Nonmedical Use of Prescription Stimulants During College: Four-Year Trends in Exposure Opportunity, Use, Motives, and Sources

Center on Young Adult Health and Development, University of Maryland School of Public Health, College Park, MD 20740, USA.
Journal of American College Health (Impact Factor: 1.45). 04/2012; 60(3):226-34. DOI: 10.1080/07448481.2011.589876
Source: PubMed


Examine trends in nonmedical use of prescription stimulants (NPS), including motives, routes of administration, sources, cost, and risk factors.
1,253 college students.
Data were collected annually during academic years 2004-2005 through 2008-2009. Generalized estimating equations analyses evaluated longitudinal trends. Logistic regression models evaluated stability of associations between risk factors and NPS over time.
Almost two-thirds (61.8%(wt)) were offered prescription stimulants for nonmedical use by Year 4, and 31.0%(wt) used. Studying was the predominant motive (73.8% to 91.5% annually), intranasal administration was modest (< 17% annually), and the most common source was a friend with a prescription (≥ 73.9% annually). Significant changes over time included decreasing curiosity motives, increasing overuse of one's own prescription, and increasing proportion paying $5+ per pill. Lower grade point average and alcohol/cannabis use disorders were consistently associated with NPS, holding constant other factors.
Prevention opportunities exist for parents, physicians, and college administrators to reduce NPS.

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Available from: Kathryn B Vincent, Jul 20, 2015
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    • "To assess this, participants were asked " From whom did you obtain the prescription stimulant medication that was misused during the previous 12 months? " Response options were modified from previous works (Ford, 2008; Garnier-Dykstra et al., 2012) and participants could select from the following responses: (1) nonathletic friend from the same college, (2) athletic friend from the same college, (3) current teammate, (4) nonathletic friend from a different college, (5) athletic friend from a different college, (6) parent, (7) brother/sister, (8) boyfriend/girlfriend , (9) other family member, (10) an acquaintance from a different college , (11) an acquaintance from the same college, and (12) a drug dealer. "
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    ABSTRACT: The misuse of prescription stimulants (MPS) has been identified as an adverse health behavior among college students. Because stimulant medication is often taken to increase focus and decrease reaction time, these substances have the potential to enhance athletic performance. However, the role that athlete status (varsity athlete vs. non-athlete) has on MPS has rarely been examined in the college student population. To examine whether there are differences in past-year MPS and MPS-related motivations between college varsity athletes and non-athletes. A sample of 682 (482 non-athletes; 200 athletes) college students between the ages of 18 and 25 completed a paper-based questionnaire to assess MPS, MPS-related motivations, and other potential MPS correlates (e.g., gender, energy drink consumption, tobacco use, heavy episodic drinking). Then, we conducted bivariate and multivariate analyses to examine potential correlates of MPS, including athlete status. Finally, we examined differences in MPS-related motivations between varsity athletes and non-athletes. Overall, 98 (13.9%; 16.6% non-athletes v. 7.5% varsity athletes) respondents reported past-year MPS and varsity athletes were significantly less likely (p<0.05) to do so. Past-year MPS was also significantly associated with energy drink consumption, tobacco use, and heavy episodic drinking in our sample. Concerning MPS-related motivations, athletes more often cited a need to enhance athletic performance as the impetus for their misuse. MPS was prevalent among the sample. Varsity athletes were significantly less likely to engage in past-year MPS and were motivated to do so for different reasons. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Addictive behaviors 07/2015; 51:44-50. DOI:10.1016/j.addbeh.2015.07.004 · 2.76 Impact Factor
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    • "First, college students with a prescription for stimulant medication play a critical role. Not only do these students have a high rate of misuse themselves (Sepúlveda et al. 2011; Rabiner et al. 2009a), but they are also the most common source from which other students obtain stimulant medication to misuse (DeSantis et al. 2008; Garnier-Dykstra et al. 2012). It is therefore important for physicians who provide college students with prescriptions for stimulant medications to discuss the possible consequences of misusing or diverting medication, including potential negative health outcomes and legal consequences. "
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    ABSTRACT: The misuse of stimulant medication among college students is a prevalent and growing problem. The purpose of this review and meta-analysis is to summarize the current research on rates and demographic and psychosocial correlates of stimulant medication misuse among college students, to provide methodological guidance and other ideas for future research, and to provide some preliminary suggestions for preventing and reducing misuse on college campuses. Random-effects meta-analysis found that the rate of stimulant medication misuse among college students was estimated at 17 % (95 % CI [0.13, 0.23], p < .001) and identified several psychological variables that differentiated misusers and nonusers, including symptoms of attention-deficit/hyperactivity disorder, problems associated with alcohol use, and marijuana use. A qualitative review of the literature also revealed that Greek organization membership, academic performance, and other substance use were associated with misuse. Students are misusing primarily for academic reasons, and the most common source for obtaining stimulant medication is peers with prescriptions. Interpretation of findings is complicated by the lack of a standard misuse definition as well as validated tools for measuring stimulant misuse. The relation between stimulant medication misuse and extra curricular participation, academic outcomes, depression, and eating disorders requires further investigation, as do the reasons why students divert or misuse and whether policies on college campuses contribute to the high rates of misuse among students. Future research should also work to develop and implement effective prevention strategies for reducing the diversion and misuse of stimulant medication on college campuses.
    Clinical Child and Family Psychology Review 01/2015; 18(1). DOI:10.1007/s10567-014-0177-z · 4.75 Impact Factor
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    • "While several cross-sectional research studies have found that nonmedical users of prescription stimulants tend to have lower grade point averages (GPA) than non-users (Clegg-Kraynok, McBean, & Montgomery-Downs, 2011; McCabe, Knight, Teter, & Wechsler, 2005; McCabe, Teter, & Boyd, 2006), media reports (Carey, 2008; Talbot, 2009) and some scientific commentaries (Greely et al., 2008; Maher, 2008) have debated the potential benefits of prescription stimulant use for individuals without attention deficit hyperactivity disorder (ADHD) to improve concentration and academic performance. Although these purported benefits have yet to be substantiated scientifically , research with college student samples has shown that the most frequently reported reason for NPS is to purportedly improve concentration so as to enhance academic performance (Clegg-Kraynok et al., 2011; DeSantis, Noar & Webb, 2009, 2010; DeSantis et al., 2008; Garnier-Dykstra et al., 2012; Low & Gendaszek, 2002; Rabiner et al., 2009; Teter, McCabe, Cranford, Boyd, & Guthrie, 2005; Teter, McCabe, LaGrange, Cranford, & Boyd, 2006; White, Becker-Blease, & Grace- Bishop, 2006). Yet the academic motives for NPS contrast with a pattern of other associated behaviors that would appear to impede nonmedical users' of prescription stimulants academic performance, such as spending less time studying, skipping more classes, and spending more time socializing than their counterparts (Arria, O'Grady, Caldeira, Vincent, & Wish, 2008). "
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    ABSTRACT: This study tested the hypothesis that college students' substance use problems would predict increases in skipping classes and declining academic performance, and that nonmedical use of prescription stimulants (NPS) for studying would occur in association with this decline. A cohort of 984 students in the College Life Study at a large public university in the US participated in a longitudinal prospective study. Interviewers assessed NPS; Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) cannabis and alcohol use disorders; and frequency of skipping class. Semester grade point average (GPA) was obtained from the university. Control variables were race, sex, family income, high school GPA, and self-reported attention deficit hyperactivity disorder diagnosis. Longitudinal growth curve modeling of four annual data waves estimated the associations among the rates of change of cannabis use disorder, percentage of classes skipped, and semester GPA. The associations between these trajectories and NPS for studying were then evaluated. A second structural model substituted alcohol use disorder for cannabis use disorder. More than one-third (38%) reported NPS for studying at least once by Year 4. Increases in skipping class were associated with both alcohol and cannabis use disorder, which were associated with declining GPA. The hypothesized relationships between these trajectories and NPS for studying were confirmed. These longitudinal findings suggest that escalation of substance use problems during college is related to increases in skipping class and to declining academic performance. NPS for studying is associated with academic difficulties. Although additional research is needed to investigate causal pathways, these results suggest that nonmedical users of prescription stimulants could benefit from a comprehensive drug and alcohol assessment to possibly mitigate future academic declines.
    Addictive behaviors 10/2012; 38(3):1643-1650. DOI:10.1016/j.addbeh.2012.10.002 · 2.76 Impact Factor
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