Prescription Stimulant Misuse Research Articles

College student goals in the context of prescription stimulant misuse: An application of goals–plans–action theory

Guided by goals–plans–action theory (Dillard, 1990), this study examines the goals and strategic message plans underlying college student interventions to prevent or reduce peers’ misuse of prescription stimulants. College students (n = 115) participated in an online survey in which they read a hypothetical scenario of a close friend’s Adderall misuse. Participants were prompted to provide the goals they would have for an intervention and strategic message plans for how they would intervene. Results of grounded theory analysis reveal five unique goals for these interactions, as well as six strategic message plans. Post hoc analyses revealed that several of the strategic message plans could be predicted by college students’ underlying goals for the interaction. These findings are discussed in terms of their theoretical and practical implications.

Neurocognitive, Autonomic, and Mood Effects of Adderall: A Pilot Study of Healthy College Students.

Prescription stimulant medications are considered a safe and long-term effective treatment for Attention Deficit Hyperactivity Disorder (ADHD). Studies support that stimulants enhance attention, memory, self-regulation and executive function in individuals with ADHD. Recent research, however, has found that many college students without ADHD report misusing prescription stimulants, primarily to enhance their cognitive abilities. This practice raises the question whether stimulants actually enhance cognitive functioning in college students without ADHD. We investigated the effects of mixed-salts amphetamine (i.e., Adderall, 30 mg) on cognitive, autonomic and emotional functioning in a pilot sample of healthy college students without ADHD (n = 13), using a double-blind, placebo-controlled, within-subjects design. The present study was the first to explore cognitive effects in conjunction with mood, autonomic effects, and self-perceptions of cognitive enhancement. Results revealed that Adderall had minimal, but mixed, effects on cognitive processes relevant to neurocognitive enhancement (small effects), and substantial effects on autonomic responses, subjective drug experiences, and positive states of activated emotion (large effects). Overall, the present findings indicate dissociation between the effects of Adderall on activation and neurocognition, and more importantly, contrary to common belief, Adderall had little impact on neurocognitive performance in healthy college students. Given the pilot design of the study and small sample size these findings should be interpreted cautiously. The results have implications for future studies and the education of healthy college students and adults who commonly use Adderall to enhance neurocognition.

Correlates of Recreation- Versus Academic-Motivated Misuse of Prescription Stimulants

Our goal was to compare and contrast the correlates of academic- and recreation-motivated misuse of prescription stimulants (MPS). Questionnaires were distributed to a probability sample of students attending two universities. We used a series of logistic regression analyses to examine intrapersonal, interpersonal, and environmental correlates of use among academic-motivated users (versus nonacademic-motivated users) and recreation-motivated users (versus nonrecreation-motivated users; N = 257 students with MPS experience). Sensations seeking, older age, academic concern, family perception of MPS, family and faculty endorsement of MPS, perceived prevalence of MPS among friends, and financial stress were unique correlates of recreation-motivated MPS. Inattention, friends’ perception of MPS, friend endorsement of MPS, perception of willingness of health care providers to write prescriptions and negative expectancies were unique correlates of academic-motivated MPS. Variables that were correlates of both motives were race/ethnicity, year in school, avoidance self-efficacy, diversion, positive MPS expectancies, MPS intention, and other substance use. These findings have important prevention and intervention implications.

Sources of Prescription Medication Misuse Among Young Adults in the United States: The Role of Educational Status.

This study examined prescription drug misuse (PDM), sources of PDM, and substance use disorder (SUD) symptoms as a function of educational status among US young adults based on a large nationally representative sample. Data from the 2009-2014 National Survey on Drug Use and Health came from a sample of 106,845 young adults aged 18-25 years. Respondents were categorized by educational status and PDM, sources of PDM, other substance use, and SUD symptoms, with analyses performed separately for prescription opioids, stimulants, and sedatives/tranquilizers. Prescription opioid (past-year: 11.9%) and sedative/tranquilizer (past-year: 5.8%) misuse were most prevalent among young adults not attending college, especially among high school dropouts. In contrast, full-time college students and college graduates had the highest rates of prescription stimulant misuse (past-year: 4.3% and 3.9%, respectively). Obtaining prescription medications from friends/relatives for free was the most common source of PDM, especially among college students/graduates. Prescription drug misusers who obtained medications from theft/fake prescriptions, purchases, or multiple sources were more likely to report past-year SUDs and had the most severe overall risk profile of concurrent substance use and SUD. More than 70% of past-month prescription drug misusers who reported multiple sources for PDM had at least 1 past-year SUD. Sources of PDM vary by educational status among US young adults, and the college environment is associated with sharing prescription medications. Clinicians can help assess an individual's risk for SUD by determining whether the individual engaged in PDM and the source of prescription medication the individual is misusing.

Prevalence and Correlates of Prescription Stimulant Use, Misuse, Use Disorders, and Motivations for Misuse Among Adults in the United States.

The authors sought to simultaneously examine the prevalence and correlates of prescription stimulant use, misuse, use disorders, and motivations for misuse in the U.S. adult population. This was a nationally representative household population study of adults age 18 or older from the 2015 and 2016 National Surveys on Drug Use and Health (N=102,000). Measurements included prescription stimulant use, use without misuse, misuse without use disorders, and misuse with use disorders, as well as sociodemographic characteristics, health conditions, and mental health factors. Among U.S. adults, 6.6% (annual average) used prescription stimulants overall; 4.5% used without misuse, 1.9% misused without use disorders, and 0.2% had use disorders. Adults with past-year prescription stimulant use disorders did not differ from those with misuse without use disorders in any of the examined sociodemographic characteristics and in many of the examined substance use problems. The most commonly reported motivations for misuse were to help be alert or concentrate (56.3%). The most likely source of misused prescription stimulants was by obtaining them free from friends or relatives (56.9%). More frequent prescription stimulant misuse and use disorder were associated with an increased likelihood of obtaining medications from physicians or from drug dealers or strangers and less likelihood of obtaining them from friends or relatives. Approximately 16.0 million U.S. adults used prescription stimulants in the preceding year (annual average), 5.0 million misused prescription stimulants, and 0.4 million had use disorders. Cognitive enhancement was the most commonly reported reason for misusing prescription stimulants. Patients who are using their medication for cognitive enhancement or diverting their medication to others present a high risk.

Adolescent d-amphetamine exposure enhances the acquisition of cocaine self-administration in male and female rats.

Diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD) has risen drastically over the past 20 years in the United States and abroad. Amphetamine-based prescription stimulants are the most prescribed treatment for ADHD and the diversion of these drugs has also increased. Reports indicate 61% of individuals with an ADHD medication prescription have sold or shared their medication. Exposure to prescription stimulants, especially for those without an ADHD diagnosis, may increase susceptibility to drugs of abuse. The present study aimed to model ADHD medication misuse during adolescence in male and female rats. The primary dependent measure was the acquisition of intravenous cocaine self-administration. Male and female, Long-Evans rats were exposed to d-amphetamine (0.7 mg/kg, i.p.) or saline in adolescence (35-41 days old), during which locomotor activity was measured. At approximately 75 days old, animals were implanted with jugular catheters. All animals then entered a 15-day acquisition procedure with no prior operant training. Finally, following acquisition all animals responded on a progressive-ratio (PR) schedule to obtain 0, 0.1, 0.3, and 1.0 mg/kg/infusion cocaine. Animals exposed to amphetamine acquired cocaine self-administration faster than saline-exposed controls when the acquisition criterion was operationally defined as two consecutive days with 12 infusions or greater. Discrete-time hazard modeling also found amphetamine exposure to increase the likelihood of acquiring cocaine self-administration. There were no differences detected during PR testing. These data suggest that individuals with histories of prescription stimulant misuse may be at increased risk to use other drugs of abuse. (PsycINFO Database Record

Undergraduate Prescription Stimulant Misuse: The Impact of Academic Strain

ABSTRACTBackground: This study investigated the misuse of prescription stimulants among undergraduates for academic purposes. This research is important as existing literature has indicated that this type of prescription drug misuse is a growing concern, especially among college undergraduates aged 18–25. Objective: This study focused on how various types of academic strain (i.e., academic strain, grade strain, and academic impediments) influenced the misuse of prescription stimulants. Methods: Roughly 900 quantitative surveys were collected at a large Southeastern university in May 2014 that specifically addressed prescription stimulant misuse. Results: Results from regression analyses indicated that college students are at an increased likelihood of misusing prescription stimulants for academic purposes if they experienced academic impediments and/or grade strain during the past academic year. Conclusions/Importance: It is necessary to identify how academic strain impacts undergraduates' likelihood of engaging in the misuse of prescription stimulants as this information may aid in college based educational and prevention programs.

Examining the Relationship between Religious Coping and the Misuse of Prescription Stimulants among a Sample of Undergraduate Students

ABSTRACTBackground: There is a well-established inverse relationship in undergraduate samples between a person's religious coping and substance abuse. Positive religious coping (PRC) has been associated with decreases in the use of alcohol, tobacco, and marijuana. Investigations examining prescription drug misuse and PRC found that higher levels of PRC were related to a reduction in the misuse of some prescription drugs. However, the literature has yet to identify an inverse relationship between PRC and the misuse of prescription stimulants (MPS) among undergraduates. Objective: Examine the association between religious coping and past-year MPS in a sample of undergraduate students. Methods: Undergraduates were recruited to complete an anonymous online survey from three universities (1 private, 2 public) in the United States. Results: The sample consisted of 908 undergraduates between the ages of 18 and 25. Statistical analyses revealed that higher levels of PRC were associated with a reduction in past-year MPS. A separate model found that attending religious events also decreased the behavior. Conversely older students, males, Greek organization affiliation, a lower GPA and having a current stimulant prescription all increased the odds of reporting past-year MPS. Negative religious coping and a student's race were not significantly associated with MPS. Conclusions: Findings indicate that PRC skills have the potential to reduce MPS in college students. Therefore, it is possible that the development of similar secular skills could have the same effect. Future studies should explore the role that positive coping skills having on the reduction of MPS among undergraduates regardless of religious conviction.

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.

Attention-Deficit Hyperactivity Disorder: Clinical Considerations for Women.

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by hyperactivity, impulsivity, and/or inattention. Women with ADHD represent a particularly vulnerable group, given their increased risk for psychosocial and parenting difficulties. Women's health care clinicians should expect to encounter women with diagnosed and undiagnosed ADHD that may or may not be treated. Pharmacologic intervention, namely, prescription stimulants, is an important consideration for pregnant and breastfeeding women with ADHD, especially because the US Food and Drug Administration has determined that there is not enough information to confirm either harm or lack of harm to the developing fetus following exposure to these drugs. Due to the increase in use of prescription stimulants without a prescription, clinicians are also likely to encounter women misusing stimulants for a variety of reasons. This article provides an overview of ADHD diagnosis, outlines effective treatment options, and offers insight into the importance for clinicians to consider prescription stimulant misuse. Guidance concerning treatment of ADHD during pregnancy and lactation is reviewed.

Nonmedical use of over-the-counter medications is significantly associated with nonmedical use of prescription drugs among university students

ABSTRACTObjective: To examine the association between nonmedical use of over-the-counter medications (NMUOTC) and nonmedical use of prescription drugs (NMUPD). Participants: University students surveyed on NMUOTC and NMUPD between August and December 2011 (N = 939). Methods: Cross-sectional data analysis of online survey. Results: The majority of respondents were women, undergraduate, Caucasian, and not affiliated with Greek life. NMUPD and NMUOTC were reported by 21.4% and 11.2% of students, respectively. NMUOTC was significantly associated with NMUPD in unadjusted analyses and after adjustment for gender, age, race/ethnicity, and Greek membership (odds ratio: 3.37, 95% confidence interval: 2.17, 5.23). Secondary analyses showed a relationship between over-the-counter (OTC) cough medication misuse and NMUPD, OTC stimulant misuse and prescription stimulant misuse, and OTC sleep aid misuse with prescription depressant misuse. Conclusions: Results suggest the importance of both measuring the prevalence of OTC misuse and incorporating its misuse into assessments of polydrug use in the university population.

Collaborative care from the emergency department for injured patients with prescription drug misuse: An open feasibility study

Collaborative Care is a comprehensive longitudinal care management strategy. The purpose of this pilot effectiveness-implementation hybrid study was to determine the feasibility of a Collaborative Care intervention initiated from the Emergency Department and proceeding longitudinally for six months for injured patients with prescription drug misuse (PDM). Adult patients presenting to an urban ED with an injury were screened for eligibility from 2/2015–8/2015. Eligible participants with a positive screen for PDM were enrolled in the ‘ED-LINC’ intervention which included the following elements: 1) active care coordination and linkage, 2) medication safety and utilization of opioid guidelines 3) longitudinal care management and 4) utilization of Electronic Medical Record (EMR) innovations such as the statewide Emergency Department Information Exchange (EDIE) and statewide prescription monitoring program information for assessment and follow-up. Baseline characteristics of the sample were assessed and regression models were used to evaluate longitudinal trajectories of risk for PDM. A total of 36 participants (56% of patients approached) had PDM and 30 participants were enrolled. Of those enrolled, 37% had prescription stimulant misuse, 20% with prescription sedative misuse and 97% had prescription opioid misuse. Follow-up rates at all time points were ≥83%. Baseline levels of comorbidity were high; 57% endorsed recent heroin use and 70% endorsed symptoms consistent with major depression. Over 50% had five or more statewide ED visits and 53% had used three or more different ED‘s in the past year. On average, participants received a total of 85 minutes of ED-LINC over six months with 90% of participants receiving all four intervention elements. All patients had care coordinated with new or existing primary care providers (PCP's) and 23% were linked to a new PCP. A majority of patients (≥80%) reported receiving high quality, desired intervention services. There was no significant change in PDM over time. Collaborative Care initiated from the ED is feasible and acceptable to patients with trauma and PDM. Future directions could include effectiveness-implementation hybrid trials to study implementation barriers and strategies as well as patient-level outcomes of this intervention for this complex patient population.

Neuropsychological functioning in college students who misuse prescription stimulants.

Relatively little is known about the neuropsychological profiles of college students who misuse prescription stimulant medications. Data presented are from college students aged 18-28 years who misused prescription stimulants prescribed for attention-deficit/hyperactivity disorder and controls (no prescription stimulant misuse). Students were assessed neuropsychologically using the self-report Behavioral Rating Inventory of Executive Functioning (BRIEF-A), the Cambridge Automated Neuropsychological Test and Battery (CANTAB), and other tests of cognitive functioning. The analyses included 198 controls (age 20.7 ± 2.6 years) and 100 prescription stimulant misusers (age 20.7 ± 1.7 years). On the BRIEF-A, misusers were more likely than controls to endorse greater dysfunction on 8 of 12 measures including Inhibition, Self Monitor, Initiation, Working Memory, and Plan/Organize, when adjusting for race and sex (all p's < .05). Similarly, when dichotomizing the BRIEF-A as abnormal (T score ≥ 65), misusers had more abnormalities on five of nine subscales, as well as all major indices (p's < .05). Misusers also performed worse on several subtests of the CANTAB and standardized cognitive battery (p's < .05). A proxy of prescription stimulant misuse frequency was positively correlated with greater executive dysfunction on the BRIEF-A. These data demonstrate elevated risk for neuropsychological dysfunction among students who misuse prescription stimulants compared to non-misusing peers. The presence of ADHD contributed significantly to these cognitive findings. Students who misuse prescription stimulants should be screened for neuropsychological dysfunction. These data may better elucidate the neuropsychological profile of college-aged prescription stimulant misusers. (Am J Addict 2017;26:379-387).

Racial/ethnic variation in mental health correlates of substance use among college students

ABSTRACTThis study investigated mental health indicators, substance use, and their relationships, by race/ethnicity. A probability sample of 1,053 students at two California universities self-reported their frequency of substance use and rated their experience with indicators of mental health. One-way analysis of variance (ANOVA), chi-square tests, and multivariate censored regression models were estimated to examine which indicators of mental health were associated with each substance use form by race/ethnicity. Results from the one-way ANOVA and chi-square tests showed differences in substance use prevalence and mental health by race/ethnicity. For example, students who identified as White demonstrate a higher prevalence for every form of substance use in comparison to the Asian, Latino, and “All other” categories. Results from the regression showed, among Whites, inattention was associated with prescription stimulant misuse, and psychological distress was associated with marijuana use. Among Latinos, inattention was associated with cocaine and prescription stimulant use. Among Asians, psychological distress was associated with tobacco use and the misuse of prescription painkillers. Findings highlight the need to ensure subpopulations receive needed services.

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.

Prescription Stimulant Misuse and ADHD Symptomatology Among College Students in Iceland

Objective: Misuse of prescription stimulant medication is a prevalent problem on American college campuses; however, few studies have been conducted beyond the United States. Although Iceland has the highest methylphenidate prescription rates in the world, prevalence of stimulant misuse within the Icelandic college student population remains to be investigated. Method: We examined the prevalence of prescription stimulant misuse among N = 521 college students in Iceland, using an online survey. Results: Overall prevalence of lifetime stimulant misuse was approximately 13%; 11% among participants without a prescription for stimulant medication, and 42% among participants holding a prescription. The primary reported reason for misuse was academic enhancement; risk factors included male sex, anxiety symptoms, and ADHD symptomatology. Conclusion: The present findings have implications for public health policy in Iceland, particularly as it relates to the college population. Prevention and intervention programs that provide college students with safer strategies to manage academic demands are warranted.

Motives for Prescription Stimulant Misuse in a College Sample: Characteristics of Users, Perception of Risk, and Consequences of Use

ABSTRACTBackground: Prescription stimulant misuse is increasingly prevalent in college populations, with some misuse estimates over 40%. Stimulant use is associated with a variety of health and psychological problems. Motives for use may provide insight into problematic trajectories. Objectives: The purpose of the current study was to evaluate characteristics of users and motives for prescription stimulant misuse in a large southeastern university. Method: College students reported on prescription stimulant use, motives for use, consequences associated with use, perceptions of risk, and social norms. We specifically elicited participation from prescription stimulant misusers. Of the 199 participants, 86 reported misusing prescription stimulants in the past 60 days. We assessed motives for use, rates of substance use, risk perception, normative beliefs, and consequences associated with use. We evaluated differences between misusers and non-misusers, differentiate motives subscales, and identify relationships between motives subscales, rates of use, and consequences. Results: Misusers used more alcohol and other drugs, held different normative beliefs regarding stimulants, and had lower risk perceptions than non-misusers. We evaluated seven motives subscales among misusers: coping, social, enhancement, expansion, conformity, academic performance, and weight loss. Enhancement, social, weight loss, and expansion scales were correlated with negative consequences, while social motives were correlated with use. Results from regression analyses revealed positive associations between weight and expansion with negative consequences, and a negative association between conformity and consequences. Conclusions/Importance:Motives for prescription stimulant use and user characteristics may provide insight into prevention and treatment. Continued work is needed to refine item content and replicate findings.

Prescription stimulant medication misuse: Where are we and where do we go from here?

Prescription stimulants, including methylphenidate (e.g., Ritalin) and amphetamine compounds (e.g., dextroamphetamine; Adderall), have been approved by the U.S. Food and Drug Administration for the treatment of attention-deficit/hyperactivity disorder (ADHD) and are classified by the United States Drug Enforcement Administration as Schedule II medications because of their high potential for abuse and dependence (Drug Enforcement Administration, U.S. Department of Justice, 2015). Despite the potential health and judicial consequences, misuse of prescription stimulants, typically defined as taking stimulants without a valid prescription, or use of stimulants other than as prescribed, has become a serious problem in the United States and abroad, especially on college campuses. The purpose of the present article is to review historical information concerning prescription stimulants and to summarize the literature with respect to misuse among adults, particularly college students, including risk factors, mediators and moderators, and motivations for prescription stimulant misuse. In addition, evidence is presented concerning the question of whether prescription stimulants truly enhance cognitive functioning in individuals with and without ADHD, and the ethical and professional implications of these findings are explored. Lastly, recommendations for addressing prescription stimulant misuse and suggestions for future research are advanced. (PsycINFO Database Record

Prescription Stimulant Misuse: International Findings and Implications for Policy, Prevention, and Intervention

Free AccessPrescription Stimulant Misuse: International Findings and Implications for Policy, Prevention, and InterventionBergljot Gyda Gudmundsdottir, Lisa Weyandt and Bailey MunroBergljot Gyda GudmundsdottirAddress correspondence to Bergljot Gyda Gudmundsdottir at [email protected]Search for more papers by this author, Lisa WeyandtSearch for more papers by this author and Bailey Munro1 University of Rhode Island in the Department of Psychology.2 University of Rhode Island Department of Psychology and the Interdisciplinary Neuroscience Program.3 University of Rhode Island Interdisciplinary Neuroscience Program.Search for more papers by this authorPublished Online:September 2016https://doi.org/10.1521/adhd.2016.24.6.1PDFPDF PLUS ShareShare onFacebookTwitterLinkedInRedditEmail ToolsAdd to favoritesDownload CitationsTrack Citations About Next article FiguresReferencesRelatedDetails Cited byCited by1. Study strategies and “study drugs”: investigating the relationship between college students’ study behaviors and prescription stimulant misuseOnline publication date: 16 July 2020. Go to citation Crossref Google Scholar2. Role of non-specialist nurses in supporting people who misuse drugsOnline publication date: 27 April 2020. Go to citation Crossref Google Scholar3. Neurocognitive, Autonomic, and Mood Effects of Adderall: A Pilot Study of Healthy College StudentsOnline publication date: 27 June 2018. Go to citation Crossref Google Scholar4. Pharmacological cognitive enhancement in pediatricsOnline publication date: Go to citation Crossref Google Scholar Volume 24Issue 6Sep 2016 Information© 2016 The Guilford PressPDF download

Half of college students who misuse prescription stimulants have SUDs

Nonmedical use of stimulants is misuse, and in the college setting, where students may be misusing these medications in order to stay up late and study, it turns out that most, compared to controls, actually have psychiatric disorders, including attention‐ deficit hyperactivity disorder (ADHD), according to recent research.