Illicit Use Of Prescription Stimulants Research Articles

Educational and Personal Opportunity Costs of Medical Student Preparation for the United States Medical Licensing Examination Step 1 Exam: A Single-Center Study.

PurposeTo assess the degree to which medical students choose to disengage from their regular preclinical curriculum and extracurricular activities in order to focus on United States Medical Licensing Examination (USMLE) Step 1 exam preparation, as well as learner-perceived effects of Step 1 preparation on their physical, social, and mental health.MethodOnline survey of medical students who have taken the USMLE Step 1 exam at a single large Midwestern academic medical center.ResultsThe response rate was 54%. Students often reported absenteeism from a variety of preclinical curricular activities, including lectures (44%) and didactics focusing on medical ethics (37%), clinical skills (28%), and encounters with actual and standardized patients (9%) in order to study for USMLE Step 1. Many students also forewent extracurricular opportunities including research (53%), elective patient care opportunities (45%), community service (39%), and healthcare advocacy experiences (38%) in order to study for USMLE Step 1. Majorities of students identified Step 1 preparation as a cause of burnout (79%) or significant anxiety or depression (61%), for which nearly a third sought mental healthcare; students also reported Step 1 preparation as a cause of engaging in dangerous behaviors such as illicit prescription stimulant use as well as driving or providing patient care while impaired by fatigue. In narrative comments, students frequently described Step 1 to be a barrier to their development into effective clinicians, the traditional medical school curriculum to be a barrier to performance on Step 1, or both.ConclusionsMedical students often prioritize Step 1 exam preparation over engaging with the standard preclinical curriculum, extracurricular opportunities, and activities to promote wellbeing. These findings have implications for the emphasis residency program directors place on single high-stakes standardized exams in the resident recruitment process.

Risk/benefit perceptions underlying lower African American Students' illicit stimulant use

Researchers have documented lower illicit use of prescription stimulants (IUPS) in African American (AA) populations but have not provided empirically-based explanations for this finding. Four gender-balanced groups of AA and Caucasian male/female college students (n = 120/group, mean age of 19.23, SD = 1.30) reported any IUPS and rated their ADHD symptoms (using the Adult ADHD Self-Report Scale; ASRS). AA participants endorsed IUPS less frequently compared to Caucasian participants (9.2% vs. 21.3%; χ2(1) = 13.59, p < .001) and reported lower levels of ADHD symptoms (M = 4.65, SD = 4.17) compared to Caucasians (M = 5.84, SD = 4.22), F(1,473) = 9.83, p < .01. Second, AA participants perceived lower benefits for IUPS than Caucasian participants for targets of concentration (M = 2.29, SD = 1.22 vs. M = 1.79, SD = 1.04, F(1,473) = 23.57, p < .001), alertness (M = 2.29, SD = 1.24 vs. M = 1.92, SD = 0.93, F(1,473) = 18.04, p < .001), and help with studying (M = 2.53, SD = 1.25 vs. M = 1.90, SD = 1.05, F(1,473) = 35.69, p < .001). Third, AA participants perceived higher social risk (M = 2.63, SD = 1.11) than Caucasian participants (M = 3.03, SD = 0.91, F(1,476) = 18.44, p < .001). No significant differences were found for legal or health risks. Despite lower rates of IUPS in AA populations, prevention and treatment programs for AA students are still needed and may benefit from targeting the observed risk/benefit belief patterns.

Illicit Use of Prescription Stimulants: Gender Differences in Perceptions of Risk

Background: Little research exists on gender differences regarding the relationship between illicit use of prescription stimulants (IUPS) and perceptions of risk of illicit use. Risk perception is a common target for both prevention and intervention programs. Objectives: To measure gender differences in prevalence rates of illicit use and perceptions of legal, health, and social risks of illicit use. Method: Data from undergraduate students at a large, southeastern university (N = 1,714) were examined for gender differences in prevalence of illicit use and related risk perceptions. Results: More men engaged in illicit use than women (26.2% vs. 18.7%). Overall, men perceived lower legal, health, and social risks related to illicit use. Further, illicit users also perceived lower legal, health, and social risks. Nonusing men perceived lower legal and health risks than nonusing women, but similar levels of social risks. Within the subgroup of illicit users, men perceived lower health risks than women, but similar levels of legal and social risk. Conclusions/Importance: There were significant gender differences in IUPS and risk perception, with particular importance of lack of social risk perceived for all groups and lower health risk perception for men who had engaged in IUPS. It is unclear if the lower risk perceptions are present prior to or after illicit use begins and whether risk perceptions affect the development, maintenance, or termination of illicit use behaviors. Future research is needed to clarify these relationships and to evaluate whether increasing risk perceptions is a viable target for prevention or intervention efforts.

Confirming the Prevalence, Characteristics, and Utility of Ecological Theory in Explaining Prescription Stimulant Misuse

To examine the prevalence, characteristics, and utility of ecological theory in explaining prescription stimulant misuse, a probability sample of 499 students from one southern California university (response rate = 94.71%) completed a 100-item paper-based survey. The illicit use of prescription stimulants (IUPS) during college was reported by approximately 21% of students, with approximately 13% of users reporting 10 or more occurrences per academic term. Characteristics of use that were examined suggest a growing trend toward recreational use. We used structural equation modeling to replicate a previously tested ecological model. The number of significant paths in this replication study (i.e., 22) was similar to the number of significant paths in the original study (i.e., 25), and 21 of the significant paths from the original study retained their significance in the replication. Results confirm prescription stimulant misuse remains prevalent, characteristics of the behavior are cause for concern, and ecological theories are a useful tool for explaining the multifaceted nature of IUPS.

A Mixed-Methods Approach Examining Illicit Prescription Stimulant Use: Findings From a Northern California University.

Preventing the illicit use of prescription stimulants, a particularly high-risk form of substance use, requires approaches that utilize theory-guided research. We examined this behavior within the context of a random sample of 554 undergraduate students attending a university in northern California. Approximately 17% of students self-reported engaging in this behavior during college; frequency of misuse per academic term ranged from less than once to 40 or more times. Although most misusers reported oral ingestion, a small proportion reported snorting and smoking the drug. The majority of misusers reported receiving the drug at no cost, and the primary source of the drug was friends. Misusers were motivated by both academic (e.g., to improve focus) and non-academic (e.g., to experiment) reasons. Our thematic analyses of an open-end question revealed that students abstaining from illicit use of prescription stimulants did so primarily for reasons related to health risks, ethics, and adherence regulations. Results from adjusted logistic regression analyses showed that correlates of the behavior were intrapersonal, interpersonal, and environmental in nature. We conclude that characteristics of misuse are a cause for concern, and correlates of the behavior are multifaceted. These findings, in addition to insights provided by students who choose not to engage in this behavior, suggest that a number of prevention approaches are plausible, such as a social norms campaign that simultaneously corrects exaggerated beliefs about prevalence while also illustrating why abstainers, in their own words, choose to abstain.

Health-compromising practices of undergraduate college students: Examining racial/ethnic and gender differences in characteristics of prescription stimulant misuse

•Illicit use of prescription stimulants (IUPS) is prevalent among college students.•Associations were found between race, gender, and IUPS characteristics.•Being Asian or Latino increased the odds of smoking stimulants.•Being Female increased the odds of using stimulants to lose weight.•Many of the associations remained after controlling for known correlates of IUPS.

Increased Energy Drink Use as a Predictor of Illicit Prescription Stimulant Use

ABSTRACTBackground: The purpose of this study was to examine energy drink usage patterns and to investigate the relationship between energy drink use and illicit use of prescription stimulants among college students. Methods: A sample of 605 undergraduate and graduate students (mean age ± SD: 21.96 ± 4.216) from a large midwestern university voluntarily participated in the study. Results: Of the participants, 48.9% (n = 296) reported using energy drinks in the past 30 days, whereas 25.3% (n = 153) reported using prescription stimulant drugs in the past 30 days. Among prescription stimulant users without a valid medical prescription, Mann-Whitney U tests and logistic regression analysis revealed that the frequency of energy drink consumption was a significant predictor of illicit prescription stimulant use, with the odds for use increasing by 14% with each additional day of energy drink use (odds ratio for using = 1.143, P ≤ .001). Analyses revealed statistically significant differences (P < .05) between prescription stimulant users and nonusers for all energy drink use variables, with the strongest predictors of prescription stimulant use being the number of days using energy drinks in the past 30 days and number of energy drink binges in the past 30 days. Conclusions: Results indicate that the frequency of energy drink use was a significant predictor of the illicit use of prescription stimulants.

The Illicit Use of Prescription Stimulants on College Campuses

The illicit use of prescription stimulants (IUPS) is a substance use behavior that remains prevalent on college campuses. As theory can guide research and practice, we provide a systematic review of the college-based IUPS epidemiological literature guided by one ecological framework, the theory of triadic influence (TTI). We aim to assess prevalence, elucidate the behavior's multietiological nature, and discuss prevention implications. Peer-reviewed studies were located through key phrase searches (prescription stimulant misuse and college, "prescription stimulant misuse" and "college," illicit use of prescription stimulants in college, and nonmedical prescription stimulant use in college students) in electronic databases (PubMed, PubMed Central, and EBSCO Host) for the period 2000 to 2013. Studies meeting inclusion criteria had their references reviewed for additional eligible literature. Statistically significant correlates of IUPS in the 62 retrieved studies were organized using the three streams of influence and four levels of causation specified in the TTI. Results show that the prevalence of IUPS varies across campuses. Additionally, findings suggest the behavior is multifaceted, as correlates were observed within each stream of influence and level of causation specified by the TTI. We conclude that IUPS is prevalent in, but varies across, colleges and is influenced by intrapersonal and broader social and societal factors. We discuss implications for prevention and directions for future research.

Prescribing Some Criminological Theory: An Examination of the Illicit Use of Prescription Stimulants Among College Students.

Recent evidence indicates that the illicit use of prescription stimulants such as Adderall and Ritalin is common across college campuses and in professions (e.g., trucking) where staying awake and focused is valued. Existing research has established use patterns and explored respondents' reasons for using these stimulants. Less is known, however, about whether or how well mainstream criminological theory explains this type of illegal activity. This article reports results from a survey (N = 484) of college students from a Midwestern university, examining whether measures of strain, self-control, and social learning predict the illicit use of prescription stimulants. Measures from social learning and social control theories were significant predictors of illicit use of prescription stimulants, whereas the measure of academic strain was not; the strongest predictor of illicit use of prescription stimulants was general deviance. Implications of these findings are discussed.

Using structural equation modeling to understand prescription stimulant misuse: A test of the Theory of Triadic Influence

ObjectiveTo test a theory-driven model of health behavior to predict the illicit use of prescription stimulants (IUPS) among college students. ParticipantsA probability sample of 554 students from one university located in California (response rate=90.52%). MethodsStudents completed a paper-based survey developed with guidance from the Theory of Triadic Influence. We first assessed normality of measures and checked for multicollinearity. A single structural equation model of frequency of IUPS in college was then tested using constructs from the theory's three streams of influence (i.e., intrapersonal, social situation/context, and sociocultural environment) and four levels of causation (i.e., ultimate causes, distal influences, proximal predictors, and immediate precursors). ResultsApproximately 18% of students reported engaging in IUPS during college, with frequency of use ranging from never to 40 or more times per academic term. The model tested had strong fit and the majority of paths specified within and across streams were significant at the p<0.01 level. Additionally, 46% of the variance in IUPS frequency was explained by the tested model. ConclusionsResults suggest the utility of the TTI as an integrative model of health behavior, specifically in predicting IUPS, and provide insight on the need for multifaceted prevention and intervention efforts.

Frequency of Energy Drink Use Predicts Illicit Prescription Stimulant Use

ABSTRACT. Background: The purpose of this study was to examine energy drink (ED) usage patterns and to investigate the illicit use of prescription stimulants among college students. Methods: A sample of 267 undergraduate and graduate students (mean age of 22.48 among stimulant users) from a large midwestern university and its branch campus locations voluntarily participated in the study. Results: Among prescription stimulant users without a valid medical prescription, Mann-Whitney U tests and logistic regression analysis revealed that the frequency of ED use was a significant predictor of the illicit use of prescription stimulants. Moreover, frequency of ED consumption was a significant predictor of the illicit use of prescription stimulant medications, with the odds for using increasing by .06 with each additional day of ED use past 0 day (odds for use = 1.06, P =.008). Conclusions: Results indicate that the frequency of ED use is a significant predictor of the illicit use of prescription stimulants. All prescription stimulant users with or without a valid script also used EDs. This finding is important to practitioners because of the harmful interactions (eg, serotonin syndrome) that can occur when ED ingredients (eg, ginseng, yohimbine, evodamine, etc) are mixed with prescription stimulants.

Illicit use of prescription stimulants in a college student sample: A theory-guided analysis

BackgroundThe illicit use of prescription stimulants (IUPS) has emerged as a high-risk behavior of the 21st century college student. As the study of IUPS is relatively new, we aimed to understand (1) characteristics of IUPS (i.e., initiation, administration routes, drug sources, motives, experiences), and (2) theory-guided intrapersonal, interpersonal, and environmental correlates associated with use. MethodsUsing one-stage cluster sampling, 520 students (96.3% response rate) at one Pacific Northwest University completed a paper-based, in-classroom survey on IUPS behaviors and expected correlates. Aim 1 was addressed using descriptive statistics and aim 2 was addressed via three nested logistic regression analyses guided by the Theory of Triadic Influence. ResultsThe prevalence of ever engaging in IUPS during college was 25.6%. The majority (>50.0%) of users reported initiation during college, oral use, friends as the drug source, academic motives, and experiencing desired outcomes. Intrapersonal correlates associated with use included identifying as White, lower grade point average, diagnoses of attention deficit disorder, and lower avoidance self-efficacy. Interpersonal correlates of use included off-campus residence, varsity sports participation, IUPS perceptions by socializing agents, and greater behavioral norms. Exposure to prescription drug print media, greater prescription stimulant knowledge, and positive attitudes towards prescription stimulants were environmental correlates associated with use. In all models, IUPS intentions were strongly associated with use. ConclusionsIUPS was prevalent on the campus under investigation and factors from the intrapersonal, interpersonal and environmental domains were associated with the behavior. Implications for prevention and future research are discussed.

Adderall Abuse on College Campuses: A Comprehensive Literature Review

Prescription stimulant abuse has dramatically increased over the past 10 years, but the amount of research regarding college students and illicit prescription stimulant use is still very limited. This has important implications for college mental health professionals and higher education administrators. In this comprehensive literature review the author explores factors contributing to illicit use, self-medication, and recreational use of controlled prescription stimulants; discusses the potential consequences for those students abusing stimulants; and provides recommendations for educating, combating, and assisting students who illicitly use prescriptions stimulants on college campuses.

Illicit use of prescription stimulants among college students: Prescription status, motives, theory of planned behaviour, knowledge and self-diagnostic tendencies

Published studies have reported that illicit prescription stimulant use is increasingly common on college campuses in the United States. The present study investigates the relationship between prescription status, motives, theory of planned behaviour, knowledge of side effects and self-diagnostic tendencies and illicit use of prescription stimulants among undergraduates (N = 333). Prescription holders and non-holders responded to a self-administered online survey. Results revealed that dependent variables were significantly different between illicit users and non-illicit users. Specifically, prescription holders were more likely than non-holders to report illicit use. Illicit users, relative to non-illicit users, reported more motives to use, less concern with ethics and safety of use, greater perception of use as socially acceptable, less perceived control over their behaviour without stimulant aid, more knowledge, and, among non-prescription holders, were more likely to self-diagnosis having an attention disorder. This study provides additional insight into students’ attitudes, beliefs, knowledge and practices related to prescription stimulant use on campus. Implications for future research and the need for interventions to provide aid to students who are at risk for using stimulant medications illicitly are discussed.

Illicit Prescription Stimulant Use Among College Students Living Near the United States–Mexico Border

Previous research has suggested that the illicit use of prescription stimulant drugs may he a significant problem on U.S. college campuses. We examined the nonmedical use of prescription stimulants at a large university situated 20 miles from the United States-Mexico border, surveying a predominantly Hispanic population of students that is geographically and culturally distinct from those used in previous studies. Approximately 7% of the students sampled reported having used prescription stimulants during the previous year v^fithout a prescription. The majority of students bought the drugs in the United States as opposed to Mexico, and the most frequendy cited source for these stimulants was friends. In spite of comparatively easy access to inexpensive prescription stimulants from Mexican pharmacies, illicit usage appears to closely match national averages.

Illicit use of specific prescription stimulants among college students: prevalence, motives, and routes of administration.

To explore the illicit use of specific prescription stimulants among college students and add to our understanding of reasons (motives) and routes of administration associated with illicit use of these drugs. A random sample of 4580 college students self-administered a Web-based survey. The survey contained a variety of items pertaining to the illicit use of prescription stimulants. An extensive list of prescription stimulants was provided, and students were asked to select all the specific prescription stimulants that they had used illicitly. Items were also included to assess the motives and routes of administration associated with illicit use of prescription stimulants. Lifetime and past-year prevalence rates for illicit use of prescription stimulants were 8.3% (382 students) and 5.9% (269 students), respectively. Approximately three fourths (75.8%) of the 269 past-year illicit users of prescription stimulants reported using an amphetamine-dextroamphetamine combination agent (e.g., Adderall) in the past year, and approximately one fourth (24.5%) reported using methylphenidate (e.g., Ritalin, Concerta, Metadate, Methylin). Past-year illicit use of prescription stimulants was more than 3 times more likely among Caucasians (odds ratio [OR] 3.1, 95% confidence interval [CI] 1.5-6.6) and Hispanics (OR 3.8, 95% CI 1.6-9.3) compared with African-Americans, and more than twice as likely among Caucasians (OR 2.1, 95% CI 1.3-3.4) and Hispanics (OR 2.6, 95% CI 1.4-5.1) compared with Asians. The most commonly reported motives for illicit use were to help with concentration (65.2%), help study (59.8%), and increase alertness (47.5%). Other motives included getting high (31.0%) and experimentation (29.9%). Nearly every illicit user (95.3%) reported oral administration, and 38.1% reported snorting prescription stimulants. Illicit use of amphetamine-dextroamphetamine is more prevalent than illicit use of methylphenidate formulations among college students.

Medical Use, Illicit Use and Diversion of Prescription Stimulant Medication

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 dlicit 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.