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McCabe SE, Schepis TS, Schulenberg JE, Wilens TE, Veliz PT. Is Early Onset of Nonmedical Prescription Stimulant Use Associated With Cocaine Use During Adolescence? Results From a National Study. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:314-324. [PMID: 38258848 PMCID: PMC11293527 DOI: 10.1177/29767342231219139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND To examine the associations between early onset of nonmedical prescription stimulant use (NPSU) and cocaine use. METHODS Nationally representative samples of high school seniors were surveyed annually. Data were collected via self-administered questionnaires in nationally representative public and private schools in the United States (1976-2020) as part of the Monitoring the Future Study. The sample consisted of 45 cohorts of 12th grade students (N = 121 909). The main outcome was lifetime, past-year, and past-month cocaine use. RESULTS An estimated one in every 10 (10.1%) individuals reported lifetime NPSU while 8.5% reported any cocaine use. The vast majority of youth (87.2%) initiated NPSU before cocaine among those who reported both substances. Cocaine use was most prevalent among youth who reported early onset of NPSU in 8th grade or earlier (51.7%) followed by those who reported later onset of NPSU in 12th grade (24.7%), and those who never initiated NPSU (3.7%). Binary logistic regression analysis indicated that early onset of NPSU had greater adjusted odds of cocaine use compared to those with later onset of NPSU or those who never reported NPSU. Moreover, the adjusted odds of cocaine use were higher for adolescents who initiated NPSU before or after medical use of prescription stimulants compared to those with no history of medical use or NPSU. Similar results were found for lifetime, past-year, and past-month cocaine use as a function of NPSU onset; this association was stronger among more recent cohorts. CONCLUSIONS Early onset of NPSU appears to be a signal of increased risk of cocaine use among US adolescents. NPSU should be included in screening and early prevention strategies among secondary school students. Health professionals, school officials, and families are encouraged to monitor youth for NPSU based on the increased risk of later cocaine use and related consequences.
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Affiliation(s)
- Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Ty S. Schepis
- Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | | | - Timothy E. Wilens
- Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Philip T. Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, Michigan, USA
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Shearer RD, Jones A, Howell BA, Segel JE, Winkelman TNA. Associations between prescription and illicit stimulant and opioid use in the United States, 2015-2020. J Subst Abuse Treat 2022; 143:108894. [PMID: 36206585 PMCID: PMC9706463 DOI: 10.1016/j.jsat.2022.108894] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/09/2022] [Accepted: 09/23/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Overdose deaths involving opioids and stimulants continue to reach unprecedented levels in the United States. Although significant attention has been paid to the relationship between prescription and illicit opioid use, little work has focused on the association between prescription and illicit stimulant use. Thus, this study explores characteristics of those who use or misuse prescription stimulants and/or opioids and associations with use of cocaine, methamphetamine, and heroin. METHODS We used 2015-2020 data from the National Survey on Drug Use and Health. Using adjusted multivariable logistic regression, we estimated the associations between past year prescription stimulant or prescription opioid prescribed use and misuse; various demographic characteristics; and past-year cocaine, methamphetamine, or heroin use. RESULTS From 2015 to 2020, 4.9 and 9.8 million US adults annually reported misusing prescription stimulants and opioids, respectively. Individuals who misused prescription stimulants were more likely to be ages 18-25 (45.8 %; 95 % CI: 44.0-47.5) than individuals who misused prescription opioids (21.7 %; 95 % CI: 20.7-22.7). We observed higher rates of cocaine use among individuals reporting prescription stimulant misuse (12.0 %; 95 % CI: 11.0-12.9) compared to those reporting prescription opioid misuse (5.7 %; 95 % CI: 5.1-6.3, p < 0.001). Heroin use was more common among individuals with prescription opioid misuse (2.1 %; 95 % CI: 1.7-2.2) than prescription stimulant misuse (0.6 %; 95 % CI: 0.4-0.7, p < 0.001). However, rates of methamphetamine use among individuals with prescription stimulant misuse (2.4 %; 95 % CI: 1.9-3.0) did not differ from individuals with prescription opioid misuse (2.1 %; 95 % CI: 1.7-2.5, p = 0.67). CONCLUSIONS Prescription stimulant misuse, compared to prescription opioid misuse, was associated with higher levels of cocaine use but not methamphetamine use. Treatment providers should consider screening for other substance use disorders among people who report prescription stimulant use or misuse. Additional research should seek to understand the mechanism underlying the different associations between prescription stimulant misuse and cocaine or methamphetamine use.
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Affiliation(s)
- Riley D Shearer
- University of Minnesota School of Public Health, 420 Delaware St SE, Mayo Building B681, Minneapolis, MN 55455, USA; Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, 701 Park Ave., Suite PP7.700, Minneapolis, MN 55415, USA.
| | - Abenaa Jones
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
| | - Benjamin A Howell
- SEICHE Center for Health & Justice, Yale School of Medicine, 333 Cedar St, New Haven 06510, USA; Section of General Internal Medicine, Yale School of Medicine, PO Box 208025, New Haven, CT 06520, USA
| | - Joel E Segel
- Department of Health Policy and Administration, Penn State University, University Park, PA, USA; Penn State Cancer Institute, Penn State College of Medicine, Hershey, PA, USA
| | - Tyler N A Winkelman
- Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, 701 Park Ave., Suite PP7.700, Minneapolis, MN 55415, USA; Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, 716 S 7th St, Minneapolis, MN 55415, USA
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Kollath-Cattano C, Hatteberg SJ, Kooper A. Illicit drug use among college students: The role of social norms and risk perceptions. Addict Behav 2020; 105:106289. [PMID: 32007829 DOI: 10.1016/j.addbeh.2020.106289] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/20/2019] [Accepted: 01/03/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To examine the prevalence and correlates of college student use of illicit substances including cocaine, designer drugs, and nonmedical use of prescription stimulants and opioids, and to identify how different drug-related perceptions are related to past year use of these substances. METHODS Data were analyzed from a cross-sectional anonymous web-based survey among a sample (n = 1345, 81% female) of students attending a mid-sized liberal arts college in the US. Logistic regression models were estimated to assess the relationships between substance-specific descriptive norms, injunctive norms, perceived availability, risk perceptions and past year use of cocaine, designer drugs, prescription stimulants, and opioids, adjusting for current marijuana use, alcohol dependence, sensation seeking, and sociodemographic factors. FINDINGS Past year use of illicit substances ranged from 6% for nonmedical prescription opioids to 21% for nonmedical prescription stimulants. The sociodemographic correlates past year substance use differed by substance type. Descriptive norms (perceptions of peer use) and perceived risk were not consistently related to use of these substances. Current marijuana use was the strongest correlate across substances, and both injunctive norms (perceptions of peer approval) and perceived availability were consistently related to use of each substance. CONCLUSIONS Findings suggest that future college student drug prevention efforts should more directly target current marijuana users since they are most at risk of using other illicit substances. Additionally, findings indicate that injunctive norms may be an important consideration for education-focused drug prevention programs. However, findings should be interpreted in light of limitations of the sample, which is predominantly female.
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Affiliation(s)
- Christy Kollath-Cattano
- Department of Health and Human Performance, College of Charleston, Charleston, SC 29424, USA.
| | - Sarah J Hatteberg
- Department of Sociology and Anthropology, College of Charleston, Charleston, SC 29424, USA
| | - Anna Kooper
- Department of Health and Human Performance, College of Charleston, Charleston, SC 29424, USA
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Steward A, Pickersgill M. Developing expertise, customising sleep, enhancing study practices: exploring the legitimisation of modafinil use within the accounts of UK undergraduate students. DRUGS (ABINGDON, ENGLAND) 2019; 26:347-355. [PMID: 31391711 PMCID: PMC6636896 DOI: 10.1080/09687637.2018.1555231] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 11/01/2022]
Abstract
Introduction and aim: Increasing numbers of students are reportedly using prescription medications to enhance cognition. This study aimed to generate qualitative data on UK students' understandings and perspectives of the risks and benefits surrounding so-called 'study drugs' (particularly, modafinil). Design and methods: Fifteen undergraduate students studying biomedical science subjects were interviewed about their perspectives on study drugs. Interviews were recorded and transcribed for thematic analysis. Users and non-users were included in the sample. Results: The prescription status and comparisons to other legal and illicit stimulants informed accounts of the (lack of) risks associated with study drugs, legitimising use. The customisation of sleep(iness) and wakefulness was described as a key benefit of study drug use. Drivers of use related to university pressures and desires to increase productivity. In periods of heightened stress, such as examinations, students reported altered practices and perspectives on risk. Discussion and conclusions: We noted the contextual nature of students' use and risk appraisals, with fluctuating social contexts and pressures over time being capable of altering prior assessments and current practices (including the legitimisation of study drug consumption). Further, we highlighted the degree to which students leveraged their biomedical and experiential expertise to account for drug consumption.
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Affiliation(s)
- Alice Steward
- Independent, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - Martyn Pickersgill
- Centre for Biomedicine, Self and Society, Usher Institute, Old Medical School, Teviot Place, University of Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland
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Zander ME, Norton-Baker M, De Young KP, Looby A. The Role of Anonymity in Determining the Self-Reported Use of Cocaine and Nonmedical Prescription Stimulant Use Among College Students. Subst Use Misuse 2016; 51:795-802. [PMID: 27097077 DOI: 10.3109/10826084.2016.1155607] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Nonmedical prescription stimulant use (NPSU) is commonly reported by college students and is on the rise. It is possible that increases in NPSU rates may stem from a lack of stigmatization regarding use, given recent evidence that students do not hold strong negative perceptions related to NPSU. OBJECTIVES This study aimed to assess NPSU and cocaine use using a conventional method and a method that assures anonymity. As anonymous data collection has typically found higher prevalence rates for stigmatized behaviors compared to conventional techniques, it was expected that cocaine rates would differ between techniques, while NPSU rates would not. METHODS At a Midwestern university during the Fall 2012 and Spring 2013 terms, groups of college student participants were randomly assigned either to a condition in which the data collection method guaranteed their anonymity (n = 204) or to a condition using a more conventional data collection technique that did not guarantee anonymity (n = 236). Participants responded to self-report measures assessing stimulant use, perception of anonymity of the methods, and demographics. RESULTS When anonymity was guaranteed, male participants were significantly more likely to report cocaine use. However, no differences in NPSU rates were noted for either sex, regardless of anonymity. CONCLUSIONS These results suggest that NPSU may not have the same perceived negative social consequences as other more stigmatized stimulant drugs, with young men in particular giving little weight to the potential consequences of NPSU.
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Affiliation(s)
- Mary E Zander
- a Department of Psychology , University of North Dakota , Grand Forks , North Dakota , USA
| | - Mara Norton-Baker
- a Department of Psychology , University of North Dakota , Grand Forks , North Dakota , USA
| | - Kyle P De Young
- a Department of Psychology , University of North Dakota , Grand Forks , North Dakota , USA
| | - Alison Looby
- a Department of Psychology , University of North Dakota , Grand Forks , North Dakota , USA
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Donaldson CD, Siegel JT, Crano WD. Nonmedical use of prescription stimulants in college students: Attitudes, intentions, and vested interest. Addict Behav 2016; 53:101-7. [PMID: 26476006 DOI: 10.1016/j.addbeh.2015.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 09/03/2015] [Accepted: 10/03/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Research on vested interest theory (VIT) indicates that the importance and hedonic relevance of attitudes moderates the link between attitudes and attitude-congruent behavior. Though largely untested in prevention research, this relationship may prove crucial in determining the success or failure of prevention efforts. The current study was designed to determine if subjectively perceived vested interest maximized the association between attitudes and intentions regarding the nonmedical use of prescription stimulants (NUPS). METHODS A cross-sectional survey was conducted with college student respondents (N=162) using Amazon's MTurk. Participant age ranged from 19 to 49years old. A subsample analysis (n=129) was also conducted with younger respondents, as the typical college student is usually under the age of 30. RESULTS Four-step hierarchical regression analysis indicated that both attitudes and perceived vested interest were significantly associated with NUPS behavioral intentions (p<.001). Further, vested interest moderated the relationship between stimulant-related attitudes and usage intentions (p<.001). Attitudes were significantly associated with intentions of moderately and highly vested respondents (p<.001), but not those of participants expressing low levels of perceived vested interest. CONCLUSIONS Findings support the proposition that vested interest may be a useful target for attenuating NUPS. Rather than attempting to weaken positive attitudes toward NUPS, campaigns may prove more successful if designed to convince receivers that NUPS is not in their best interest.
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Affiliation(s)
- Candice D Donaldson
- Department of Psychology, Claremont Graduate University, 150 E. 10th St., Claremont, CA 91711, USA.
| | - Jason T Siegel
- Department of Psychology, Claremont Graduate University, 150 E. 10th St., Claremont, CA 91711, USA.
| | - William D Crano
- Department of Psychology, Claremont Graduate University, 150 E. 10th St., Claremont, CA 91711, USA.
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Ramos AM, Becker B, Biemer JA, Clark L, Fields S, Smallman R. The Role of Counterfactual Thinking on Attitudes Toward ADHD Medication Use. Subst Use Misuse 2016; 51:508-16. [PMID: 26942485 DOI: 10.3109/10826084.2015.1126739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Despite serious health risks, attitudes toward Attention-Deficit Hyperactivity Disorder (ADHD) medication use in college students remain favorable. Given the robust link between attitudes and behavior (e.g., the Theory of Planned Behavior), it is important to understand how these attitudes are developed and maintained. The current study examined the role of counterfactual, or "what if'" thinking as a mechanism for the development of attitudes toward ADHD medications. METHOD All participants (n = 190) were asked to read either a positive or negative scenario regarding ADHD medication misuse and rate their attitudes toward the behavior; half of the participants were also asked to generate counterfactuals prior to rating their attitudes. RESULTS Results suggest that scenario valence influenced the direction of counterfactual statements. Further, through the generation of upward counterfactuals, the negative scenario elicited more positive attitudes toward ADHD medication misuse. CONCLUSIONS Based on limited prior research, it is suggested that upward counterfactuals may allow individuals to explain away the misuse of ADHD medication and avoid negative emotions such as guilt and shame related to current or prior ADHD medication misuse. In sum, additional research is needed to confirm preliminary findings that suggest counterfactual thinking could be a precursor to ADHD medication misuse.
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Affiliation(s)
- Ashley M Ramos
- a Department of Psychology , Texas A&M University , College Station , Texas , USA
| | - Brittney Becker
- a Department of Psychology , Texas A&M University , College Station , Texas , USA
| | - Julie A Biemer
- a Department of Psychology , Texas A&M University , College Station , Texas , USA
| | - Lindsay Clark
- a Department of Psychology , Texas A&M University , College Station , Texas , USA
| | - Sherecce Fields
- a Department of Psychology , Texas A&M University , College Station , Texas , USA
| | - Rachel Smallman
- a Department of Psychology , Texas A&M University , College Station , Texas , USA
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Reid AM, Graziano PA, Balkhi AM, McNamara JPH, Cottler LB, Meneses E, Geffken GR. Frequent nonprescription stimulant use and risky behaviors in college students: the role of effortful control. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2014; 63:23-30. [PMID: 25222628 DOI: 10.1080/07448481.2014.960422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The goal of this study was to (a) investigate the association between nonprescription stimulant use (NPSU) and risky behaviors, including risky sex, driving, financial behaviors, and drug use and (b) collect preliminary evidence on mechanisms that may link NPSU to risky behaviors. PARTICIPANTS A sample of 555 college students was collected between August 2010 and February 2012. METHODS Students completed several self-report measures assessing their drug use history, attention-deficit and hyperactivity symptoms, temperament, and risky behaviors beyond drug use. RESULTS Those who reported more frequent NPSU were more likely to engage in high-risk behavior across all 4 domains studied. Further, effortful control abilities partially mediated the link between NPSU and risky behaviors. CONCLUSIONS These results highlight the associated risks of frequent NPSU for college students as well as provide future directions for examining effortful control as a potentially important mechanism linking NPSU to other risky behaviors.
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Affiliation(s)
- Adam M Reid
- a Department of Psychiatry , University of Florida , Gainesville , Florida
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