatment and to have support. You know, if somebody has asthma and has to take asthma medication every day or diabetes or high blood pressure, we wouldn't question their need for medication," Hughes said.
The medical facilitators argue colleges face a tough dilemma. "We need to have these protocols in place, but believe me, our last resort is to turn down somebody we think has ADHD."
Some schools also consider the unauthorized use of the drugs as a form of cheating and failure to meet the school's honor code, meaning students could also face expulsion.
Sharing these drugs is a felony for all parties involved. Western Washington in Bellingham is among the colleges requiring students to sign a contract.