Nonmedical Prescription Stimulant Research Articles

Prevalence and factors associated with non-medical prescription stimulant use to promote wakefulness in young adults

Objective: This study examined the prevalence and factors associated with non-medical use of prescription stimulants to promote wakefulness. Participants: We surveyed 3,160 university students aged 18–35 between June 2016 and May 2017. Method: Participants reported whether they used prescription stimulants non-medically to stay awake and completed measures of anxiety and depressive symptoms, sleep quality, insomnia, daytime sleepiness, and attitudes toward non-medical prescription drug use. Univariate and multivariate regression models were used. Results: Prevalence of non-medical prescription stimulant use to promote wakefulness was 3.1%. The following factors remained significant in the multivariate model: alcohol, tobacco, and nicotine vapor use, attitude toward non-medical use of prescription medication, poor sleep quality, and daytime sleepiness. Conclusion: Poor sleep, substance use and more liberal attitudes to non-medical prescription drug use were associated with the misuse of stimulants to promote wakefulness. Prevention/intervention programs should promote sleep hygiene and highlight the risks of using prescription drugs non-medically.

Psychiatric comorbidity in adolescent use and poly-use of combustible, vaporized, and edible cannabis products

Cannabis legalization and commercialization has resulted in novel alternative cannabis products on the market, including edible and vaporized cannabis, which may appeal to youth with psychiatric problems. Psychiatric comorbidity in adolescent use and poly-use (i.e., use of >2 products) of combustible, edible, and vaporized cannabis products has largely gone uninvestigated. This 2015 cross-sectional survey of Los Angeles, California area adolescents (Mage = 16.1, N = 3177) characterized associations of various psychiatric problems with use and poly-use of combustible, edible, and vaporized cannabis. Exposure variables included past 30-day non-cannabis substance use (alcohol, e-cigarettes, combustible cigarettes, and nonmedical prescription opioid and stimulant use; yes/no), and psychiatric problems including past-week depressive symptom frequency, past 6-month ADHD symptom and conduct problem frequency, anhedonia, and five dimensions of impulsivity (sensation seeking, perseverance, lack of premeditation, positive urgency, and negative urgency). Outcome variables included past 30-day use (yes/no) of combustible, edible, and vaporized cannabis, independently, and number of cannabis products used (single, dual-use, poly-use). Results showed that all forms of non-cannabis substance use (ORs range: 13.7–36.1) and all psychiatric symptoms and traits (ORs in SD units range: 1.1–2.1) were positively associated with combustible, edible, and vaporized cannabis product use. The magnitude of comorbidity did not significantly differ by cannabis product type used in most cases. Psychiatric comorbidity was typically stronger in poly-product than single-product cannabis use and greater for externalizing-type than internalizing-type psychiatric problems. Practitioners, policy makers, and scientists should be aware that pervasive psychiatric comorbidity may be observed across the spectrum of cannabis product use among adolescents, particularly poly-product users.

Disordered eating is associated with non-medical use of prescription stimulants among college students

BackgroundDisordered eating behaviors are associated with non-medical use of prescription stimulants for weight and appetite-related purposes. Yet, estimates of the prevalence and types of disordered eating associated with non-medical use vary. Additionally, little is known about the association between medical use of prescription stimulants and disordered eating. MethodData were collected from 87,296 college students at 127 institutions that participated in the Healthy Minds Study. We assessed the relationship between disordered eating, medical and nonmedical prescription stimulant use using multivariable logistic regression models adjusted for demographic characteristics, lifestyle and behavioral factors, and psychiatric comorbidity. ResultsNon-medical use of prescription stimulants (NMUPS) was reported by 2.8 % n = 2435 of the sample. One-third of students using prescription stimulants non-medically reported two or more disordered eating attitudes and behaviors. Disordered eating was a significant predictor of non-medical, but not medical use of prescription stimulants. A dose-response relationship was identified between disordered eating and non-medical use, where risk for non-medical use increased with the number of disordered eating attitudes and behaviors reported. ConclusionsThe risk for NMUPS increases with disordered eating symptomatology. There is a need to assess for NMUPS among college students presenting with disordered eating.

Illicit drug use among college students: The role of social norms and risk perceptions

PurposeTo examine the prevalence and correlates of college student use of illicit substances including cocaine, designer drugs, and nonmedical use of prescription stimulants and opioids, and to identify how different drug-related perceptions are related to past year use of these substances. MethodsData were analyzed from a cross-sectional anonymous web-based survey among a sample (n = 1345, 81% female) of students attending a mid-sized liberal arts college in the US. Logistic regression models were estimated to assess the relationships between substance-specific descriptive norms, injunctive norms, perceived availability, risk perceptions and past year use of cocaine, designer drugs, prescription stimulants, and opioids, adjusting for current marijuana use, alcohol dependence, sensation seeking, and sociodemographic factors. FindingsPast year use of illicit substances ranged from 6% for nonmedical prescription opioids to 21% for nonmedical prescription stimulants. The sociodemographic correlates past year substance use differed by substance type. Descriptive norms (perceptions of peer use) and perceived risk were not consistently related to use of these substances. Current marijuana use was the strongest correlate across substances, and both injunctive norms (perceptions of peer approval) and perceived availability were consistently related to use of each substance. ConclusionsFindings suggest that future college student drug prevention efforts should more directly target current marijuana users since they are most at risk of using other illicit substances. Additionally, findings indicate that injunctive norms may be an important consideration for education-focused drug prevention programs. However, findings should be interpreted in light of limitations of the sample, which is predominantly female.

Sex differences in nonmedical prescription tranquilizer and stimulant use trends among secondary school students in Argentina, Chile, and Uruguay

BackgroundLittle is known about recent nonmedical prescription tranquilizer and stimulant use trends in Latin America. We tested whether recent trends among students in three South American countries differed by sex over time. MethodsThree countries independently collected National School Students Survey on Drugs. Students in 8th, 10th, and 12th grades were sampled in Argentina (2007–2014, N = 328,202), Chile (2007–2015, N = 136,379), and Uruguay (2007–2016, N = 32,371). Weighted linear regression models predicted the prevalences and trends over time of past-year nonmedical tranquilizer and stimulant use by country, and tested whether trends differed by sex, adjusting for school type and grade. ResultsIn Argentina from 2007 to 2014, past-year nonmedical prescription tranquilizer (girls: 2.8 to 2.6%, boys: 2.5 to 2.3%) and stimulant (girls: 1.7 to 1.3%, boys: 1.9 to 1.5%) use trends did not differ by sex. In Chile from 2007 to 2015, nonmedical prescription tranquilizer use trends significantly differed comparing girls (3.9 to 10%) with boys (3.2 to 6.9%); stimulant use trends did not differ comparing girls (1.6 to 2.0%) with boys (2.0 to 1.3%). In Uruguay from 2007 to 2014 and 2014–2016, past-year nonmedical prescription tranquilizer (girls: 5.1 to 6.6%; boys: 2.8 to 4.2%) and stimulant (girls: 1.8 to 0.7%; boys: 1.8 to 0.7%) use trends did not differ by sex. ConclusionsTrends of nonmedical prescription tranquilizer use recently increased in Chile and Uruguay, widening by sex over time in Chile only. The drivers of increasing tranquilizer use among girls in Chile and Uruguay merit further investigation.

Predicting Future Academic Willingness, Intentions, and Nonmedical Prescription Stimulant (NPS) Use with the Theory of Reasoned Action and Prototype/Willingness Model

Background: Nonmedical prescription stimulant (NPS) use for academic reasons (e.g., to improve concentration) is a growing problem among college students. However, there is limited theory-driven research that attempts to identify risk cognitions underpinning decisions to use and NPS use for academic purposes. Furthermore, it is unclear if academic NPS use is characterized by deliberative and/or socially reactive processing and what health decision-making model or combination of models best predicts NPS use decisions and use. Identifying cognitions associated with NPS use decisions is essential to develop interventions aimed at preventing and reducing NPS use. Objective: The present study tested the Theory of Reasoned Action (TRA), Prototype/Willingness Model (PWM), and a combined TRA/PWM model to identify which model best predicts academic NPS use decisions (willingness and intentions) and past 2-month use among college students. Method: Undergraduates (N = 344) participated in a two-wave study assessing T1 constructs from the TRA and PWM as predictors of T2 (2 months later) academic NPS use decisions and use. Results: In the combined TRA/PWM, all T1 constructs were associated with T2 NPS willingness, intentions, and use except for injunctive norms. The integrated model also explained greater variance in T2 use, willingness, and intentions than each model alone. Conclusions/Importance: The combination of cognitions from the TRA/PWM was superior to each individual model and improved the prediction of future NPS use willingness, intentions, and use. The overall results derived from all three models suggest that both deliberative and socially reactive processing influence and characterize academic NPS use decisions and use.

Burning the candle at both ends: motivations for non-medical prescription stimulant use in the American workplace

Studies indicate prescription stimulant use for cognitive performance enhancement is normalized, contributing to increases in non-medical prescription stimulant use (NPSU) through peer recommendations and drug diversion. NPSU may follow users beyond their academic years to the workforce with some initiating use later in adulthood.Aims: Examine findings from a San Francisco Bay Area National Institute on Drug Abuse funded research project. Explore motivations to initiate and continue NPSU focusing on San Francisco Bay Area adults in the workforce. Analyze motivations for use and use practices within the American sociocultural context. We also examine consequences of use, including falling into the ‘Adderall trap’ – a cycle of using to perform, sleeplessness, then using again to wake up and perform.Methods: 67 in-depth interviews analyzed using Grounded Theory methods.Findings: Increased availability combined with pressure to perform and compete at work, facilitated decisions to initiate and continue use. Some also used recreationally to mitigate the effects of alcohol and prolong a night out.Conclusions: Cultural factors such as the pressure to perform in a society as the US valuing hard work, competition, and success motivate NPSU. In these cases, NPSU is not necessarily considered to be deviant, but rather following conventional values.

Impact of Nicotine and Other Stimulants on Sleep in Young Adults.

Sleep problems can have long-term negative consequences. This study explored the relationship of commonly used stimulant substances to poor sleep quality in young adults. We surveyed 498 participants, aged 18 to 25, who reported recent alcohol or marijuana use. Stimulant substances measured included coffee, energy drinks, nonmedical prescription stimulants (NPS), cocaine, and nicotine. Sleep outcomes were measured using the Pittsburgh Sleep Quality Index (PSQI) and its components. Participants averaged 21.3 (±2.07) years of age, 47.8% male, 65.5% non-Latino white, 10.8% African-American, 12.3% Latino, and 11.5% other ethnic origins. In the past 30 days, 24.9% had used cigarettes, 48.1% energy drinks, 17.3% NPS, 79.3% coffee, and 7.9% cocaine. Mean PSQI global score was 6.21 (±3.66, median = 5). After adjusting for background characteristics, PSQI global scores were positively and significantly associated with number of cigarettes/day (b = 0.16, 95% confidence interval 0.07 to 0.25, P < 0.001) and days of NPS (b = 0.10, 95% confidence interval 0.01 to 0.18, P = 0.030). NPS negatively affects sleep, but nicotine is particularly deleterious to sleep quality. Addressing smoking cessation to improve sleep may be a novel way to motivate young adult smokers to quit.

Evaluation of nonmedical use of prescription stimulants by college students at three northeastern pharmacy schools

ObjectiveTo evaluate the prevalence of self‐reported nonmedical prescription stimulant use among college students of three northeastern pharmacy schools in the United States by examining the relationship of nonmedical use with underlying factors, academic performance, consequences associated with drug abuse, and quality of life (QOL).MethodsThis study was approved by the respective institutional review boards of the pharmacy schools involved. Data were collected from consenting students in their first, second, and third professional years using an anonymous survey between April and September 2017. The survey assessed underlying factors, self‐reported grade point average (GPA), and patterns of nonmedical use. Patient‐reported outcome (PRO) measures included were the Drug Abuse Screening Test (DAST‐10) to assess consequences associated with drug abuse and the Short Form (SF‐12) to measure QOL.ResultsIn total, 651 responses of 1201 students surveyed were collected. In the included sample, 11.6% of students reported nonmedical use of prescription stimulants during college, with varying reported frequencies from 36% using once or twice to 8% using regularly. Factors associated with increased odds of nonmedical use with statistical significance included male gender (odds ratio [OR] 2.75, 95% confidence interval [CI]: 1.68‐4.52, P = 0.001) and fraternity or sorority involvement (OR 2.84, 95% CI: 1.72‐4.70, P = 0.001). Nonmedical users had statistically lower GPAs (3.38, 95% CI: 3.44‐3.50) than nonusers (3.47, 95% CI: 3.30‐3.45, P = 0.02), and increased risks associated with drug abuse, as measured by the DAST‐10. No significant differences in QOL were found between nonmedical users and nonusers, as measured by the SF‐12.ConclusionThe findings examined the impact of nonmedical prescription stimulant use by pharmacy students and found that nonmedical use was similar to rates observed by college students in other studies. Nonmedical use is associated with lower GPA and increased risks associated with drug abuse. More research must be conducted to understand and increase awareness of the effects of prescription stimulants.

Substances as Self-Treatment for Cognitive Test Anxiety among Undergraduate Students

ABSTRACTThis research investigates associations between cognitive test anxiety (CTA) and use of alcohol, tobacco, cannabis, and medical and non-medical prescription stimulants (MNPS) among undergraduate students in Israel. A structured, self-report, anonymous questionnaire was distributed to 814 undergraduate students in Israel. According to the test anxiety questionnaire, 16.6% of participants were found to experience CTA. CTA was higher among users of MNPS than among students who did not use MNPS. Students with CTA were 2.21 times more likely to engage in use of MNPS than students who did not have CTA (OR 2.21, 95% CI: 1.50–3.26; P < 0.001). A significant association was found between CTA and use of MNPS among the entire sample and among non-medical use of prescription stimulants (NPS). In addition, a significant negative correlation was found between CTA and attitudes toward cannabis and MNPS, such that students with higher CTA had more positive attitudes towards MNPS. A logistic regression model was found to be significant, predicting about 24.7% of the variance in MNPS use. Counseling services for students should be focused on consulting and treatment programs for students with CTA. In addition, preventive educational programs should be formed to target substance habits, especially NPS use.

Non-medical prescription stimulant use to improve academic performance among Australian university students: prevalence and correlates of use

BackgroundSome university students consume pharmaceutical stimulants without a medical prescription with the goal of improving their academic performance. The prevalence of this practice has been well documented in the US, but less so in other countries. The potential harms of using prescription stimulants require a better understanding of the prevalence of this practice within Australian universities.MethodsAn internet survey of 1136 Australian students was conducted in 2015 in three large Australian universities. Students were asked about their personal use of prescription stimulants, attitudes and experiences with prescription stimulants. They were also asked about their use of caffeine, energy drinks and illicit drugs to enhance their academic performance.ResultsLifetime self-reported use of stimulant medication to improve academic performance was 6.5, and 4.4% in the past year. Students were far more likely to report using coffee and energy drinks (41.4 and 23.6% respectively, lifetime use) than prescription stimulants to help them study and complete university assessments. Non-medical use of prescription stimulants was strongly associated with a history of illicit drug use.ConclusionThe prevalence of nonmedical prescription stimulant use to improve academic performance is low among university students in Australia, especially when compared with their use of coffee and energy drinks.

Examining the Relationship Between Strain and the Use of Nonmedical Prescription Drugs Among College Students

The study of nonmedical prescription drug use (NMPDU) on college campuses is of importance, as college students tend to engage in NMPDU more often than their same-age peers not attending college. Typical correlates of NMPDU include need for alertness, perception of peer use, desire to get high, and use of other drugs including alcohol and marijuana. Few studies have explored the relationship between strain, depression, and NMPDU among college students. Using general strain theory as the theoretical framework, the current study aims to add to the literature on NMPDU by exploring the role that strain and depression play in the prevalence of nonmedical prescription stimulant, tranquilizer/sedative, and pain reliever use at a midsized university. Results support the relationship proposed by strain theorists for both nonmedical use of prescription pain relievers and tranquilizers/sedatives, but not stimulants. Policy implications and future areas of research are discussed.

Application of vested interest theory to prevention of non-medical prescription stimulant and marijuana use: Unforeseen benefits of attitude-behavior inconsistency

BackgroundVested interest (VI) has been found to enhance attitude-behavior consistency in several contexts. With an eye toward a potentially novel method of prevention (i.e., reducing perceived VI to minimize attitude-behavior consistency among those positively inclined toward psychotropic substance use), the current investigation explores whether VI moderates attitude-intention consistency regarding nonmedical use of prescription stimulants (NUPS) and marijuana. MethodsEmphasizing prevention, the study focused exclusively on non-users. Study 1a assessed college students (N = 310) attitudes, VI, and intentions regarding NUPS among those with no prior NUPS experience. Respondents were sampled using Amazon’s Mechanical Turk. Study 1b investigated marijuana-abstinent college students (N = 93), recruited from college classrooms. ResultsThe pattern of results was similar in both studies. In addition to an association between attitudes and VI, analysis revealed main effects for attitudes and VI on substance use intentions. Moreover, VI moderated the attitude-intention relationship (p < .01). Attitudes were most weakly associated with usage intentions when perceptions of VI were low (vs. moderate or strong). ConclusionResults of these studies replicate and expand prior findings relating VI to drug use, and suggest a potential path for future prevention efforts. The current study was cross-sectional, however if the causal pathways are as theorized, an intervention that reduces subjective VI has the potential to reduce positive attitudes while simultaneously reducing the influence of favorable attitudes on intentions.

Differentiating motives for nonmedical prescription stimulant use by personality characteristics

Nonmedical prescription stimulant use (NPS) is increasing, particularly among college students. College students typically engage in NPS for cognitive enhancement, recreational, and appetite/weight-related purposes; however, little research has used these motives to identify specific risk for, or consequences of, NPS. Moreover, there may be unique risk factors for motive-specific NPS that have yet to be explored, such as relevant personality traits (i.e., distress tolerance, impulsivity, and perfectionism) that are associated with NPS in general. Therefore, this study aimed to examine whether NPS users and nonusers could be differentiated via facets of impulsivity, perfectionism, and distress tolerance, and whether users could be further differentiated by reported motive for use based on these traits. Midwestern university undergraduate students (N = 668) who were enrolled in a psychology research pool completed an online survey assessing demographics, NPS and motives, and measures of distress tolerance, impulsivity, and perfectionism. Participants were primarily female (78%) and aged 18–54 (M = 20.10, SD = 3.19) years. Univariate and multivariate analysis of variance tests revealed associations between lifetime NPS and higher impulsivity, higher perfectionism, and lower distress tolerance. Further tests revealed NPS for appetite/weight-related purposes was associated with lower distress tolerance, while NPS for recreational purposes was associated with higher impulsivity. These findings contribute novel information regarding NPS motives and personality constructs. This information may aid in comprehensive identification of high-risk individuals for NPS and inform the development of specialized prevention and intervention efforts.

Prevalence of nonmedical use and routes of administration for prescription stimulant medications among adults in a substance abuse treatment population

The aim was to examine prevalence of past 30-day prescription stimulant nonmedical use (NMU) by adults assessed for substance use problems and to better understand patterns of route of administration (ROA) and drug problem severity. Data were collected from a computer administered assessment of substance use problems completed by adults (age ≥ 18) using the Addiction Severity Index-Multimedia Version (ASI-MV®) as part of the clinical intake process between January 2013 and March 2016. A cross-sectional observational study examined prevalence and prescription-adjusted prevalence of past 30-day NMU of prescription stimulants and compound-specific use by ROA (oral, snort, smoke, inject, other oral, and alternate ROA). Compounds of interest were amphetamine extended-release (ER), amphetamine immediate-release (IR), amphetamine mixed salts, methylphenidate ER, and methylphenidate IR. Of 198,411 respondents, 4,185 reported prescription stimulant NMU, prevalence ranged from 0.33% for methylphenidate IR to 1.61% for amphetamine mixed salts. Prescription-adjusted prevalence of NMU was highest for methylphenidate IR (0.51%) and lowest for amphetamine ER (0.28%). The most common ROA was oral, swallowed whole followed by snorting. There was a greater probability of nonmedical prescription stimulant use among respondents with higher drug severity ratings. Results suggest that one should not overlook the impact of prescription stimulant NMU in adults in treatment for substance use problems. NMU of prescription stimulants was associated with riskier routes of administration than reported for college student samples. A pattern of high-risk alternate ROA and increasing drug problem severity has important implications of substance use evaluation.

Nonmedical prescription stimulant users experience subjective but not objective impairments in attention and impulsivity.

Nonmedical prescription stimulant use is frequently reported by college students to improve academic performance, yet it is unknown whether users truly experience cognitive impairments that may drive use. This research compared students with at least one report of nonmedical prescription stimulant use and nonusers on both self-report and objective measures of inattention and impulsivity. Two studies examined inattention (N = 155) and impulsivity (N = 115) among college students. Participants completed self-report questionnaires and cognitive tests, including Digit Span, the Paced Auditory Serial Addition Test, and a Continuous Performance Test to assess inattention, and the Balloon Analogue Risk Task and the Stop Signal Task to assess risk-taking and impulsivity. Self-reports of inattention and impulsive symptoms were significantly higher among users, controlling for gender, GPA, self-reported ADHD, alcohol use, and drug use; however, no objective differences were found. Nonmedical prescription stimulant users may engage in use to overcome perceived deficits in cognitive abilities despite lack of objective evidence. Understanding discrepancies in objective performance and subjective reports may aid in the development of effective interventions for nonmedical prescription stimulant use. (Am J Addict 2018;27:238-244).

Examining social supply among nonmedical prescription stimulant users in the San Francisco Bay Area

In the US, prescription stimulants are prescribed for a variety of conditions including attention deficit hyperactivity disorder (ADHD) and narcolepsy. Over the last two decades, dramatic increases in stimulant prescriptions have led to greater availability and increased risk for diversion and nonmedical use. Our own and other investigators' findings indicate that many drug “suppliers” do not fit into the traditional image of drug “dealers.” These suppliers typically do not identify themselves as “dealers,” but instead understand their drug distribution as sharing with people they know. Coomber and colleagues' (2007; 2013) concept of “social supply” raises the question: When friends supply or facilitate supply of drugs to friends, is this really dealing? Further, if dealing and supplying are distinct kinds of social transactions, should different types of criminal justice approaches be applied? Social supply extends our understanding of drug dealing as a complex social activity. In this article, we examine the issue of social supply among nonmedical users of prescription stimulants. We conducted a 36-month National Institute on Drug Abuse-funded project to conduct a qualitative, mixed methods study of 150 adult nonmedical prescription stimulant users in the San Francisco Bay Area. We explore intersecting factors, including life stage and social location, that contribute to decisions to use prescription stimulants nonmedically, motivations to use, knowledge about risks and benefits of prescription stimulant use, any adverse health or social consequences experienced, availability, acquisition and diversion of prescription stimulants, and differences in attitudes and behaviours. For this analysis, we rely on participants' narratives concerning prescription stimulant acquisition practices and how they understood these interactions, purchases, and exchanges with the suppliers of prescription stimulants in their social networks. The authors argue that acknowledging the distinction between social supply and “proper” drug dealing would redress the disparity between drug sharing and profiteering particularly regarding criminal sentencing.

National Trends in and Correlates of Nonmedical Use of Prescription Stimulants, Nonmedical Use Frequency, and Use Disorders.

To examine national trends in and correlates of nonmedical use of prescription stimulants, nonmedical use frequency, and use disorders among individuals aged 12-64 years. Data from 783,400 persons aged 12-64 who participated in the 2003-2014 National Surveys on Drug Use and Health (NSDUH). Descriptive analyses and bivariable and multivariable logistic regression and zero-truncated negative binomial regression models were applied. Our multivariable results show that among individuals aged 12-64, the national prevalence of nonmedical use of prescription stimulants in 2003-2004 was higher than in 2007-2008 and was similar to that in 2009-2011, but was lower than in 2013-2014. Among those who used prescription stimulants nonmedically, the frequency of nonmedical use of prescription stimulants in 2003-2004 was lower than that in 2005-2006 and was similar to that in 2007-2014, and the prevalence of prescription stimulant use disorders in 2003-2004 was higher than that in 2005-2010, but was similar to that in 2011-2014. Among nonmedical prescription stimulant users aged 12-64 in 2013-2014, 53.2% reported that their source of stimulants used nonmedically last time was from relatives/friends for free. Our study also identified correlates of prescription stimulant nonmedical use, use frequency, and use disorders. Co-occurring substance use disorders are common among those with prescription stimulant nonmedical use problems. Among individuals aged 12-64 in the United States, after adjusting for covariates, the prevalence of nonmedical use of prescription stimulants in 2013-2014 was higher than that in 2003-2004. The results of this study help inform and target efforts to reduce prescription stimulant nonmedical use, use frequency, and use disorders.

Perceived academic benefit is associated with nonmedical prescription stimulant use among college students

IntroductionCollege students are at higher than average risk for nonmedical use of prescription stimulants (NPS). A commonly identified motive among students who engage in NPS is to improve grades. Several research studies have observed that NPS most likely does not confer an academic advantage, and is associated with excessive drinking and other drug use. This study documents the proportion of the general college student population who believe that NPS will lead to improvements in academic performance. MethodsThis study gathered online survey data from a large, demographically diverse sample of college students to document the prevalence of perceived academic benefit of NPS for improving grades and to examine the association between such belief and NPS. ResultsOverall, 28.6% agreed or strongly agreed that NPS could help students earn higher grades, and an additional 38.0% were unsure. Students with a higher level of perceived academic benefit of NPS and more frequent patterns of drinking and marijuana use were more likely to engage in NPS, even after adjustment for a wide range of covariates. ConclusionsThe results underscore the need for interventions that simultaneously correct misperceptions related to academic benefit and target alcohol and marijuana use to reduce NPS.

Nonmedical Prescription Stimulant Use Among Girls 10–18 Years of Age: Associations With Other Risky Behavior

PurposeLittle is known about the risk factors for nonmedical use (NMU) of prescription stimulants among adolescent girls. We aimed to measure the association of nonmedical prescription stimulant use with empirically linked risk factors, including weight control behavior (WCB), gambling, and depressed mood, in pre-teen and teenaged girls. MethodsWe assessed the relationship between age and race, gambling, WCB, depressive mood, and nonmedical prescription stimulant use using multivariable logistic regression. The study sample included 5,585 females, aged 10–18 years, recruited via an entertainment venue intercept method in 10 U.S. metropolitan areas as part of the National Monitoring of Adolescent Prescription Stimulants Study (2008–2011). ResultsNMU of prescription stimulants was reported by 6.6% (n = 370) of the sample. In multivariable logistic regression, 1-year increase in age was associated with a 21% (95% confidence interval [CI]: .15, .28) increase in risk for NMU. Whites and other race/ethnicity girls had 2.67 (CI: 1.85, 3.87) and 1.71 (1.11, 2.65) times higher odds for NMU, compared to African-Americans. Depressive mood (adjusted odds ratio: 2.69, CI: 2.04, 5.57) and gambling (adjusted odds ratio: 1.90, 1.23, 2.92) were associated with increased odds for NMU. A dose-response was identified between WCB and NMU, where girls with unhealthy and extreme WCB were over five times more likely to endorse NMU. ConclusionsWe contribute to the literature linking WCB, depression, gambling, and the NMU of prescription stimulants in any population and uniquely do so among girls.