The misuse of stimulant medication among college students is a prevalent and growing problem. The purpose of this review and meta-analysis is to summarize the current research on rates and demographic and psychosocial correlates of stimulant medication misuse among college students, to provide methodological guidance and other ideas for future research, and to provide some preliminary suggestions for preventing and reducing misuse on college campuses. Random-effects meta-analysis found that the rate of stimulant medication misuse among college students was estimated at 17 % (95 % CI [0.13, 0.23], p < .001) and identified several psychological variables that differentiated misusers and nonusers, including symptoms of attention-deficit/hyperactivity disorder, problems associated with alcohol use, and marijuana use. A qualitative review of the literature also revealed that Greek organization membership, academic performance, and other substance use were associated with misuse. Students are misusing primarily for academic reasons, and the most common source for obtaining stimulant medication is peers with prescriptions. Interpretation of findings is complicated by the lack of a standard misuse definition as well as validated tools for measuring stimulant misuse. The relation between stimulant medication misuse and extra curricular participation, academic outcomes, depression, and eating disorders requires further investigation, as do the reasons why students divert or misuse and whether policies on college campuses contribute to the high rates of misuse among students. Future research should also work to develop and implement effective prevention strategies for reducing the diversion and misuse of stimulant medication on college campuses.
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Advokat, C. D., Guildry, D., & Martino, L. (2008). Licit and illicit use of medications for attention-deficit hyperactivity disorder in undergraduate college students. American College Health, 56(6), 601–606. doi:10.3200/JACH.56.6.601-606.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
Angold, A., Costello, E., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40(1), 57–87. doi:10.1111/1469-7610.00424.
Arria, A. M., Caldeira, K. M., Vincent, K. B., O’Grady, K. E., & Wish, E. D. (2008a). Perceived harmfulness predicts nonmedical use of prescription drugs among college students: Interactions with sensation-seeking. Preventative Science, 9(3), 191–201.
Arria, A. M., & Dupont, R. L. (2010). Nonmedical prescription stimulant use among college students: Why we need to do something and what we need to do. Journal of Addictive Diseases, 29, 417–426.
Arria, A. M., Garnier-Dykstra, L. M., Caldeira, K. M., Vincent, K. B., O’Grady, K. E., & Wish, E. D. (2011). Persistent nonmedical use of prescription stimulants among college students: Possible association with ADHD symptoms. Journal of Attention Disorders, 15(5), 347–356.
Arria, A. M., O’Grady, K. E., Caldeira, K. M., Vincent, K. B., & Wish, E. D. (2008b). Nonmedical use of prescription stimulants and analgesics: Association with social and academic behaviors among college students. Journal of Drug Issues, 38(4), 1045–1060.
Arria, A. M., Wilcox, H. C., Caldeira, K. M., Vincent, K. B., Garnier-Dykstra, L. M., & O’Grady, K. E. (2013). Dispelling the myth of “smart drugs”: Cannabis and alcohol use problems predict nonmedical use of prescription stimulants for studying. Addictive Behaviors, 38(3), 1643–1650.
Austerman, J., & Muzina, D. J. (2014). Turning attention to ADHD: U. S. Medication trends for attention deficit hyperactivity disorder. Retrieved from http://lab.express-scripts.com/publications/~/media/89fb0aba100743b5956ad0b5ab286110.ashx
Barkley, R. A. (2006). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (3rd ed.). New York: Guilford Press.
Borenstein, M., Hedges, L. V., Higgins, J. P., & Rothstein, H. R. (2009). Introduction to meta-analysis (1st ed.). Hoboken, NJ: Wiley.
Brown, S. A., Goldman, M. S., & Christiansen, B. A. (1985). Do alcohol expectancies mediate drinking patterns of adults? Journal of Consulting and Clinical Psychology, 53(4), 512.
Caplan, J. P., Epstein, L. A., Quinn, D. K., Stevens, J. R., & Stern, T. A. (2007). Neuropsychiatric effects of prescription drug abuse. Neuropsychology Review, 17(3), 363–380.
Chai, G., Governale, L., McMahon, A. W., Trinidad, J. P., Staffa, J., & Murphy, D. (2012). Trends of outpatient prescription drug utilization in US children, 2002–2010. Pediatrics, 130(1), 23–31.
Dennhardt, A. A., & Murphy, J. G. (2013). Prevention and treatment of college student drug use: A review of the literature. Addictive Behaviors, 38(10), 2607–2618.
DeSantis, A., Noar, S., & Webb, E. (2010). Speeding through the frat house: A qualitative exploration of nonmedical ADHD stimulant use in fraternities. Journal of Drug Education, 40(2), 157–171.
DeSantis, A. D., Webb, E. M., & Noar, S. M. (2008). Illicit use of prescription ADHD medications on a college campus: A multimethodological approach. Journal of American College Health, 57(3), 315–323. doi:10.3200/JACH.57.3.315-324.
DuPaul, G., Schaughency, E., Weyandt, L., Tripp, G., Kiesner, J., Ota, K., & Stanish, H. (2001). Self-report of ADHD symptoms in university students: Cross-gender and cross-national prevalence. Journal of Learning Disabilities, 34, 370–379.
DuPaul, G., Weyandt, L., O’Dell, S., & Varejoa, M. (2009). College students with ADHD: Current status and future directions. Journal of Attention Disorders, 13, 234–250.
Dussault, C. L., & Weyandt, L. L. (2013). An examination of prescription stimulants misuse and psychological variables among sorority and fraternity college populations. Journal of Attention Disorders, 27(2), 87–97.
Findling, R. L., & Dogin, J. W. (1998). Psychopharmacology of ADHD: Children and adolescents. Journal of Clinical Psychiatry, 59(suppl 7), 42–49.
Garnier, L. M., Arria, A. M., Caldeira, K. M., Vincent, K. B., O’Grady, K. E., & Wish, E. D. (2010). Sharing and selling of prescription medications in a college student sample. Journal of Clinical Psychiatry, 71(3), 262–269. doi:10.4088/JCP.09m05189ecr.
Garnier-Dykstra, L. M., Caldeira, K. M., Vincent, K. B., O’Grady, K. E., & Arria, A. M. (2012). Nonmedical use of prescription stimulants during college: Four year trends in exposure opportunity, use, motives, and sources. Journal of American College Health, 60(3), 226–234.
Graff Low, K., & Gendaszek, A. E. (2002). Illicit use of psychostimulants among college students: A preliminary study. Psychology, Health & Medicine, 7(3), 283–287.
Gudjonsson, G. H., Sigurdsson, J., Sigfusdottir, I., & Young, S. (2012). An epidemiological study of ADHD symptoms among young persons and the relationship with cigarette smoking, alcohol consumption and illicit drug use. Journal of Child Psychology and Psychiatry, 53(3), 304–312. doi:10.1111/j.1469-7610.2011.02489.x.
Hakkarainen, P., & Metso, L. (2009). Joint use of drugs and alcohol. European Addiction Research, 15(2), 113–120. doi:10.1159/000209244.
Hall, K. M., Irwin, M. M., Bowman, K. A., Frankenberger, W., & Jewett, D. C. (2005). Illicit use of prescribed stimulant medication among college students. Journal of American College Health, 53(4), 167–174. doi:10.3200/JACH.53.4.167-174.
Hedges, L. V., & Olkin, I. (1985). Statistical methods for meta-analysis (1st ed.). Orlando, FL: Academic Press.
Humphreys, K. L., Eng, T., & Lee, S. S. (2013). Stimulant medication and substance use outcomes: A meta-analysis. JAMA Psychiatry, 70(7), 740–749.
Hustad, J. T., Barnett, N. P., Borsari, B., & Jackson, K. M. (2010). Web-based alcohol prevention for incoming college students: A randomized controlled trial. Addictive Behaviors, 35(3), 183–189.
Jaffe, L. T., & Archer, R. P. (1987). The prediction of drug use among college students from MMPI, MCMI, and sensation seeking scales. Journal of Personality Assessment, 51(2), 243–253.
Jeffers, A., Benotsch, E. G., & Koester, S. (2013). Misuse of prescription stimulants for weight loss, psychosocial variables, and eating disordered behaviors. Appetite, 65, 8–13.
Judson, R., & Langdon, S. W. (2009). Illicit use of prescription stimulants among college students: Prescription status, motives, theory of planned behaviour, knowledge and self-diagnostic tendencies. Psychology, Health & Medicine, 14(1), 97–104. doi:10.1080/13548500802126723.
Kayloyanides, K. B., McCabe, S. E., Cranford, J. A., & Teter, C. J. (2007). Prevalence of illicit use and abuse of prescription stimulants, alcohol, and other drugs among college students: Relationship with age at initiation of prescription stimulants. Pharmacotherapy, 27(5), 666–674.
Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: Reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231–244.
Lee, S. S., Humphreys, K. L., Flory, K., Liu, R., & Glass, K. (2011). Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review. Clinical Psychology Review, 31(3), 328–341.
Lookatch, S. J., Dunne, E. M., & Katz, E. C. (2012). Predictors of nonmedical use of prescription stimulants. Journal of Psychoactive Drugs, 44(1), 86–91. doi:10.1080/02791072.2012.662083.
Martins, S. S., Storr, C. L., Alexandre, P. K., & Chilcoat, H. D. (2008). Adolescent ecstasy and other drug use in the National Survey of Parents and Youth: The role of sensation-seeking, parental monitoring and peer’s drug use. Addictive Behaviors, 33(7), 919–933.
McCabe, S. E. (2008). Misperceptions of non-medical prescription drug use: A web survey of college students. Addictive Behaviors, 33(5), 713–724.
McCabe, S. E., & Boyd, C. J. (2005). Sources of prescription drugs for illicit use. Addictive Behaviors, 30(7), 1342–1350.
McCabe, S. E., Cranford, J. A., Morales, M., & Young, A. (2006a). Simultaneous and concurrent polydrug use of alcohol and prescription drugs: prevalence, correlates, and consequences. Journal of Studies on Alcohol, 67(4), 529–537.
McCabe, S., Teter, C. J., & Boyd, C. J. (2006b). Medical Use, Illicit Use, and Diversion of Abusable Prescription Drugs. Journal of American College Health, 54(5), 269–278. doi:10.3200/JACH.54.5.269-27.
McCabe, S., Teter, C. J., & Boyd, C. J. (2006c). Medical use, illicit use and diversion of prescription stimulant medication. Journal of Psychoactive Drugs, 38(1), 43–56. doi:10.1080/02791072.2006.10399827.
Morisano, D., Hirsh, J. B., Peterson, J. B., Pihl, R. O., & Shore, B. M. (2010). Setting, elaborating, and reflecting on personal goals improves academic performance. Journal of Applied Psychology, 95(2), 255.
Morton, W. A., & Stockton, G. G. (2000). Methylphenidate abuse and psychiatric side effects. Primary Care Companion Journal of Clinical Psychiatry, 2(5), 159–164.
Pedersen, W. (1991). Mental health, sensation seeking and drug use patterns: a longitudinal study. British Journal of Addiction, 86(2), 195–204.
Peterkin, A. L., Crone, C. C., Sheridan, M. J., & Wise, T. N. (2011). Cognitive performance enhancement: Misuse or self-treatment? Journal Of Attention Disorders, 15(4), 263–268. doi:10.1177/1087054710365980.
Pilcher, J. J., & Walters, A. S. (1997). How sleep deprivation affects psychological variables related to college students’ cognitive performance. Journal of American College Health, 46(3), 121–126. doi:10.1080/07448489709595597.
Rabiner, D. L., Anastopoulos, A. D., Costello, E., Hoyle, R. H., McCabe, S., & Swartzwelder, H. (2009a). The misuse and diversion of prescribed ADHD medications by college students. Journal of Attention Disorders, 13(3), 259–270.
Rabiner, D. L., Anastopoulos, A. D., Costello, E., Hoyle, R. H., McCabe, S., & Swartzwelder, H. (2009b). Motives and perceived consequences of nonmedical ADHD medication use by college students: Are students treating themselves for attention problems? Journal Of Attention Disorders, 13(3), 259–270. doi:10.1177/1087054708320399.
Rabiner, D. L., Anastopoulos, A. D., Costello, E., Hoyle, R. H., & Swartzwelder, H. (2010). Predictors of nonmedical ADHD medication use by college students. Journal of Attention Disorders, 13(6), 640–648. doi:10.1177/1087054709334505.
Rahmati, A., & Sharifi, P. (2013). The effect of note taking skills training on the academic self-efficacy of students. Strides in Development of Medical Education, 10(1), 27–35.
Rappley, M. D. (1997). Safety issues in the use of methylphenidate. Drug Safety, 17(3), 143–148.
Rozenbroek, K., & Rothstein, W. G. (2011). Medical and nonmedical users of prescription drugs among college students. Journal of American College Health, 59(5), 358–363.
Schoenfelder, E. N., Faraone, S. V., & Kollins, S. H. (2014). Stimulant treatment of ADHD and cigarette smoking: A meta-analysis. Pediatrics, 133(7), 1070–1080.
Sepúlveda, D. R., Thomas, L. M., McCabe, S., Cranford, J. A., Boyd, C. J., & Teter, C. J. (2011). Misuse of prescribed stimulant medication for ADHD and associated patterns of substance use: Preliminary analysis among college students. Journal Of Pharmacy Practice, 24(6), 551–560. doi:10.1177/0897190011426558.
Sharp, J. T., & Rosén, L. A. (2007). Recreational stimulant use among college students. Journal Of Substance Use, 12(2), 71–82. doi:10.1080/14659890601022865.
Teter, C. J., Falone, A. E., Cranford, J. A., Boyd, C. J., & McCabe, S. E. (2010). Nonmedical use of prescription stimulants and depressed mood among college students: Frequency and routes of administration. Journal of Substance Abuse Treatment, 38(3), 292–298.
Teter, C. J., McCabe, S. E., Cranford, J. A., Boyd, C. J., & Guthrie, S. K. (2005). Prevalence and motives for illicit use of prescription stimulants in an undergraduate student sample. Journal of American College Health, 53(6), 253–262. doi:10.3200/JACH.53.6.253-262.
Van Eck, K., Markle, R. S., & Flory, K. (2012). Do conduct problems and sensation seeking moderate the association between ADHD and three types of stimulant use in a college population? Psychology of Addictive Behaviors, 26(4), 939–947.
Vetter, V. L., Elia, J., Erickson, C., Berger, S., Blum, N., Uzark, K., & Webb, C. L. (2008). Cardiovascular monitoring of children and adolescents with heart disease receiving stimulant drugs a scientific statement from the American heart association council on cardiovascular disease in the young congenital cardiac defects committee and the council on cardiovascular nursing. Circulation: Journal of the American Heart Association, 117, 2407–2423.
Volkow, N. D., Ding, Y. S., Fowler, J. S., Wang, G. J., Logan, J., Gatley, J. S., et al. (1995). Is methylphenidate like cocaine? Studies on their pharmacokinetics and distribution in the human brain. Archives of General Psychiatry, 52(6), 456.
Weyandt, L. L., Janusis, G., Wilson, K. G., Verdi, G., Paquin, G., Lopes, J., et al. (2009). Nonmedical prescription stimulant use among a sample of college students: Relationship with psychological variables. Journal of Attention Disorders, 13(3), 284–296.
Weyandt, L. L., Marraccini, M. E., Gudmundsdottir, B. G., Zavras, B. M., Turcotte, K. D., Munro, B. A., & Amoroso, A. J. (2013). Misuse of prescription stimulants among college students: A review of the literature and implications for morphological and cognitive effects on brain functioning. Experimental and Clinical Psychopharmacology, 21, 385–407.
Wolf, L. (2001). College students with ADHD and other hidden disorders: Outcomes and interventions. Annals of the New York Academy of Arts and Sciences, 931, 385–395.
Zullig, K. J., & Divin, A. L. (2012). The association between non-medical prescription drug use, depressive symptoms, and suicidality among college students. Addictive Behaviors, 37(8), 890–899.
Work on this manuscript was supported by a University of South Carolina Honors College Exploration Scholar Award and a University of South Carolina Magellan Fellowship, both awarded to Kari Benson.
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Benson, K., Flory, K., Humphreys, K.L. et al. Misuse of Stimulant Medication Among College Students: A Comprehensive Review and Meta-analysis. Clin Child Fam Psychol Rev 18, 50–76 (2015). https://doi.org/10.1007/s10567-014-0177-z
- Stimulant medication
- College students
- Psychological correlates