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Cognitive Enhancement Drug Use Among Future Physicians: Findings from a Multi-Institutional Census of Medical Students

ABSTRACT

BACKGROUND

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.

OBJECTIVE

To conduct an online census of psychostimulant use among medical students.

DESIGN

In 2011, we conducted a multi-institutional census using a 31–48 item online survey regarding use of prescription psychostimulants.

PARTICIPANTS

2,732 actively enrolled medical students at four private and public medical schools in the greater Chicago area.

MAIN MEASURES

Prevalence and correlates of psychostimulant use

KEY RESULTS

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).

CONCLUSIONS

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.

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Acknowledgements

The authors wish to thank Marina Wolf, Ph.D., Department of Neuroscience, Rosalind Franklin University of Medicine and Science, for her contributions to the study conception and to manuscript preparation, and Holly Geyer, M.D., Department of Internal Medicine, Mayo Clinic, for her contributions to the study conception.

Funding was provided with support from Rosalind Franklin University of Medicine and Science.

Ethical approval has been granted for this study from Institutional Review Boards of all participating schools.

The contents of this article do not represent the views of the Department of Veterans Affairs or the United States Government.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Correspondence to Cathy J. Lazarus MD, FACP.

Additional information

The contents of this article do not represent the views of the Department of Veterans Affairs or the United States Government. Funding for this project was provided through an educational development fund at Rosalind Franklin University of Medicine and Science.

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Emanuel, R.M., Frellsen, S.L., Kashima, K.J. et al. Cognitive Enhancement Drug Use Among Future Physicians: Findings from a Multi-Institutional Census of Medical Students. J GEN INTERN MED 28, 1028–1034 (2013). https://doi.org/10.1007/s11606-012-2249-4

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KEY WORDS

  • cognitive enhancement
  • nootropics
  • amphetamine salts
  • methylphenidate
  • medical students
  • drug use