Seven percent of college students have used prescription stimulants for non-medical purposes over their lifetimes and 4 percent have used in the past year, according to a study of students at 119 four-year colleges and universities nationwide published in the January issue of the journal Addiction.
The national study, led by a University of Michigan researcher and based on data from the Harvard School of Public Health College Alcohol Study, found that past year rates ranged from none to 25 percent at individual colleges and universities. Students attending three historically black colleges reported the lowest rate (none) of non-medical prescription stimulant use. Reported use was higher among students who were male, white and members of fraternities. The study also showed that abuse of non-medical prescription stimulants was higher among women who are members of sororities.
The study also found that students who use prescription stimulants non-medically are more likely to abuse other substances such as alcohol, marijuana, ecstasy and cocaine.
"They are also more likely to engage in other risky behaviors such as driving after heavy drinking," said Sean Esteban McCabe, lead author of the study and assistant research scientist at the University of Michigan Substance Abuse Research Center.
Non-medical prescription stimulant users were over 20 times more likely to report cocaine use in the past year and over five times more likely to report driving after heavy drinking than college students who had not used prescription stimulants non-medically.
The highest rates of non-medical use of prescription stimulants are on college campuses in the Northeastern region of the United States, schools with highly competitive admissions criteria and those college campuses with higher rates of binge drinking, the study finds.
Males were nearly twice as likely as women to report the non-medical use. White students were also more likely than Asian and African-American students to report non-medical use. Grade point was also associated with non-medical stimulant use. Students with grade point averages of B or lower were two times more likely to use prescription stimulants non-medically than those earning a B-plus or higher grade point average.
"While much is known about college student use of alcohol, cigarettes, marijuana, and other illicit drugs, we've not had a handle on the abuse of prescription drugs. Estimating drug abuse by only looking at illicit drugs makes the problem appear smaller than it really is," said Henry Wechsler, lecturer, Department of Society, Human Development and Health at the Harvard School of Public Health , and a co-author of the study.
One specific focus of the study was the non-medical use of three prescription stimulants—Ritalin, Dexedrine and Adderall—that are considered the first-line pharmacotherapy for treatment of attention deficit hyperactivity disorder (ADHD). The rise in medical prescriptions for stimulants to treat ADHD in the United States has led to concern on the part of some public health researchers.
Based on the findings of this study, the researchers are encouraging colleges and universities to assess their own schools to find out whether the non-medical use of prescription stimulants represents a problem on their campuses, McCabe says.
"Any intervention aimed at reducing non-medical use will have to take into consideration that prescription stimulants are a highly effective and safe medication for most individuals with ADHD," McCabe said. "Given the proven therapeutic efficacy of prescription stimulants for the treatment of ADHD, there is a need to balance the medical necessity of these drugs and the risk for non-medical use and abuse."
In addition to McCabe and Wechsler, the article "Non-medical use of prescription stimulants among U.S. college students: prevalence and correlates from a national survey" was co-authored by Dr. John Knight, (Harvard Medical School and Children's Hospital Boston, Center for Adolescent Substance Abuse Research, Boston), and Christian Teter, (McLean Hospital Alcohol and Drug Abuse Treatment Program and Northeastern University Bouvé College of Health Sciences, Boston).
The study was supported by grants from the Robert Wood Johnson Foundation and the National Institute on Drug Abuse.