Medical use, illicit use and diversion of prescription stimulant medication. J Psychoactive Drugs

Substance Abuse Research Center, University of Michigan, Ann Arbor 48105-2194, USA.
Journal of psychoactive drugs (Impact Factor: 1.1). 04/2006; 38(1):43-56. DOI: 10.1080/02791072.2006.10399827
Source: PubMed

ABSTRACT The objective of this study was to examine the prevalence and factors associated with the illicit use of prescription stimulants and to assess the relationship between the medical and illicit use of prescription stimulants among undergraduate college students. A Web survey was self-administered by a random sample of 9,161 undergraduate students attending a large public midwestern university in the spring of 2003. A total of 8.1% reported lifetime illicit use of prescription stimulants and 5.4% reported past year illicit use. The number of undergraduate students who reported illicit use of prescription stimulants exceeded the number of students who reported medical use of prescription stimulants for ADHD. The leading sources of prescription stimulants for illicit use were friends and peers. Multivariate logistic regression analyses revealed several risk factors for illicit use of prescription stimulants such as being male, White, member of a social fraternity or sorority, Jewish religious affiliation, and lower grade point average. All of these characteristics were also related to medically prescribed use of prescription stimulants. Those who initiated medically prescribed use of prescription stimulants for ADHD in elementary school were generally not at increased risk for illicit use of prescription stimulants or other drugs during college as compared to those who were never prescribed stimulant medication. The present study provides evidence that the illicit use of prescription stimulants is a problem among undergraduate college students, and certain subgroups appear to be at heightened risk.

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Available from: Sean Esteban McCabe, Mar 16, 2014
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    • "In order to examine the expectancy challenge as a prevention effort, inclusion criteria required that participants report lifetime nonuse of any prescription stimulant medication, though they also were required to endorse at least two relevant risk factors for NPS. These risk factors included involvement in a fraternity or sorority (McCabe et al., 2005; Shillington et al., 2006), GPA below 3.5 (Teter et al., 2005; McCabe et al., 2006), at least one episode of binge drinking in the past 2 weeks (Herman-Stahl et al., 2007; McCabe et al., 2005; Shillington et al., 2006), and past-month cannabis use (McCabe et al., 2005). The remaining eligibility criteria included age between 18 and 25 years and current enrollment in college, which are additional risk factors for NPS (Johnston et al., 2005; Kroutil et al., 2006). "
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    ABSTRACT: BACKGROUND: College students continue to report nonmedical prescription stimulant use to enhance alertness and concentration. Despite increasing prevalence of this behavior, techniques for preventing or treating it are lacking. An intervention that focuses on challenging positive consequence-oriented beliefs about prescription stimulants may be efficacious in preventing use. METHODS: The current study examined the efficacy of a randomized controlled expectancy challenge intervention to prevent nonmedical prescription stimulant use among 96 at-risk, stimulant-naïve college students (i.e., low grade point average, Greek involvement, binge drinking, cannabis use). Forty-seven participants completed a brief expectancy challenge intervention aimed at modifying positive expectancies for prescription stimulants, to consequently deter initiation of use. The remaining participants received no intervention. RESULTS: The expectancy challenge successfully modified expectancies related to prescription stimulant effects. Nevertheless, this intervention group and a control group showed comparable rates of nonmedical prescription use at 6-month follow-up. However, negative expectancies were significant predictors of reduced odds of future use. CONCLUSIONS: A challenge session appears to modify stimulant-related expectancies, which are related to nonmedical prescription stimulant use. Nevertheless, a more potent challenge or booster sessions might be essential for longer-term changes.
    Drug and alcohol dependence 04/2013; 132(1-2). DOI:10.1016/j.drugalcdep.2013.03.003 · 3.28 Impact Factor
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    • "They found that users had higher levels of perceived acceptability of NPS use compared with non-users (Judson & Langdon, 2009). In addition, their results suggest that students believe that NPS use will have a positive effect on academic performance, which may influence use (McCabe et al., 2006). However, it is important to examine if other cognitions may be associated with NPS willingness and use. "
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    ABSTRACT: Nonmedical prescription stimulant (NPS) use is an important problem among university students. The present studies applied the prototype-willingness model (Gibbons, Gerrard & Lane, 2003) to academic-based NPS use and examined the impact of academic versus health information on university students' NPS use cognitions. Study 1 used the prototype-willingness model to examine cognitions associated with academic-based willingness to use NPS. In Study 2, participants were randomly assigned to a control condition or to read information on the negative academic or negative health effects of NPS use. Beliefs, willingness, and expectation of engaging in future NPS use, prototypes of users, and perceived vulnerability were assessed. Students without a prescription for stimulants or a diagnosis of attention deficit hyperactivity disorder (ADHD) participated in each study (Ns = 555; 166). Twenty to thirty per cent reported NPS use, primarily for academic reasons. Controlling for past NPS, alcohol, and marijuana use: friends' NPS use, prototypes, perceived vulnerability, and negative health and positive academic beliefs were associated with willingness to use NPS in Study 1. Study 2 demonstrated that participants in the academic-information condition reported the lowest willingness and expectations as well as the least favourable prototypes of NPS users. Participants in the health-information condition reported the highest perceived vulnerability. These studies highlight: the utility of using a health model framework to examine NPS cognitions, the importance of examining beliefs about the behaviour, and the potential for academic and health information to reduce risky NPS use cognitions. What is already known? Nonmedical prescription stimulant (NPS) use is a common health-risk behaviour among college students. The most common reasons cited by students for NPS use are related to academics (e.g., increase concentration, stay awake to study). What does this study add? Shows the utility of the prototype-willingness model to examine NPS use cognitions. Experimentally demonstrates the positive impact of academic and health information on NPS use cognitions. Reveals new relationships among health cognitions (including academic and health beliefs) that predict behaviour and are targets for future interventions.
    British Journal of Health Psychology 09/2012; 18(3). DOI:10.1111/j.2044-8287.2012.02087.x · 2.70 Impact Factor
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    • "However, another contributing factor should be considered: when stimulants are prescribed for adolescent and adults who are seeking treatment for themselves, there may be a higher rate of diversion for non-medical use than for children whose parents are seeking treatment for them. For example, in a series of publications based on school-based surveys, McCabe et al. (2004, 2006) reported that about 8% of non-ADHD students in middle school, high school, and college engaged in nonmedical use of stimulants. Others have confirmed this pattern in adults as well as in children (see Wilens et al., 2008 for a review). "
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    ABSTRACT: Our 'opinion-driven and conceptual review' of the past decade of research has identified many differences between the prior and current use and understanding of effects of stimulant medications, which are summarized in Table 2. As requested, we will offer some conclusions based on personal experiences in research related to the five concepts considered here.
    Journal of Child Psychology and Psychiatry 02/2009; 50(1-2):180-93. DOI:10.1111/j.1469-7610.2008.02062.x · 5.67 Impact Factor
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