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

Abstract

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

“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

“…Findings from a meta-analysis further reveal that the main reasons for college students' participation in NMUPS are (1) to improve sports or academia-related performance, (2) to control sleep cycle and reduce anxiety levels, and 3to assist with managing current health conditions [44]. That is, overall, only a small portion of college students' NMUPS activities are associated with recreational purposes (e.g., use in parties to get high) [4,44,45]. These findings are very alarming, as college students' "justified use" of NMUPS may further fuel their participation in NMUPS and in turn, harm their long-term academic performance and wellbeing [46,47].…”

“…One well-accepted function of health campaigns is their ability to induce positive attitudinal and behavioral changes in individuals by changing the overall social norms surrounding the health practice [45,50,51]. Social norms could be understood as "shared expectations of culturally appropriate and desirable behavior" [52].…”

“…Due to the close-knit structure of college environments, social norms have a pronounced influence on students' participation in NMUPS [45,53,54]. In general, social norms impact college students' attitudes and behavior towards NMUPS in two ways: (1) shaping the macro sociocultural environment in which college students are immersed in (e.g., the permissive college culture on NMUPS) [55][56][57] and (2) influencing the micro social networks which college students are closely surrounded by (e.g., friends and family's enabling attitude towards NMUPS) [45,54,58,59]. In terms of macro-level influence, evidence suggests that on-campus social norms play an important role in shaping college students' NMUPS-related attitudes and behavior [45,60,61].…”

“…On a micro level, social norms shared by intimate social ties also influence college students' attitudes and behavior towards NMUPS [4,45,61]. Evidence shows that college students' perceptions and behavior towards NMUPS are often associated with how their intimate social contacts perceive and interact with NMUPS [45]. Findings suggest that more than 60% of college students surveyed obtained their prescription stimulants from their friends and peers [63].…”

The impact of a theory-based web-intervention on the intention to use prescription drugs for non-medical purposes among college students: a randomized controlled trial

“…In addition, theory-based interventions specifically designed to address constructs within a health behavior theory are more successful at influencing behavioral changes compared with interventions that lack a theoretical framework [16]. With respect to NMUPD, several health behavior theories have been used to explain various aspects of prescription drug misuse among college students such as the theory of triadic influence (ecological level) [17,18], social learning theory (interpersonal level) [19][20][21][22] and the theory of planned behavior (intrapersonal level) [23][24][25].…”