Nonmedical Use of Prescription Stimulants Among College Students: Associations with Attention‐Deficit‐Hyperactivity Disorder and Polydrug Use

Abstract

Study Objectives-This study examines nonmedical use of prescription stimulants (NPS) among 1,253 first-year college students. Comparisons are made between non-users, nonmedical users, and medical users of prescription stimulants for ADHD (ADHD+), some of whom overused their medication.Design-Cross-sectional study. Setting-Large public university in the mid-Atlantic region.Subjects-Twelve hundred fifty three college students. Measurements and MainResults-Of 1,208 students who were not using prescription stimulants medically for ADHD (ADHD-), 18.0% (n = 218) engaged in NPS. Among 45 ADHD+ students, 26.7% (n = 12) overused their ADHD medication at least once in their lifetime, and 15.6% (n = 7) nonmedically used someone else's prescription stimulants at least once in their lifetime. Among nonmedical users, NPS was infrequent and mainly associated with studying, although 15.6% used prescription stimulants to party or to get high. Lifetime NPS was associated with past-year other drug use. Both NPS and overuse of prescribed stimulants for ADHD were independently associated with past-year use of five drugs, holding constant sociodemographic characteristics. NPS was also associated with alcohol and marijuana dependence.Conclusions-Physicians should be vigilant for possible overuse and/or diversion of prescription stimulants among ADHD+ patients attending college, as well as the co-occurrence of illicit drug use with NPS. Initiation of comprehensive drug prevention activities that involve parents as well as colleges is encouraged to raise awareness of NPS and its association with illicit drug use. KeywordsCollege students; nonmedical use of prescription stimulants; ADHD; polydrug use; drug dependence Several medications are used in the treatment of attention deficit hyperactivity disorder (ADHD), including different formulations of methylphenidate (e.g., Concerta ® (methylphenidate extended release; ALZA Corporation, Mountain View, CA)), Ritalin ® Address reprint requests to Amelia M. Arria, PhD, Deputy Director of Research, Center for Substance Abuse Research, 4321 Hartwick Rd, Suite 501, College Park, MD, 20740, tel: 301-405-9795, fax: 301-403-8342, email address: aarria@cesar.umd.edu. Poster presented at the College on Problems of Drug Dependence, Scottsdale, AZ, June [17][18][19][20][21][22] 2006 NIH Public Access Author ManuscriptPharmacotherapy. Author manuscript; available in PMC 2010 July 21. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript (methylphenidate; Novartis Pharmaceuticals Corporation, East Hanover, NJ)) and mixtures of amphetamine salts (e.g., Adderall ® (amphetamine-dextroamphetamine; Shire, Wayne, PA)).1 These medications are very effective in reducing symptoms of ADHD.2 -8 During the past several years, much attention has focused on the nonmedical use of these medications, as well as other forms of prescription drugs. The general definition of nonmedical use of prescription stimulants (NPS) developed by the Substance Abuse and Mental Health Services Administratio...

The importance of stress, self-efficacy, and self-medication for pharmacological neuroenhancement among employees and students

“…Consistent with previous studies, the present findings support the third moderate selfmedication hypothesis that PCE and PME are associated with illegal drug use (Arria et al, 2008;McCabe et al, 2005). Cannabis users were three times more likely to report PCE and five times more likely to report PME.…”

“…Nonmedical use of prescription drugs is defined as use without having a prescription or use for another purpose than prescribed (Maier and Schaub, 2015). More specifically, some people with a mental disorder use their medication in higher doses or through a different route of administration than prescribed for the purpose of enhanced cognitive performance (Arria et al, 2008;Maier et al, 2013).…”

“…Moreover, PNE with stimulants is strongly associated with risky health behaviors such as illegal drug use (Arria et al, 2008;McCabe et al, 2005). Insufficient coping skills and substance abuse in the face of chronic stress might cause mental health problems, and vice versa (Mohr et al, 2014).…”

Impulsive choice and environmental enrichment: Effects of d-amphetamine and methylphenidate

“…Conversely, the present results may also suggest that use of psychostimulants by individuals without ADHD could increase the risk of substance abuse problems. Indeed, in college students, nonmedical use of stimulants is associated with use of other illicit drugs [3,8,51]; however, these studies are correlational in nature and do not definitively indicate that nonmedical use of stimulants increases subsequent drug use.…”

Nonmedical Use of Prescription Drugs: Perceptions of Minority College Students

“…For instance, the literature indicates that the primary motives for NMUPD among college students include experimentation, recreational purposes, and to increase their academic performance [11][12][13][14]. More specifically, common reasons college students reported engaging in the non-medical use of stimulants (i.e., Adderall, Vyvanse, and Ritalin) to increase performance during academic examination periods [15,16].…”