Nonmedical Use Of Prescription Stimulants Research Articles

PHENOME-WIDE GENETIC CORRELATION AND CAUSALITY OF COVID-19 SEVERITY HIGHLIGHTS OVERLAP WITH SUBSTANCE-USE TRAITS

Nearly 10% of U.S. 12th graders report high-intensity drinking (10+ or 15+ drinks in a row), but the extent to which these drinkers also engage in nonmedical use of prescription drugs (NMUPD) is largely unknown. This study examined the associations between different thresholds of past two-week high-intensity drinking and past-month NMUPD among U.S. 12th graders.The sample consisted of eleven nationally representative cross-sections of 12th graders in the Monitoring the Future study (2005–2015) who answered questions on past two-week drinking behaviors and past-month nonmedical use of prescription opioids, sedative, stimulants, and tranquilizers (N = 26,502 respondents).High-intensity drinking during the past two-weeks was associated with an increased risk of past-month NMUPD. The odds of NMUPD were four times larger among 12th graders who indicated drinking 15 or more drinks on at least one occasion (AOR = 4.43, 95% CI = 3.18, 5.01) relative to those who had 0–4 drinks during the past two-weeks, after adjusting for relevant covariates. These associations were similar across different classes of prescription drugs and tended to be stronger among non-white respondents. A sub-analysis revealed simultaneous co-ingestion of alcohol and NMUPD was more prevalent among high-intensity drinkers.More than 1 in every 4 U.S 12th graders who engage in high-intensity drinking (15+ drinks in a row) also report NMUPD. Given the greater likelihood of simultaneous co-ingestion of alcohol and prescription drugs among high-intensity drinkers, adolescent substance use interventions need to address the risks associated with mixing alcohol and prescription drugs.

Non-medical Use of Prescription Stimulants Among College Students: Non-oral Routes of Administration, Risk Factors, Motivations, and Pathways.

Introduction: Non-medical use (NMU) of prescription stimulant medications is a continuing public health concern. Stimulant medications prescribed for attention-deficit/hyperactivity disorder (ADHD) are widely available on college campuses, and, as a consequence, college students may have multiple opportunities to engage in prescription stimulant NMU. This online self-report survey examined prescription stimulant NMU among college students, including: (1) patterns of non-oral route of administration (ROA); (2) motivations for non-oral ROAs; and (3) retrospectively recalled pathways of initiation.Method: The survey sample was created from a pool of 3,379 respondents, who were matched to a sampling frame constructed from the 18–26-year-old, college student sample of the 2016 American Community Survey (ACS). About 14% (n = 486) from the overall pool were identified as college students with self-reported prescription stimulant NMU, all of whom completed the survey. The survey covered user characteristics, prescription and illicit substance use, age of first NMU, motivations for NMU, sources of procurement, and ROAs used.Results: Among 486 students reporting prescription stimulant NMU, 43% had a lifetime diagnosis of ADHD. More than 90% reported polysubstance use, with 55% using illicit substances other than marijuana. Slightly more than 2 in 5 (43.3%) reported using illicit substances prior to prescription stimulant NMU, 24.6% used both at the same age, and 32.0% engaged in NMU of prescription stimulants prior to using illicit substances. Prescription stimulant NMU preceded prescription opioid NMU 45% of the time. More than a quarter of those engaged in prescription stimulant NMU (27.9%) initiated prescription stimulants alone or at the same age as other drugs. Most prescription stimulant NMU was oral, however 23.0% reported any non-oral use: snorting (20.4%), smoking (6.0%)and/or injection (3.5%). Non-oral use was associated with being male, obtaining medication from a dealer, use to get high, and/or a substance use disorder diagnosis.Conclusions: Prescription stimulant NMU often occurs in the larger context of other substance use among college students. Injection, an under-researched route for prescription stimulants, was associated with male gender, history of substance use and higher likelihood of illicit substance use. Nearly a quarter of college student survey respondents reported use with non-oral routes, which is associated with other high-risk behaviors. Efforts to reduce non-oral prescription stimulant NMU in college students are warranted.

A Preliminary Study Examining Self-Reported Invincibility, Alcohol Problems, and the Nonmedical Use of Prescription Stimulants in College Students

The nonmedical use of prescription stimulants (NMUPS) is becoming more common among college students. Identifying the variables associated with NMUPS is important for educational efforts and to promote wellness in vulnerable students. The present study examined the relationships between self-reported invincibility, alcohol problems, and NMUPS in 175 college students. Path analysis tested the hypotheses that males would report higher invincibility that would be related to alcohol use and alcohol problems. Using structural equation modeling, significant relationships were found between invincibility and alcohol-related problems. Alcohol problems may be related to NMUPS. A total effect of invincibility, mediated by alcohol use, may be a path whereby invincibility positively influences NMUPS. Students reporting high levels of invincibility may be at risk for the NMUPS and might benefit from efforts regarding the potential harmful consequences of taking these substances without a prescription.

Patterns, Consequences, and Motives in Simultaneous Use of Prescription Stimulant Medication with Alcohol and Marijuana

Objective Nonmedical use of prescription stimulants (NPS) continues to be a concern on college campuses. Previous research demonstrates a strong link between NPS and use of other substances, particularly alcohol and marijuana among college students. Simultaneous use of NPS with other substances has become an increasing concern. Given the high rates of NPS and simultaneous NPS with other substances, research examining substance use patterns and motives among students is warranted. Method: This study evaluated group differences in alcohol and marijuana use patterns, consequences, and motives among college students: a) with no NPS history (No NPS); b) engaged in NPS with no simultaneous use (Non-Sim NPS); and c) engaged in simultaneous NPS with alcohol and/or marijuana (Sim NPS). Participants included 1,108 students from three universities who reported past-year marijuana and alcohol use. Results: Overall, 32.8% reported lifetime NPS with 12.5% indicating NPS in the previous 3 months, of which 51.1% reported simultaneous NPS with alcohol and 40.2% with marijuana. Significant group differences for all drinking and marijuana outcomes were found, with heaviest rates among the Sim NPS group, followed by the Non-Sim NPS group, and the No NPS group. The Sim NPS group reported greater motives for using marijuana to alter the effects of other substances. Conclusions: College students engaged in simultaneous NPS with alcohol and marijuana are a high-risk group that should be the focus of prevention and intervention programs in the campus setting.

Discordant report of vaping of cannabis among high school seniors in the United States

ABSTRACT Introduction: Reliable responses on surveys are important to ensure accurate estimates of drug use. This study compared prevalence of self-reported vaping of cannabis based on two separate questions on the same survey. Methods: We examined combined data from the 2017–2019 Monitoring the Future nationally representative survey of high school seniors in the US (N = 6,982). Students were first asked whether they had used cannabis in the past year via vaporizer in a section about cannabis use. Later on, students were asked about vaping behaviors, including cannabis vaping. Prevalence of self-reported vaping of cannabis was compared and a multivariable model delineated correlates of providing a discordant response – defined as reporting vaporizer use but not reporting vaping. Results: Estimated prevalence of use based on the question in the cannabis section was 11.9% (95% CI: 11.0–12.9) and prevalence based on the question in the vaping section was 13.2% (95% CI: 12.3–14.2). Among those reporting vaping of cannabis, 17.3% provided a discordant response. The corrected prevalence was 16.5% (95% CI: 15.5–17.6). Black students were more likely to provide a discordant report (aPR = 1.82, 95% CI: 1.23–2.69) and those reporting past-year vaping of nicotine (aPR = 0.27, 95% CI: 0.19–0.38) and/or nonmedical use of prescription stimulants (aPR = 0.44, 95% CI: 0.21–0.91) were less likely to provide a discordant report. Conclusions: Self-report of vaping of cannabis varies depending on whether it is asked in a section about vaping practices or about overall cannabis use (use via vaporizer). Survey researchers need to consider how to best query cannabis vaping practices on surveys.

Assessing motivations and gender as factors in college students’ views of nonmedical prescription stimulant use

Introduction: Two prominent motivation categories of college student nonmedical prescription stimulant use (NMUPS) are for academic and recreational purposes. However, little research focuses on these motivations’ association with college students’ NMUPS views. Further, limited research assesses if user gender influences views. Methods: The current online scenario study implemented a 2 × 2 factorial design assessing 148 college undergraduates’ (75% females; M age = 19.18; SD age = 1.30) NMUPS views based on user motivation and gender. Participants reported their drug use stigmatization, prescription stimulant expectancies (ie, anticipated drug use beliefs and outcomes), and personal substance use. Results and Discussion: Results showed that user gender did not influence participants’ NMUPS views; however, participants viewed academic use less negatively compared to recreational use, thus highlighting the need to educate students on the negative consequences of NMUPS, even when use is for academically related tasks. Furthermore, exploratory analyses showed drug use stigmatization and prescription stimulant expectancies predicted participant NMUPS views. Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2021.1942005 .

Nonmedical Prescription Opioid Use among a Sample of College Students: Prevalence and Predictors.

Nonmedical use of prescription opioid medication (NMPO) in the United States is a public health crisis, resulting in high rates of emergency room visits, morbidity, and mortality. The purpose of this study was to explore prevalence estimates and correlates of NMPO among a convenience sample of college students in the northeast and southeast regions of the US to help generate directions for future research. Motivations for misuse, age of onset, access, concomitant substance use, and individual factors were investigated among a sample of undergraduate students from two universities. Participants (N = 847) completed a battery of various self-report measures. Findings revealed that 7.7% (Southeastern University) and 12.8% of students (Northeastern University) reported lifetime NMPO, whereas past-month NMPO was reported by 0.8% and 0.9% of participants, respectively. Lifetime history of regularly using alcohol, nonmedical use of benzodiazepine medication, nonmedical use of prescription stimulants, symptoms of depression and anxiety, and executive functioning (i.e., metacognition and behavioral regulation) were significantly related to lifetime history of NMPO in this college sample. These findings offer several potential subsequent lines of investigation regarding the associations between various demographic and psychological factors and NMPO. Future research is needed to help identify college students who are at risk of NMPO.

Substance Use Trajectories: Nonmedical Use (NMU) of Prescription Stimulants via Non-Oral Routes of Administration Among Adults Recruited from Reddit

NMU of prescription stimulant medications (RxStim) intended for treatment of attention deficit/hyperactivity disorder (ADHD) is a growing public health concern, particularly when used via non-oral routes of administration. However, the role of non-oral routes of administration for RxStim NMU in the larger substance abuse pathway is less well studied. The purpose of this study was to characterize RxStim NMU and investigate substance use trajectories among adults who reported non-oral RxStim NMU recruited from Reddit.Eligible participants must have been located in the US, English speaking, age 18 y, and have reported RxStim NMU via a non-oral route (any route other than ingestion) within the past 5 y. Participants were recruited from Feb-Sep 2019 using banner ads on Reddit, the 5th most visited website in the US. Participants completed an online survey which captured demographics, lifetime RxStim NMU and illicit substance use; they were compensated for their time. For purposes of this study, NMU included ANY of the following: (1) use for any reason, even once, without their own prescription, (2) use in ways other than prescribed, and (3) use for the feeling or experience the medication caused.Respondents (n=225) were primarily male (86.2%), 18-24 (48.0%) or 25-34 (43.1%) years of age, and Caucasian (78.2%), Black (7.1%) or Hispanic (5.3%). Lifetime diagnosis of ADHD was reported by 27.6%, with 53.2% diagnosed at age 11-19 and 35.5% at age 20+ years. RxStim NMU via snorting was reported by 99.1%, smoking 3.6% and injecting 6.2% (multiple routes could be reported). Almost all (n=222; 98.7%) also reported lifetime illicit drug use, among whom 182 (82.0%) initiated substance use by using an illicit drug (77.9% marijuana, 1.8% cocaine/crack, 0.9% inhalants, 0.9% hallucinogens, 0.5% methamphetamine/amphetamines) prior to RxStim NMU. Forty (18.0%) respondents initiated with RxStim NMU; 14.4% then initiated marijuana use, 0.9% initiated cocaine/crack use, 0.9% initiated barbiturate use, and 0.5% initiated heroin, inhalant, methamphetamine/amphetamine, and hallucinogen use. Average age of initial RxStim NMU was 18.7 (SD 3.7) years and most often was via swallowing (89.1%) followed by snorting (10.9%). Respondents began using marijuana at age 15.9 (SD 2.5), cocaine or crack at 19.7 (SD 3.3), and heroin at 20.9 (SD 5.5).Engagement in RxStim NMU via a non-oral route of administration is most often preceded by marijuana use. Among this Reddit-recruited population of non-oral RxStim nonmedical users, only 1 in 4 reported an ADHD diagnosis and <1 in 5 reported RxStim NMU as their first substance use experience; most of these then added marijuana and few moved toward cocaine/crack or methamphetamine. RxStim NMU via non-oral routes is associated with a larger pattern of risky substance use behaviors. Nearly all non-oral RxStim NMU is associated with concomitant drug use, especially marijuana.Funding. Arbor Pharmaceuticals, LLC.

Nonmedical Use of Prescription Stimulants as a “Red Flag” for Other Substance Use

Background Nonmedical use of prescription stimulants (NMPS) has increased on college campuses during the past two decades. NMPS is primarily driven by academic enhancement motives, and normative misperceptions exist as well. However, large, nationwide studies have not yet been conducted to generalize findings more broadly and gain a deeper understanding of the relationship between NMPS and other substance use (e.g. alcohol use, marijuana, etc.). The present study was conducted to lay the foundation for prevention efforts related to NMPS by establishing NMPS prevalence, practices surrounding NMPS, and other substance use. Methods N = 2,989 students from seven universities around the U.S. completed a web-based survey assessing NMPS practices and related behaviors. Prevalence and factors associated with NMPS were explored. Results Analyses revealed a 17% past-year prevalence of NMPS with associated widespread misperceptions of peer use. NMPS was significantly related to alcohol use, binge drinking, and marijuana use, as well as skipped classes and affiliation with Greek life. Conclusions Although most college students do not report NMPS, those who do also are more likely to report alcohol use, binge drinking, and marijuana use, and NMPS could be a “red flag” for other risk behaviors worth exploring. Implications for prevention and intervention are discussed.

Mental Health, Academic Engagement, and Youths’ Nonmedical Use of Stimulants: A Latent Profile Analysis

Background: Nonmedical prescription stimulant (NPS) use is a growing problem in Europe. Poor mental health and lack of academic engagement are potent sources of risk for substance use. Studies suggest that considerable heterogeneity may characterize the risk profiles of NPS users. To understand better the potential profiles of risk that characterize NPS users, we conducted a latent profile analysis (LPA) to document subgroups of users based on their mental health and academic engagement. Methods: A nationally representative, cross sectional survey of Icelandic youth was analyzed. The sample included 584 (5% of the sample) older adolescent students participating in a national study in Iceland who reported lifetime NPS use. Results: Three subgroups of NPS users emerged from our analyses. The largest subgroup (43.1%) we labeled mentally healthy achievers; youth who appear to be academically motivated and have few if any mental health concerns. The second largest group (40.4%), low achievers, resembled a typical profile for drug users in that they reported low or modest academic engagement and moderate levels of mental health concerns. The third group, anxious achievers (16.5%) appears to represent youth who felt academics were very important, had moderate study motivation, and also reported elevated mental health concerns, especially anxiety. Conclusions: LPA revealed considerable heterogeneity among these users. Group membership suggests distinct approaches to prevention to address heterogeneity in motivations for NPS use.

Students’ stimulant use for cognitive enhancement: A deliberate choice rather than an emotional response to a given situation

BackgroundPrescription stimulants such as methylphenidate are usually prescribed to treat attention deficit (and hyperactivity) disorders (ADHD). Recently, these drugs have gained popularity among college students, because of the belief that they can help improve academic performance. ObjectivesThis study assessed whether engaging in nonmedical use of prescription stimulants for cognitive enhancement is a rational or a more spontaneous decision-making process. MethodA survey was conducted among 661 students (63.5 % females, n = 420, Mage = 21.40). Data were analyzed using structural equation modeling. ResultsA total of 15.9 % (n = 105) of the students had previously taken stimulants to improve their academic performance. The use of stimulants was significantly higher among males (22.4 %) than females (12.1 %).Positive attitudes toward stimulant use for cognitive enhancement were strongest related to students’ intention to take stimulants for increasing their academic performance, followed by the norm of parents. Additionally, the more the students identified themselves with the prototype of a student using stimulants for cognitive enhancement, the more likely they were to be willing to misuse stimulants. ConclusionsThe findings suggest that using stimulants for cognitive enhancement is a rational choice rather than an unplanned one.

Medicate to Graduate: Academic Strain and Nonmedical Prescription Stimulant Use Among Graduate and Undergraduate Students

The nonmedical use of prescription stimulants has been prevalent on college campuses in recent years. Previously, nonmedical prescription stimulant use (NMPSU) has been associated with increased use of other illicit substances, drug abuse, school dropout, and arrest. It is, therefore, imperative to understand the etiology of NMPSU for prevention, intervention, and harm reduction purposes. This study builds upon previous research on the role of academic strain in NMPSU by (a) considering a measure of strain that is more consistent with strain theory and (b) extending the examination to include graduate students. By utilizing an original data set of 1,121 undergraduate and graduate students at a Southern urban university, our overall results are consistent with general strain theory but mixed with respect to the role of academic strain in particular. The implications of our study for academic strain are discussed.

Prenatal and early childhood exposure to tetrachloroethylene (PCE) and non-medical use of prescription drugs: A retrospective cohort study in Cape Cod, MA

BackgroundBetween 1968 and 1983, public drinking water supplies of Cape Cod, Massachusetts were contaminated with the chlorinated solvent tetrachloroethylene (PCE). We previously found an affinity for risk-taking behaviors, including the use of illicit drugs, following prenatal and early childhood exposure to PCE. Using newly collected data, we investigated the risk of non-medical use of prescription drugs (NMUPD) following prenatal and early childhood PCE exposure. MethodsParticipants were identified from a retrospective cohort study ("Cape Cod Health Study”) via cross-matching birth certificates and water system data. The original self-administered questionnaire gathered data on demographics, work and medical history, and alcohol and illicit drug use from 618 individuals (363 exposed and 255 unexposed). The follow-up survey added questions on non-medical use of prescription pain relievers, tranquilizers, stimulants and sedatives. A validated leaching and transport model was used to estimate exposure to PCE exposure in drinking water. ResultsThere was a wide distribution of cumulative prenatal and early childhood PCE exposure levels (range: 0.04 g–3722.2 g). PCE exposed subjects had a 1.92-fold increase in risk of any non-medical use of prescription drugs [Adjusted RR: 1.92, (95% CI: 1.31, 2.83)]. Furthermore, the association followed a dose-response relationship where the risk of NMUPD was higher for those exposed to PCE levels greater than or equal the median level versus those exposed to levels less than the median [Adjusted RR: 2.05 (95% CI: 1.34, 3.15) vs. 1.83 (95% CI: 1.20, 2.79) (p-value for trend < 0.01)]. Additionally, we found moderate increases in risk by level of non-medical use (any non-medical use, non-medical use of 1 or more categories of prescription drugs, or 2+ categories) as well as by category of drug for pain relivers, stimulants and tranquilizers. ConclusionWe found that prenatal and early childhood exposure to PCE was associated with a moderate increase in the risk of NMUPD. Exposed subjects had dose-related increased risks of NMUPD of pain relievers, tranquilizers, and stimulants. This study has a number of limitations and is the first to report this association. Additional longitudinal studies of populations exposed to PCE during early life should be conducted to examine its long-term neurotoxic effects.

Medical, Nonmedical, and Illegal Stimulant Use by Sexual Identity and Gender

Major knowledge gaps regarding medical and nonmedical prescription stimulant use and illegal stimulant use (i.e., cocaine/crack/methamphetamine) by sexual identity and gender have implications for individuals' health and well-being. This study improves stimulant use measurement by differentiating the type of stimulant use and focusing on lesbian, gay, and bisexual subpopulations. Data were pooled for adults in the 2015-2017 National Survey on Drug Use and Health (n=126,463; analyzed in 2019). Gender-stratified logistic regression models examined associations between sexual identity and past-year illegal stimulant use. Gender-stratified multinomial logistic regression models estimated odds of (1) medical use only versus no past-year prescription stimulant use, (2) any nonmedical stimulant use versus no past-year use, and (3) any nonmedical stimulant use versus medical use only. Illegal stimulant use varied by sexual identity (men: gay, 9.2%; bisexual, 7.5%; heterosexual, 3.2%; women: gay/lesbian, 3.2%; bisexual, 7.8%; heterosexual, 1.5%), as did nonmedical prescription stimulant use. Relative to same-gender heterosexuals, gay (AOR=2.61, 95% CI=2.00, 3.40) and bisexual (AOR=1.70, 95% CI=1.24, 2.33) men had higher odds of past-year illegal stimulant use, as did gay/lesbian (AOR=1.63, 95% CI=1.16, 2.28) and bisexual (AOR=2.70, 95% CI=2.23, 3.26) women. Sexual minorities reported higher odds of nonmedical prescription stimulant use than heterosexuals. Any nonmedical prescription opioid use was reported by 26.4% of people who reported nonmedical stimulant use and 27.0% of people who reported illegal stimulant use. Lesbian, gay, and bisexual individuals had a higher prevalence of stimulant use than their heterosexual counterparts. This has important implications for health disparities, especially given the high levels of polysubstance use. Taking a multilevel approach is crucial to reduce stimulant-related harms for lesbian, gay, and bisexual individuals.

Medical cannabis laws and medical and non-medical prescription stimulant use among a nationally representative sample of US Adults: Examining the role of sexual identity and gender

BackgroundMedical marijuana laws (MMLs) can impact marijuana and opioid use, but the relationship between MMLs and other drugs, such as prescription stimulants, remains unexamined. Because lesbian, gay and bisexual (LGB) individuals report higher levels of prescription stimulant use than heterosexuals, we explored the relationship between MMLs and past-year medical and non-medical stimulant use by sexual identity and gender. MethodsWe pooled 2015–2017 National Survey on Drug Use and Health data for adults (n = 126 463), and used survey-weighted multinomial logistic regression to estimate odds of past-year (a) medical prescription stimulant use, (b) non-medical prescription stimulant use and (c) non-medical versus medical stimulant use. We stratified by gender, adjusted for sociodemographic characteristics, and tested the interaction between MML state residence and sexual identity. ResultsBisexual men had higher medical (6.4% versus 4.1%; aROR=1.93[1.29–2.88]) and non-medical stimulant use 6.6% versus 2.4%; aROR=2.23[1.44–3.44]) than heterosexual men. Bisexual women had higher non-medical stimulant use (6.8% versus 1.6%; aROR=1.54[1.23–2.93] than heterosexual women. Female (aROR=0.70[0.62–0.78]) and male (aROR=0.74[0.66–0.82]) heterosexuals in MML states had lower odds of medical stimulant use than in non-MML states. Bisexual men in MML states had lower odds of medical (aROR=0.36[0.21–0.61]) and non-medical stimulant use (aROR=0.48[0.29–0.81]) than bisexual men in non-MML states. Similar patterns emerged for bisexual women's non-medical use (aROR=0.57[0.40–0.81]). ConclusionPrescription stimulant use was higher in non-MML states for most LGB subgroups. MMLs may differentially impact stimulant use, primarily for bisexual men and women. States enacting MMLs should consider potential impacts on drugs other than marijuana, especially among LGB populations.

Prescription Stimulant Nonmedical Use Among Adolescents Evaluated for Substance Use Disorder Treatment (CHAT™)

Objective: The purpose of the present study was to characterize prescription stimulant non-medical use (NMU) in adolescents between the ages of 13 and 18 years seeking treatment for substance use disorder (SUD) with the Comprehensive Health Assessment Tool for Teens (CHAT™). Method: Adolescents being evaluated for SUD treatment between Q1 2010 and Q3 2017 (n = 20,189) completed the CHAT™. Results: About 4.3% of the sample (N = 867) of adolescents in SUD treatment reported past 30-day prescription stimulant NMU. Compared to those without past 30-day prescription stimulant NMU, more reported a lifetime diagnosis of learning disorder or ADHD, more took medication for emotional, behavioral, or learning disorders, received past-month inpatient treatment, or were currently not enrolled in school. Prescription stimulants were most often taken orally for NMU, however, approximately half reported using alternate routes of administration, the most prominent of which was intranasal use. Conclusion: About 4.3% of adolescents in SUD treatment evaluation reported past 30-day prescription stimulant NMU. Greater percentages of lifetime learning disorder, medication use, past-month inpatient treatment, school unenrollment, and overall substance misuse were associated with prescription stimulant NMU, as were alternate routes of administration. These data reveal an ongoing, persistent level of past-30-day NMU of prescription stimulants among adolescents being evaluated for SUD treatment.

Food Insecurity, Sexual Risk, and Substance Use in Young Adults

PurposeThe aim of the study was to determine the association between food insecurity, sexual risk behaviors, sexually transmitted infections (STIs), and substance use in a nationally representative sample of U.S. young adults. MethodsCross-sectional nationally representative data of U.S. young adults aged 24–32 years from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health were analyzed. Multiple logistic and linear regression analyses were conducted with food insecurity as the independent variable and self-reported STIs, sexual risk behaviors, and substance use as the dependent variables, adjusting for covariates and stratifying by sex. ResultsOf the 14,786 young adults in the sample, 14% of young women and 9% of young men were food insecure. Food-insecure young women had greater odds of any STI, HIV, chlamydia, exchanging sex for money, and multiple concurrent sex partners in the past 12 months compared to young women reporting food security, adjusting for covariates. Food insecurity was associated with higher odds of any STI, chlamydia, and exchanging sex for money among young men who identify as gay or bisexual, but not in the general population of young men. Food insecurity was associated with greater odds of marijuana use, methamphetamine use, and nonmedical use of prescription opioids, sedatives, and stimulants in both young men and women. ConclusionsFood insecurity is associated with risk behaviors and self-reported STIs, including HIV, in young adulthood. Health care providers should screen for food insecurity in young adults and provide referrals when appropriate.

"Study Natural" without Drugs: An Exploratory Study of Theory-Guided and Tailored Health Campaign Interventions to Prevent Nonmedical Use of Prescription Stimulants in College Students.

Nonmedical use of prescription stimulants (NMUPS) among college students continues to rise. While some anti-NMUPS campaigns are available, little is known about the campaign development process and how well college students evaluate these messages. To bridge this gap, we developed theory-guided anti-NMUPS campaign interventions that are tailored to college students’ characteristics and evaluated students’ response towards them. A total of 445 college students (74.4% female; Meanage of 20; 18 to 35 years old) reviewed the campaign interventions and offered their evaluation via an online survey. Findings indicate that students responded to the campaigns positively. Results also indicate that female students are more likely to perceive the campaigns as effective than their male counterparts. Overall, the findings of this study suggest that theory-guided and tailored anti-NMUPS campaigns have great potential in changing students’ attitudes and behavior towards NMUPS. While this study fills critical gaps in the literature, considering the progress needed to strengthen the research field, more research is needed to further identify effective strategies that could prevent college students’ participation in NMUPS activities.

Disentangling the Social Context of Nonmedical Use of Prescription Stimulants in College Students

The aim of this study was to investigate the social context of nonmedical use of prescription stimulants (NMUPS) among college students who endorsed NMUPS with co-occurring substance use disorders (SUD) compared with those without co-occurring SUDs. Presented here are new analyses based on data previously collected from college students aged 18 to 28 years derived from the Boston metropolitan area who endorsed NMUPS (N = 100) at least once in their lifetime. Differences between those with lifetime history of SUD (N = 46) and without a history of SUD (N = 54) on the Massachusetts General Hospital ADHD Medication Misuse and Diversion Assessment were analyzed using the Student t test, the Pearson χ2 test, and the Wilcoxon rank-sum test. College students who endorsed NMUPS with co-occurring SUD were more likely than those without SUD to have bought or traded stimulants, bought or traded in their car, used at parties with drugs/alcohol, or used intranasally (all P < .05). Intranasal administration was common (38% of all students endorsing NMUPS) and was associated with misuse at a party and simultaneous use with cocaine (P = .04), marijuana (P < .001), and alcohol (P < .001), compared with only oral use. Notable characteristics were identified among individuals who engaged in NMUPS in the type, amount, cost, and ascertainment of stimulants. The concurrence of SUD and/or intranasal administration appear to represent a more severe phenotype of NMUPS that should be considered in the implementation of future prevention and intervention protocols on college campuses. (Am J Addict 2020;29:476-484).

Preventing college student nonmedical prescription stimulant use: Development of vested interest theory-based persuasive messages

Vested interest theory (VIT) predicts that perceived importance and hedonic relevance of an expected behavioral outcome affects attitude-behavior consistency. Applied to college students’ nonmedical use of prescription stimulants (NUPS), the theory posits that persuasive information that weakens vested perceptions regarding assumed advantages of stimulant misuse will reduce usage intentions. The current study developed and experimentally assessed persuasive messages that targeted perceptions of vested interest (VI), and examined if message effectiveness varied as a function of users’ risk status. Appeals that focused on the physical harms of misuse served as the comparison condition. College student participants (N = 282) were randomly assigned to one of four message conditions. To examine group differences, data were analyzed in a 2 (VIT-based message: yes, no) × 2 (Physical harms emphasized: yes, no) × 3 (User status: resolute, vulnerable, user) between-subjects factorial design. Analyses showed that messages focused on lowering VI by convincing students that NUPS did not enhance cognitive functioning of non-ADD/ADHD students reduced perceived vested interest (p < .001) and attitude favoribility p = .005. In vulnerable nonusers, these messages also decreased NUPS intentions p = .006. The effect of exposure to the physical harm communication was not significant. Findings support the potential of VIT-guided messages in NUPS prevention, and the lack of effect of messages focused on physical consequences of misuse.