Article

Medical Use, Illicit Use and Diversion of Prescription Stimulant Medication

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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    • "Diversion entails the illicit acquisition of drugs from medical sources, primarily through theft [17] [18], prescription forgery [19] [20], and " shopping " for lenient physicians or pharmacists [15] [21] [22]. It also entails the illicit acquisition of prescription drugs from nonmedical sources, usually through trading, stealing, borrowing, or purchasing from family and friends [23] [24] [25] [26] [27] [28], street-level drug dealers or markets [16] [21] [29], and online pharmacies or websites [23] [30] [31]. In addition to acquisition, diversion includes the illicit redistribution of prescription drugs outside of a licit healthcare context [5,20,22,25,32–34]. "
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    ABSTRACT: Objective: Prescription drug diversion, the transfer of prescription drugs from lawful to unlawful channels for distribution or use, is a problem in the United States. Despite the pervasiveness of diversion, there are gaps in the literature regarding characteristics of individuals who participate in the illicit trade of prescription drugs. This study examines a range of predictors (e.g., demographics, prescription insurance coverage, perceived risk associated with prescription drug diversion) of membership in three distinct diverter groups: individuals who illicitly acquire prescription drugs, those who redistribute them, and those who engage in both behaviors. Methods: Data were drawn from a cross-sectional Internet study (N = 846) of prescription drug use and diversion patterns in New York City, South Florida, and Washington, D.C.. Participants were classified into diversion categories based on their self-reported involvement in the trade of prescription drugs. Group differences in background characteristics of diverter groups were assessed by Chi-Square tests and followed up with multivariate logistic regressions. Results: While individuals in all diversion groups were more likely to be younger and have a licit prescription for any of the assessed drugs in the past year than those who did not divert, individuals who both acquire and redistribute are more likely to live in New York City, not have prescription insurance coverage, and perceive fewer legal risks of prescription drug diversion. Conclusion: Findings suggest that predictive characteristics vary according to diverter group.
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    • "The primary goal of the present meta-analysis is to obtain a quantitative estimate of the cognitive effects of the stimulants amphetamine and methylphenidate. They are commonly prescribed for the treatment of attention deficit hyperactivity disorder (ADHD) but are frequently diverted for enhancement use by students and others (e.g.,Wilens et al., 2008;Poulin, 2007;McCabe, Teter, & Boyd, 2006). Guided by the findings ofSmith and Farah's (2011)review, we focus on the cognitive processes that seemed most likely to be enhanced by stimulants , specifically inhibitory control, working memory, and episodic memory. "
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    ABSTRACT: The use of prescription stimulants to enhance healthy cognition has significant social, ethical, and public health implications. The large number of enhancement users across various ages and occupations emphasizes the importance of examining these drugs' efficacy in a nonclinical sample. The present meta-analysis was conducted to estimate the magnitude of the effects of methylphenidate and amphetamine on cognitive functions central to academic and occupational functioning, including inhibitory control, working memory, short-term episodic memory, and delayed episodic memory. In addition, we examined the evidence for publication bias. Forty-eight studies (total of 1,409 participants) were included in the analyses. We found evidence for small but significant stimulant enhancement effects on inhibitory control and short-term episodic memory. Small effects on working memory reached significance, based on one of our two analytical approaches. Effects on delayed episodic memory were medium in size. However, because the effects on long-term and working memory were qualified by evidence for publication bias, we conclude that the effect of amphetamine and methylphenidate on the examined facets of healthy cognition is probably modest overall. In some situations, a small advantage may be valuable, although it is also possible that healthy users resort to stimulants to enhance their energy and motivation more than their cognition.
    No preview · Article · Jan 2015 · Journal of Cognitive Neuroscience
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    • "The potential for abuse of pharmaceutical stimulants has led to concerns regarding the risk for diversion and misuse.103–105 Several studies have investigated the prevalence of non-prescribed use of stimulants in postsecondary students with and without ADHD.35,87,104,106–117 Within the college and university student population, life-time prevalence rates of non-prescribed stimulant use is in the range 5%–43%, and past-year prevalence rates in the range 5%–6% have been reported, with prevalence rates peaking in those aged 16–24 years.87,117,118 "
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    ABSTRACT: A PubMed review was conducted for papers reporting on attention-deficit/hyperactivity disorder (ADHD) in postsecondary students. The review was performed in order to determine the prevalence and symptomatology of ADHD in postsecondary students, to examine its effects on academic achievement, and discuss appropriate management. The prevalence of ADHD symptoms among postsecondary students ranges from 2% to 12%. Students with ADHD have lower grade point averages and are more likely to withdraw from courses, to indulge in risky behaviors, and to have other psychiatric comorbidities than their non-ADHD peers. Ensuring that students with ADHD receive appropriate support requires documented evidence of impairment to academic and day-to-day functioning. In adults with ADHD, stimulants improve concentration and attention, although improved academic productivity remains to be demonstrated. ADHD negatively impacts academic performance in students and increases the likelihood of drug and alcohol problems. Affected students may therefore benefit from disability support services, academic accommodations, and pharmacological treatment.
    Full-text · Article · Sep 2014 · Neuropsychiatric Disease and Treatment
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