Abstract
The use of prescription or recreational drugs for cognitive enhancement (CE) is prevalent among students. However, the prevalence of CE among Swiss school students is unknown. We therefore performed a cross-sectional online survey including ≥ 16-year-old students from bridge-year schools (10th grade), vocational schools, and upper secondary schools (10th-12th grade) in the Canton of Zurich to investigate the prevalence of and motives for the use of prescription drugs, recreational drugs, and/or freely available soft enhancers for CE. A total of 1,139 students were included. Of these, 54.5% reported the use of prescription drugs (9.2%), recreational drugs including alcohol (6.2%), or soft enhancers (51.3%) explicitly for CE at least once in their lives. The last-year and last-month prevalence for CE considering all substances was 45.5% and 39.5%, respectively. Soft enhancers were the substances that were most commonly used (ever, last-year, and last-month, respectively), including energy drinks (33.3%, 28.4%, and 24.6%), coffee (29.8%, 25.1%, and 21.9%), and tobacco (12.6%, 9.3%, and 8.3%). CE with methylphenidate was less prevalent (4.0%, 2.8%, and 2.0%). However, the use of prescription drugs, alcohol, or illegal drugs for CE was reported by 13.3% of the participants. The most common motives for use were to stay awake and improve concentration. CE was more prevalent among students who reported higher levels of stress or performance pressure and students with psychiatric disorders. In conclusion, half of the school students had used a substance at least once in their lives to improve school performance. Soft enhancers were most commonly used. Prevalence rates were similar to those reported by Swiss university students, indicating that the use of prescription or recreational drugs for CE already occurs before starting higher education. Performance pressure, stress, and psychiatric disorders may be associated with CE.
Highlights
Pharmacological cognitive enhancement (CE) refers to the nonmedical use of prescription drugs and recreational drugs to improve performance while studying [1,2,3,4,5]
We explored whether performance pressure, stress, and psychiatric disorders are associated with substance use for CE
The present findings demonstrate that substance use for CE is prevalent among younger students at the secondary school level before they enter institutions of higher education
Summary
Pharmacological cognitive enhancement (CE) refers to the nonmedical use of prescription drugs and recreational drugs to improve performance while studying [1,2,3,4,5]. The use of prescription drugs (e.g., methylphenidate and modafinil) is mainly considered in studies or discussions on CE [6,7]. Other substances, such as recreational drugs (e.g., cocaine and amphetamine) [2] and “soft enhancers” [2,8] are included. Soft enhancers are readily available substances, such as coffee, caffeine tablets, energy drinks, herbal drugs, vitamins, and tonics, that can be used for CE [2,8]. “indirect” CE with sedative substances (e.g., hypnotics and alcohol) are taken to prepare for or cope with stressful situations, in which they are used to improve sleep or relax before exams or improve studying the day [2,9]
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