A Mixed-Methods Approach Examining Illicit Prescription Stimulant Use: Findings From a Northern California University
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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.
KeywordsCollege students Illicit use of prescription stimulants Etiology Prevention
- 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, 347–356. doi:10.1177/1087054710367621.CrossRefPubMedGoogle Scholar
- Bavarian, N., Flay, B. R., Ketcham, P. L., & Smit, E. (2013a). Development and psychometric properties of a theory-guided prescription stimulant misuse questionnaire for college students. Substance Use and Misuse, 48, 457–469. doi:10.3109/10826084.2013.778283.CrossRefPubMedPubMedCentralGoogle Scholar
- Bavarian, N., Flay, B. R., Ketcham, P. L., Smit, E., Kodama, C., Martin, M., et al. (2014a). Using structural equation modeling to understand prescription stimulant misuse: A test of the Theory of Triadic Influence. Drug and Alcohol Dependence, 138, 192–201. doi:10.1016/j.drugalcdep.2014.02.700.CrossRefGoogle Scholar
- Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from http://www.samhsa.gov/data/.
- Emanuel, R. M., Frellson, S. L., Kashima, K. J., Sanguino, S. M., Sierles, F. S., & Lazarus, C. J. (2013). Cognitive enhancement drug use among future physicians: Findings from a multi-institutional census of medical students. Journal of General Internal Medicine, 28, 1028–1034. doi:10.1007/s11606-012-2249-4.CrossRefPubMedPubMedCentralGoogle Scholar
- Flay, B. R., & Petraitis, J. (1994). The theory of triadic influence: A new theory of health behavior with implications for preventive interventions. In G. S. Albrecht (Ed.), Advances in Medical Sociology (Vol. IV, pp. 19–44)., A Reconsideration of Models of Health Behavior Change Connecticut: Jai Pr.Google Scholar
- Flay, B. R., Snyder, F., & Petraitis, J. (2009). The theory of triadic influence. In R. J. DiClemente, M. C. Kegler, & R. A. Crosby (Eds.), Emerging theories in health promotion practice and research (2nd ed., pp. 451–510). New York: Wiley and Sons.Google Scholar
- 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, 226–234. doi:10.1080/07448481.2011.589876.CrossRefPubMedPubMedCentralGoogle Scholar
- Hartung, C. M., Canu, W. H., Cleveland, C. S., Lefler, E. K., Mignogna, M. J., Fedele, D. A., et al. (2013). Stimulant medication use in college students: Comparison of appropriate users, misers, and nonusers. Psychology of Addictive Behaviors, 27, 832–840. doi:10.1037/a0033822.CrossRefPubMedGoogle Scholar
- Institute for Digital Research and Education. (2011). Pseudo R Squareds. Retrieved from http://www.ats.ucla.edu/stat/mult_pkg/faq/general/Psuedo_RSquareds.htm.
- Long, J. S., & Freese, J. (2006). Regression models for categorical dependent variables using Stata (2nd ed.). Texas: Stata Press.Google Scholar
- McCabe, S. E., West, B. T., Teter, C. J., & Boyd, C. J. (2014). Trends in medical use, diversion, and nonmedical use of prescription medications among college students from 2003 to 2013: Connecting the dots. Addictive Behaviors, 39, 1176–1182. doi:10.1016/j.addbeh.2014.03.008.CrossRefPubMedPubMedCentralGoogle Scholar
- Merlo, J., Chaix, B., Ohlsson, H., Beckman, A., Johnell, K., Hjerpe, P., et al. (2006). A brief conceptual tutorial of multilevel analysis in social epidemiology: Using measures of clustering in multilevel logistic regression to investigate contextual phenomena. Journal of Epidemiology and Community Health, 60, 290–297. doi:10.1136/jech.2004.029454.CrossRefPubMedPubMedCentralGoogle Scholar
- Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis. California: Sage.Google Scholar
- Substance Abuse and Mental Health Services Administration. (2013). Emergency department visits involving attention deficit/hyperactivity disorder stimulant mediations. Retrieved from http://www.samhsa.gov/data/2k13/DAWN073/sr073-ADD-ADHD-medications.htm.
- 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, 284–296. doi:10.1177/1087054709342212.CrossRefPubMedGoogle Scholar