Objective: We examined how college students manage ADHD medication and how beliefs regarding the medication and attitudes of friends and families influence adherence on weekdays and weekends during an academic semester. Method: Undergraduate students (n = 53) responded to an online survey to report their adherence, their beliefs about the effects of the medication, and their perception of important others’ views of adherence. Results: Students chose to take more medication on weekdays than weekends. On weekdays, beliefs that the medications enhance academic performance and social skills influenced adherence, and on weekends, beliefs regarding negative side effects were important. The perception that medication leads to a loss of authentic self reduced adherence at both times. Generally, students believed that important others wanted them to take medication. Conclusion: Students were actively weighing the costs and benefits of taking their ADHD medication and consciously adjusting adherence levels from day to day.