Objective: This cross-sectional survey study examines the link between ADHD medication misuse and a positive screen for adult ADHD symptoms. Method: Surveys from 184 college student volunteers in Northern Virginia are collected and analyzed. Results: A total of 71% of ADHD stimulant misusers screen positive for ADHD symptoms. Misusers are 7 times more likely to be symptomatic for ADHD than those who do not misuse. Also, 87% of misusers indicate that they do so for academic reasons, and 76% believe that the misuse of the ADHD stimulants improve their grades. Conclusion: ADHD stimulant misuse in college students is found to be strongly linked to having symptoms of adult ADHD. The desire for cognitive performance enhancement in college students may be a form of self-treatment for undiagnosed ADHD. College students need more accessibility to medical diagnosis and treatment of adult ADHD to reduce the incidence of misuse in the future. (Contains 3 tables and 2 figures.)