Compounding Privilege, Resilience, and Nonmedical Prescription Stimulant Use among College Students

Background: In this study, we examined why non-Hispanic White cisgender men are more likely than other subgroups to misuse prescription stimulants in college. The objective of the current study was to use a strength-based framework to examine intersectional demographic predictors. Methods: We examined gender and race/ethnicity as predictors of nonmedical prescription stimulant use (NPS) among college students. We also investigated resilience as a moderator. This report uses data from an online multisite study conducted at seven universities with 4,764 undergraduate students (70.1% women and 52.0% People of Color). Results: We found that college students who were cisgender men and non-Hispanic White used NPS significantly more than students who identified as another gender and as People of Color. There was also a buffering effect of resilience between race/ethnicity and NPS, such that resilience predicted lower NPS for People of Color, but not non-Hispanic White people 28% of the time. Conclusions: It may be that Students of Color are more resilient than non-Hispanic White students, and this resilience is protective of NPS use in college. Importantly, a compounding-privilege and/or intersectional approach to identity is crucial to fully understanding behavior (in this case NPS) in a diversity of college students; future studies should continue to use and develop such approaches.

An exploratory study of indicators of recent nonmedical prescription stimulant use among college students

To explore the relationship between past 30-day nonmedical prescription stimulant use (NPSU) and past 30-day marijuana and/or alcohol use, past 30-day risky marijuana and/or alcohol use, student demographics, and student activity involvement among college students. Participants: Sample of 604 college-aged students at two large universities in the southeastern U.S. Methods: A cross-sectional survey was completed electronically. Logistic regression was used to identify and test covariates of past 30-day NPSU. Results: Over 20% of participants self-reported past NPSU. Using both marijuana and alcohol in the past 30 days (B = 3.293, p = .002, OR= 26.91, 95% CI OR= 3.42, 211.92) and engaging in both risky marijuana and alcohol use (B = 2.095, p < .001, OR = 8.13, 95% CI OR = 2.52, 25.17) were significantly related to past 30-day NPSU. Conclusions: NPSU may be indicative of broader polysubstance use problems among college-aged students.

Disordered eating is associated with non-medical use of prescription stimulants among college students

BACKGROUND

Disordered eating behaviors are associated with non-medical use of prescription stimulants for weight and appetite-related purposes. Yet, estimates of the prevalence and types of disordered eating associated with non-medical use vary. Additionally, little is known about the association between medical use of prescription stimulants and disordered eating.

METHOD

Data were collected from 87,296 college students at 127 institutions that participated in the Healthy Minds Study. We assessed the relationship between disordered eating, medical and nonmedical prescription stimulant use using multivariable logistic regression models adjusted for demographic characteristics, lifestyle and behavioral factors, and psychiatric comorbidity.

RESULTS

Non-medical use of prescription stimulants (NMUPS) was reported by 2.8 % n = 2435 of the sample. One-third of students using prescription stimulants non-medically reported two or more disordered eating attitudes and behaviors. Disordered eating was a significant predictor of non-medical, but not medical use of prescription stimulants. A dose-response relationship was identified between disordered eating and non-medical use, where risk for non-medical use increased with the number of disordered eating attitudes and behaviors reported.

CONCLUSIONS

The risk for NMUPS increases with disordered eating symptomatology. There is a need to assess for NMUPS among college students presenting with disordered eating.

Sex differences in nonmedical prescription tranquilizer and stimulant use trends among secondary school students in Argentina, Chile, and Uruguay

BACKGROUND

Little is known about recent nonmedical prescription tranquilizer and stimulant use trends in Latin America. We tested whether recent trends among students in three South American countries differed by sex over time.

METHODS

Three countries independently collected National School Students Survey on Drugs. Students in 8th, 10th, and 12th grades were sampled in Argentina (2007-2014, N = 328,202), Chile (2007-2015, N = 136,379), and Uruguay (2007-2016, N = 32,371). Weighted linear regression models predicted the prevalences and trends over time of past-year nonmedical tranquilizer and stimulant use by country, and tested whether trends differed by sex, adjusting for school type and grade.

RESULTS

In Argentina from 2007 to 2014, past-year nonmedical prescription tranquilizer (girls: 2.8 to 2.6%, boys: 2.5 to 2.3%) and stimulant (girls: 1.7 to 1.3%, boys: 1.9 to 1.5%) use trends did not differ by sex. In Chile from 2007 to 2015, nonmedical prescription tranquilizer use trends significantly differed comparing girls (3.9 to 10%) with boys (3.2 to 6.9%); stimulant use trends did not differ comparing girls (1.6 to 2.0%) with boys (2.0 to 1.3%). In Uruguay from 2007 to 2014 and 2014-2016, past-year nonmedical prescription tranquilizer (girls: 5.1 to 6.6%; boys: 2.8 to 4.2%) and stimulant (girls: 1.8 to 0.7%; boys: 1.8 to 0.7%) use trends did not differ by sex.

CONCLUSIONS

Trends of nonmedical prescription tranquilizer use recently increased in Chile and Uruguay, widening by sex over time in Chile only. The drivers of increasing tranquilizer use among girls in Chile and Uruguay merit further investigation.

Differentiating motives for nonmedical prescription stimulant use by personality characteristics

Nonmedical prescription stimulant use (NPS) is increasing, particularly among college students. College students typically engage in NPS for cognitive enhancement, recreational, and appetite/weight-related purposes; however, little research has used these motives to identify specific risk for, or consequences of, NPS. Moreover, there may be unique risk factors for motive-specific NPS that have yet to be explored, such as relevant personality traits (i.e., distress tolerance, impulsivity, and perfectionism) that are associated with NPS in general. Therefore, this study aimed to examine whether NPS users and nonusers could be differentiated via facets of impulsivity, perfectionism, and distress tolerance, and whether users could be further differentiated by reported motive for use based on these traits. Midwestern university undergraduate students (N = 668) who were enrolled in a psychology research pool completed an online survey assessing demographics, NPS and motives, and measures of distress tolerance, impulsivity, and perfectionism. Participants were primarily female (78%) and aged 18-54 (M = 20.10, SD = 3.19) years. Univariate and multivariate analysis of variance tests revealed associations between lifetime NPS and higher impulsivity, higher perfectionism, and lower distress tolerance. Further tests revealed NPS for appetite/weight-related purposes was associated with lower distress tolerance, while NPS for recreational purposes was associated with higher impulsivity. These findings contribute novel information regarding NPS motives and personality constructs. This information may aid in comprehensive identification of high-risk individuals for NPS and inform the development of specialized prevention and intervention efforts.

The Role of Anonymity in Determining the Self-Reported Use of Cocaine and Nonmedical Prescription Stimulant Use Among College Students

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.

Nonmedical prescription stimulant use among youth in the emergency department: prevalence, severity and correlates

This study examined the prevalence, severity and correlates of nonmedical prescription stimulant use (NPSU) among youth in the emergency department (ED). Participants 14-20 years old presenting to the ED completed a survey. A multinomial logistic regression was used to compare those without NPSU, with mild NPSU and with moderate/severe NPSU on demographics, risk factors and ED utilization. There were 4389 participants; 8.3% reported past-year NPSU and 44% of those with past 3-month NPSU reported at least monthly use. After controlling for demographics, participants with mild NPSU or moderate/severe NPSU had higher odds of all substance use risk factors compared to those with no NPSU. Also, those with moderate/severe NPSU were more likely to report dating violence and nonmedical use of opioids or sedatives and less likely to use marijuana compared to those with mild NPSU. Healthcare setting screening and intervention efforts should consider NPSU concomitant with other substance use and explore the association of dating violence with NPSU.

Do negative stimulant-related attitudes vary for prescription stimulants and cocaine among college students?

Nonmedical prescription stimulant use (NPS) has become an increasing problem for college students across the United States. Many engage in NPS due to the belief that their academic functioning will improve - a belief that rarely extends to other illicit stimulants. Because positive attitudes toward substances potentially predict the maintenance of current and future use, the aim of the current study was to directly compare attitudes toward different stimulants of abuse (prescription stimulants and cocaine) to ascertain whether attitudes were generally more positive as a function of both drug and drug user type. Ninety-one participants completed a brief attitudinal index assessing attitudes for both prescription stimulants and cocaine. Participants held stronger positive attitudes toward prescription stimulants than cocaine on a variety of items. NPS users reported more positive attitudes toward prescription stimulants than both nonusers and cocaine users. Nonusers reported more negative cocaine-related attitudes than cocaine users and polydrug users (users of both prescription stimulants and cocaine). Intervention programs may benefit from highlighting the negative consequences of NPS, particularly by way of comparisons to cocaine. Doing so may heighten awareness on the overlap of adverse outcomes resulting from use between these stimulants.

Challenging expectancies to prevent nonmedical prescription stimulant use: a randomized, controlled trial

BACKGROUND

College students continue to report nonmedical prescription stimulant use to enhance alertness and concentration. Despite increasing prevalence of this behavior, techniques for preventing or treating it are lacking. An intervention that focuses on challenging positive consequence-oriented beliefs about prescription stimulants may be efficacious in preventing use.

METHODS

The current study examined the efficacy of a randomized controlled expectancy challenge intervention to prevent nonmedical prescription stimulant use among 96 at-risk, stimulant-naïve college students (i.e., low grade point average, Greek involvement, binge drinking, cannabis use). Forty-seven participants completed a brief expectancy challenge intervention aimed at modifying positive expectancies for prescription stimulants, to consequently deter initiation of use. The remaining participants received no intervention.

RESULTS

The expectancy challenge successfully modified expectancies related to prescription stimulant effects. Nevertheless, this intervention group and a control group showed comparable rates of nonmedical prescription use at 6-month follow-up. However, negative expectancies were significant predictors of reduced odds of future use.

CONCLUSIONS

A challenge session appears to modify stimulant-related expectancies, which are related to nonmedical prescription stimulant use. Nevertheless, a more potent challenge or booster sessions might be essential for longer-term changes.