Cognitive Enhancement Drug Use Among Future Physicians: Findings from a Multi-Institutional Census of Medical Students
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Nonmedical use of prescription psychostimulants such as methylphenidate and amphetamine salts for the purpose of cognitive enhancement is a growing trend, particularly in educational environments. To our knowledge, no recent studies have evaluated the use of these psychostimulants in a medical academic setting.
To conduct an online census of psychostimulant use among medical students.
In 2011, we conducted a multi-institutional census using a 31–48 item online survey regarding use of prescription psychostimulants.
2,732 actively enrolled medical students at four private and public medical schools in the greater Chicago area.
Prevalence and correlates of psychostimulant use
1,115 (41 %) of students responded to the web-based questionnaire (range 26–47 % among schools). On average, students were 25.1 years of age (SD = 2.7, range 20–49), and single (70 %). Overall, 18 % (198/1,115) of this medical student sample had used prescription psychostimulants at least once in their lifetime, with first use most often in college. Of these, 11 % (117/1,115) of students reported use during medical school (range 7–16 % among schools). Psychostimulant use was significantly correlated with use of barbiturates, ecstasy, and tranquilizers (Pearson’s correlation r > 0.5, Student’s t-test p < 0.01); male gender (21 % male versus 15 % female, Chi squared p = 0.007); and training at a medical school which by student self-report determined class rank (68 % versus 51 %, Chi-squared p = 0.018). Non-users were more likely to be first year students (Chi-squared p = 0.048) or to have grown up outside of the United States (Chi-squared p = 0.013).
Use of psychostimulants, including use without a prescription, is common among medical students. Further study of the side effects, medical implications, and use during post-graduate medical training and medical practice is needed to inform evidence-based policy.
- Butcher, J (2003) Cognitive enhancement raises ethical concerns. Academics urge pre-emptive debate on neurotechnologies. Lancet 362: pp. 132-3 CrossRef
- Prescription drug abuse: a fast-growing problem. NIH Medline Plus. 2011;6(3):21.
- Wilens, TE, Adler, LA, Adams, J (2008) Misuse and diversion of stimulants prescribed for ADHD: a systematic review of the literature. J Am Acad Child Adolesc Psychiatry 47: pp. 21-31 CrossRef
- Kollins, SH (2008) ADHD, substance use disorders, and psychostimulant treatment: current literature and treatment guidelines. J Atten Disord 12: pp. 115-25 CrossRef
- American Academy of Family Physicians Conditions A to Z. Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) 2009.; http://online.statref.com/document.aspx?fxid=99&docid=11. Accessed Feburary 23, 2012.
- Ropper, A, Brown, R (2005) Adams and Victor’s Principles of Neurology. The McGraw-Hill Publishing Company, New York
- Zeeuws, I, Deroost, N, Soetens, E (2010) Effect of an acute d-amphetamine administration on context information memory in healthy volunteers: evidence from a source memory task. Hum Psychopharmacol 25: pp. 326-34 CrossRef
- Soetens, E, Casaer, S, D’Hooge, R, Hueting, JE (1995) Effect of amphetamine on long-term retention of verbal material. Psychopharmacology 119: pp. 155-62 CrossRef
- Zeeuws, I, Soetens, E (2007) Verbal memory performance improved via an acute administration of D-amphetamine. Hum Psychopharmacol 22: pp. 279-87 CrossRef
- Soetens, E, D’Hooge, R, Hueting, JE (1993) Amphetamine enhances human-memory consolidation. Neurosci Lett 161: pp. 9-12 CrossRef
- Porter RS. The Merk Manual Home Health Handbook. In: Porter RS, ed. Amphetamines: Merk; 2011: http://www.merckmanuals.com/home/special_subjects/drug_use_and_abuse/amphetamines.html?qt=amphetamines&alt=sh. Accessed Feburary 23, 2012.
- Volkow, ND, Fowler, JS, Logan, J (2009) Effects of modafinil on dopamine and dopamine transporters in the male human brain: clinical implications. JAMA 301: pp. 1148-54 CrossRef
- United States Congress. U.S. Substances Control Act. Vol 84 Stat. 12421970.
- Teter, CJ, McCabe, SE, LaGrange, K, Cranford, JA, Boyd, CJ (2006) Illicit use of specific prescription stimulants among college students: prevalence, motives, and routes of administration. Pharmacotherapy 26: pp. 1501-10 CrossRef
- Baldwin, DC, Hughes, PH, Conard, SE, Storr, CL, Sheehan, DV (1991) Substance use among senior medical students. A survey of 23 medical schools. JAMA 265: pp. 2074-8 CrossRef
- Croen, LG, Woesner, M, Herman, M, Reichgott, M (1997) A longitudinal study of substance use and abuse in a single class of medical students. Acad Med 72: pp. 376-81 CrossRef
- Flaherty, JA, Richman, JA (1993) Substance use and addiction among medical students, residents, and physicians. Psychiatr Clin N Am 16: pp. 189-97
- Rai, D, Gaete, J, Girotra, S, Pal, HR, Araya, R (2008) Substance use among medical students: time to reignite the debate?. Nat Med J India 21: pp. 75-8
- Kumar, P, Basu, D (2000) Substance abuse by medical students and doctors. J Indian Med Assoc 98: pp. 447-52
- Shyangwa, PM, Joshi, D, Lal, R (2007) Alcohols and other substance use/abuse among junior doctors and medical students in a teaching institute. JNMA 46: pp. 126-9
- Newbury-Birch, D, Walshaw, D, Kamali, F (2001) Drink and drugs: from medical students to doctors. Drug Alcohol Depend 64: pp. 265-70 CrossRef
- Harris S. “I Don’t See It as a Problem”: More Medical Students Taking Prescription Stimulants, Few See Cause for Concern. AAMC Reporter. 2009;June Edition.
- Johnston, LD, O’Malley, PM, Bachman, JG, Schulenberg, JE (2012) Monitoring the future national survey results on drug use, 1975–2011. Annu Vol Trends Drug Use Relat Factors 2: pp. 314
- Dutta, AP, Pyles, MA, Miederhoff, PA (2005) Stress in health professions students: myth or reality? A review of the existing literature. J Natl Black Nurses Assoc 16: pp. 63-8
- Dyrbye, LN, Thomas, MR, Shanafelt, TD (2006) Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med 81: pp. 354-73 CrossRef
- Dyrbye, LN, Thomas, MR, Huntington, JL (2006) Personal life events and medical student burnout: a multicenter study. Acad Med 81: pp. 374-84 CrossRef
- Webb, J, Thomas, J, Valaseck, M (2010) Contemplating cognitive enhancement in medical students and residents. Perspect Biol Med 53: pp. 200-14 CrossRef
- Goebert, D (2009) Depressive symptoms in medical students and residents: a multi-school study. Acad Med 84: pp. 236-41 CrossRef
- Strine, TW (2009) Metropolitan and micropolitan statistical area estimates of depression and anxiety using the patient health questionaire-8 in the 2006 behavioral risk factor surveillance system. Int J Public Health 54: pp. 117-24 CrossRef
- Smith, ME, Farah, MJ (2011) Are prescription stimulants “smart pills”? The epidemiology and cognitive neuroscience of prescription stimulant use by normal healthy individuals. Psychol Bull 137: pp. 717-41 CrossRef
- Greely, H, Sahakian, B, Harris, J (2008) Towards responsible use of cognitive-enhancing drugs by the healthy. Nature 456: pp. 702-5 CrossRef
- Rose, SH, Curry, TB (2009) Fatigue, countermeasures, and performance enhancement in resident physicians. Mayo Clin Proc 84: pp. 955-7
- Marsden P, Wright J. Handbook of Survey Research. 2nd ed: Emerald Publishing Group Limited; 2010.
- Cognitive Enhancement Drug Use Among Future Physicians: Findings from a Multi-Institutional Census of Medical Students
Journal of General Internal Medicine
Volume 28, Issue 8 , pp 1028-1034
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- cognitive enhancement
- amphetamine salts
- medical students
- drug use
- Industry Sectors
- Author Affiliations
- 1. Mayo Clinic, Scottsdale, AZ, USA
- 2. Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
- 3. Department of Medicine at Rush Medical College, Rush University, Chicago, IL, USA
- 4. University of Illinois College of Medicine, Chicago, IL, USA
- 5. Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
- 6. Department of Psychiatry and Behavioral Sciences, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
- 7. Tulane University School of Medicine, 1430 Tulane Ave. SL 12, New Orleans, LA, 70112, USA
- 8. Southeast Louisiana Veterans Health Care System, P.O. Box 61011, New Orleans, LA, 70161, USA
- 9. Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA