The Increase of Illicit Stimulant Use on College Campuses

The Increase of Illicit Stimulant Use on College Campuses Stephanie Lobe Upper Iowa University December 5, 2011 ABSTRACT Numerous studies are finding that college students in the United States are relying on stimulant medications prescribed for ADHD without a prescription and for nonmedical reasons, most commonly because students believe these medications can enhance their cognitive performance. Research finds that students report these stimulants have become a part of the college culture and are easier to obtain than alcohol.This paper will discuss the prevalence of use on college campuses in the United States and both the academic and nonacademic motivations these students use prescription stimulants illicitly. In the United States, the domestic sales for prescription stimulant ADHD (Attention Deficit Hyperactivity Disorder) medications such as Ritalin, Adderall, and Dexedrine are increasing at significant rates. Between 1991 and 1999, sales of these prescription stimulants increas ed over 500 percent. As the rate of legal use increases, so does the rate of illegal or nonmedical use, especially on our college campuses.Data shows that these drugs have high abuse potentials and produce effects very similar to cocaine. Because of the potential for physical and psychological dependency and risk of abuse, the US Drug Enforcement Administration classifies these stimulants as Schedule II substances (Woodworth, 2000). Unfortunately, most students consider these drugs safe and do not realize the potential side effects and risk for abuse. There is a perception that nonmedical use of these drugs is morally acceptable if used for academic rather than recreational purposes (DeSantis, 2008).In, 2002, there had not yet been a lot of research conducted on illicit stimulant use on campus. At this time, Graf Low and A. E. Gendaszak surveyed undergraduates at a small college in the United States to gather information on the legal and illegal use of stimulants on the college camp us. The authors also wanted to explore how perfectionism and sensation seeking behavior contributed to abuse of both legal and illegal stimulants. Low and Gendaszak hypothesized that students influenced by perfectionism would be likely to abuse prescription stimulants (i. e.Ritalin, Adderall) and sensation seeking students would be more likely to abuse both prescription stimulants and illegal stimulants (i. e. methamphetamines, cocaine). Of 160 questionnaires distributed to students in an undergraduate psychology course, 150 questionnaires were returned. The questionnaires assessed selected demographic variables and the abuse of prescription and illegal stimulants during the previous 12 months. It is important to note that for this study, illicit stimulant use is defined as taking prescription stimulants (Adderall, Ritalin, etc) without a prescription.Illegal stimulant use is defined as taking the illegal â€Å"street† stimulants cocaine or MDMA (ecstasy). Participants were a lso questioned about their reasons for using stimulants. Two measures that have demonstrated reliability and validity with college students were administered to assess possible correlates of use: the Multidimensional Perfectionism Scale and the Sensation Seeking Scale. Ten percent of the students participating were prescribed stimulants by a medical professional and researchers automatically categorized them as non-abusers.In this journal article, the authors do not report the total number or percent of participants that were considered illicit users. They do report that analysis of the illicit users showed that 10% abused stimulants monthly and 8% weekly. There were a significantly higher number of men than women reporting illicit use, but no difference in their motivations for use. The common motivations for use were: to improve intellectual performance, to be more efficient and to use in combination with alcohol. Of the total of students participating, 34% reported taking cocaine , MDMA or both within the last 12 months.It was found that illegal stimulant use was highly correlated with illicit use of prescription stimulants. Researchers also found there was a correlation between having a prescription for stimulants and using illegal stimulants. Eighty-eight percent of the illegal users reported using MDMA vs. cocaine with men reporting greater use than women. Almost always, the motivation for illegal stimulant use was for recreational purposes. Sensation seeking and perfectionism were dichotomized based on a median split to produce categorical variables for analysis of variance.A two by two analysis of variance was carried out (high or low perfectionism by high or low sensation seeking) with the illicit use of prescription drugs as the dependent variable and gender as a covariate. The main effect for sensation seeking was significant, but perfectionism was not associated with self-reported use. However, the two-way interaction between sensation seeking and p erfectionism was significant. High sensation seeking perfectionists had the greatest self-reported abuse of prescription stimulants (Low, 2002).In the research study, Illicit Use of Prescription ADHD Medications on a College Campus: a Multimethodical Approach, both quantitative surveys and qualitative interviews were conducted to collect data on college students’ perceptions of illicit prescription stimulant use and the prevalence of use. With the combined methods, 1,811 undergraduate students from a large, public, southeastern research university participated. Seventy-eight of these students had a prescription to treat ADHD and were removed from the study, leaving a total of 1,733 participants.This study found that of those participants, 34 % of used prescription stimulants illegally and for nonmedical reasons. The results suggested that illicit use of the stimulants was more common in Caucasians, men, upperclassmen, and students belonging to Greek organizations. Interviews with students allowed researchers to gather detailed information about their perceptions of stimulant prescription drugs, the circumstances of the first time they used a stimulant and what their motives were.During the interviews, it was discovered how prevalent illicit use of these medications are as well as how casually this use was discussed on campus with many students stating, â€Å"it’s no big deal†. Of the illegal users in the study, 63% used stimulants for the first time in college and for most the first time of use was at a time of high academic stress. For more than two-thirds of these users, this occurred during finals or when they had multiple tests in one day. First time users had little knowledge about the side effects of stimulant medication, the appropriate doses, or the legal consequences of using these drugs illicitly.Of illegal users, 72% reported using the drugs to stay awake and study longer or to concentrate on work. Many students claimed they cou ld be more productive and reported being able to study for up to 3-5 hours straight without getting distracted or taking a break. Others reported the stimulants made them â€Å"smarter† because they were able to memorize & retain information, grasp ideas and recall information better. One participant’s description of the drug Adderall was, â€Å"the stuff is like an academic anabolic steroid†. There were a few students that reported use of the stimulants for nonacademic purposes.Some these reasons included that the drugs gave them the ability to stay up all night for parties, be more talkative and social at parties and feel the effects of alcohol quicker. Students also reported that when crushed and snorted, the drugs produced a high similar to cocaine (DeSantis, 2008). In the study, Illicit Use of Prescription Stimulant Medication Among College Students, authors also investigate how prevalent illicit use is at a Midwestern campus as well as why students are abu sing these drugs. Three different methods were used to recruit students for the study.A list of randomly selected students residing in residence halls, 500 female and 500 male, was obtained from the university’s registrar office. A cover letter and questionnaire were sent to these students and then a second questionnaire was mailed to those who had not responded within two weeks. The researchers also held three sessions that were open to introductory psychology students who would receive credit for completing the questionnaire. The last effort to recruit students included researchers going door to door on men’s wings in residence halls.The combined total of responses was 552. The survey completed consisted of 85 items with the first section including questions about demographics and personal information. The questions on the remainder of the survey used a Likert-type scale (1=strongly disagree, 2=disagree, 3=neutral, 4=agree, 5=strongly agree). Questions were separated into two sections for statistical analysis. The second section obtained specific information from individuals who reported they had illicitly taken stimulant medication.Results from the survey found that 17% of the men surveyed and 11% of the women surveyed had used prescription stimulants for non-medical reasons. Forty-four percent of the students surveyed reported that they knew someone who had used prescribed stimulant medication illicitly for academic or recreational reasons. Authors found that the main reason for use was to increase alertness and energy and use was associated with experiencing time and academic pressures of college life (Hall, 2005). The purpose of a study published in the Journal of Human Pharmacology andDrug Therapy was to explore illicit use of specific prescription stimulants among college students and the reasons and routes of administration associated with illicit use of these drugs. The study was conducted at a large Midwestern university in 2005. A ran dom sample of 5,389 full-time, undergraduate students were selected from the total population of 20, 138 full-time students. In order to produce reliable prevalence estimates for minority racial and ethnic groups, researchers oversampled 652 Hispanic, 634 African American and 244 Asian students.Students in the sample were mailed a letter describing the study and inviting students to self-administer a confidential web survey. Participants were eligible for a sweepstakes that included cash prizes, travel vouchers and other prizes. The final response rate exceeded the average rate for national college based studies of alcohol and other drugs with a 66% response rate. The final sample closely resembled the demographics of the overall student population and consisted of 4,580 undergraduate students.The results from the survey indicated that 8. 3% of the participants had used illicit prescription stimulants in their lifetime and 5. 9% had used them in the past year. Three out of four of t he illicit users reported taking Adderall and one out of four illicit users reported taking Ritalin. Unlike other studies of this nature, the authors report there were no differences in past year illicit prescription stimulant use between men and women. They did find statistically significant ethnic-racial differences in past year use with 8. % of Hispanics having used illicit prescription stimulants, 7% of Caucasians, 3. 4% of Asians, 1. 9% of African Americans and 3. 6% of those categorized as other. Sixty-five percent of the lifetime users began using illicit prescription stimulants during college rather than before starting college. Logistic regression showed students who began using prescription stimulants illicitly before entering college were three times as likely to use these drugs during college compared to those who had not used them before entering college.When looking at the motivations of students using illicit prescription stimulants, researchers found significant diff erences between gender and ethnic-racial groups. Men were more likely than women to report using these drugs to experiment, get high, and counteract the effects of other drugs. Women were more likely than men to report using prescription stimulants to lose weight, to help study, and to increase alertness. There was not a difference between sexes regarding the most frequently cited motive which was to help with concentration.There were no African Americans that reported using illicit prescription stimulants to get high, but over 20% of Caucasians, Hispanics, Asians, and others reported this as a motive. The results for experimenting as a motive were similar. Most African American students who reported using prescription stimulants illicitly listed the motives to help concentrate or to help study. Students who reported using prescription stimulants illicitly before entering college were more likely to use these drugs during the past year to get high, lose weight or experiment.Students who did not start using prescription stimulants until enrolled in college were more likely to report the motive to help study. The results of this study also revealed findings about the routes in which students administered illicit prescription stimulants. Ninety-five percent of illicit users reported oral administration. Thirty-eight percent reported snorting the prescription stimulants and a very small percentage reported smoking, inhaling or injecting these drugs. Neither gender nor race-ethnicity were associated with routes of administration.However, students who began using illicit prescription stimulants before college were more likely to report snorting the drugs than those who started using during college. The authors report their study is the first to empirically document the claim that use of Adderall is the primary prescription stimulant used illicitly by college students. Hypothesizes to why the use of Adderall may be growing relative to other stimulants such as Ritlan, generally fall into three categories: availability, pharmacokinetic differences between stimulant drugs, and pharmacologic differences.In another study cited by the authors, college students reported Adderall was used more frequently because it was easily accessible, caused fewer emotional ups and downs, and was believed to work better overall. The authors explain that there are differences in the mechanism of action of Adderall that may result in this drug being more appealing to college students. The effects of the drug will last longer and may generate higher dopamine levels in the brain than occur when taking Ritalin (Teter, 2006).A study done by Rachel Judson & Susan W Langdon investigated illicit use of stimulant medications on college campuses considering the theory of planned behavior. This theory states that attitudes, beliefs about social norms, and perceived control work together to create intentions which predict health related behavior. The study included a total of 33 3 participants from two small competitive New England college campuses. Two survey forms were distributed – one for current stimulant prescription holders and one for non-prescription holders. The surveys were self-administered online.The study found that 20% of all participants reported illicit use of stimulants. Of the prescription holders, 46% reported illicit use (using for reasons other than prescribed or at increased doses) and of the non-prescription holders, 18. 3% reported illicit use. The two most predominant motives were to improve concentration and to increase alertness or stay awake. This indicates that academic reasons were more prevalent than recreational reasons for taking the medication. For non-prescription holders, the results were consistent with the theory of planned behavior.Attitudes, perceived norms and a sense of low control held by illicit users may act as rationalizations for their illicit use of stimulant medication (Judson, 2009). Many studies hav e been done investigating how perceived harmfulness influences nonmedical drug use and there have also been separate studies done investigating the association between nonmedical drug use and high sensation-seeking characteristics. This study takes both variables into consideration and explores whether the association between perceived harmfulness and nonmedical drug use vary by level of sensation-seeking.Participants included 1, 253 first year college students from a large, publicly-funded university in the mid-Atlantic region with an ethnically diverse student body. Personal interviews were conducted with participants and then participants were followed up with twice at six month intervals. Researchers examined the association between the two variables of perceived harmfulness and level of sensation-seeking characteristics because they believed it was important to consider the possibility that sensation-seeking characteristics can influence risk perception.Results from this study indicated that one in four students perceived a great risk of harm from occasional nonmedical use of prescription stimulants and analgesics. Low perceived harmfulness and high sensation-seeking were independently associated with increased risk of nonmedical use. At most levels of sensation-seeking, high perceived harmfulness did affect nonmedical prescription drug use; however, among high sensation-seekers, perceived harmfulness was not related to nonmedical use of prescription analgesics.This study found that individuals with low perceived harmfulness were approximately 10 times more likely to use prescription drugs for both stimulants and analgesics, as compared to those individuals with high perceived harmfulness. Another important finding was that individuals with low or moderate sensation-seeking tendencies were especially susceptible to the influence of perceived harmfulness (Arria, 2008). An article published online, New Findings on the Misuse of ADHD Medications by College S tudents, reviews one of the largest studies conducted regarding nonmedical use of stimulants on college campuses.In 2001, nearly 11,000 students attending 119 nationally representative, 4-year colleges in the United States were surveyed about their nonmedical use of prescription stimulants. The involvement of such a high number of universities across the country overcomes one of the major limitations of other studies done on this topic. Because most studies collect data from only one college, the results cannot be accurately generalized to college populations outside of that type of institution or region. This study found that the average rate for nonmedical use of stimulants during the participant’s lifetime was 6. %; during the last year was 4. 1% and during the last month was 2. 1%. The rate of use of stimulants varied dramatically across the campuses surveyed with rates ranging from 0% to as high as 25%. Findings from this study indicate that the highest rates of nonmedic al use of prescription stimulants are highest at colleges with competitive admission standards. More than 80% of schools with a past year prevalence rate higher than 10% had highly competitive admission standards and were located in the Northeast or Southern United States.Results of the motives for illicit stimulant use were comparable to other studies with the three top motivations being to help with concentration, to help with alertness and to get high (Ashley Children's Psychology Center, n. d. ). Most research studies regarding the illicit use of prescription stimulants on college campuses use a randomly selected sample size of over 1,000 participants. In the study, Illicit Use of Prescription ADHD Medications on a College Campus: A Multimethodological Approach, students participating in part I of the research, a quantitative survey, are recruited through a large introductory communications course.This course is a social science requirement and was selected to represent students from different majors across the campus. To ensure the upperclassmen were also represented in the study, additional surveys were distributed in an upper division communications course as well as the general student body. The second part of the study included qualitative interviews with 175 full-time, undergraduate students. The authors fail to report how these students were recruited.It is not know if these students were randomly selected from the general student population or if they were selected from the group of students who completed the survey. This research was done at a large, southeastern research university in the United States (DeSantis, 2008). Studies relating to the illicit use of stimulants on college campuses have found a significant variance in the prevalence of usage depending on factors such as admission standards and location of the university (Ashley Children's Psychology Center. (n. . ). Due to this, the study done at this southeastern research university canno t be generalized to the college population as a whole. This study used both quantitative and qualitative studies. Data was collected from surveys administered in the classroom as well as from scripted, in-depth interviews with students. The authors designed and pretested the 25-item survey for this study by conducting a pilot study of 94 students. After receiving feedback from the students, question wording and survey structure were revised.The interviews were conducted by students who had all completed an upper-division research methods course and were certified by the university’s institutional review board. Interviewers were assigned specific demographic groups to facilitate the comfort and trust levels of interviewees. Interviews with students allowed researchers to gather detailed information about their perceptions of stimulant prescription drugs, the circumstances of the first time they used a stimulant and what their motives were. Interviews revealed that many student s viewed illicit prescription stimulant use as part of the culture of ampus life (DeSantis, 2008). This study showed that 34% of the students who participated in the study had used prescription stimulant medications for nonmedical purposes. This rate is significantly higher than most published studies about stimulant use on college campuses; however, studies have found that rates vary greatly depending on demographic factors (Teter, 2006). The authors offer three explanations as to the reason their study reported a significantly higher prevalence rate of use on campuses: 1.ADHD stimulant use may be rising nationwide and as time passes, this phenomenon continues to grow; 2. Rates of use may vary on different college campuses and this campus may have a higher prevalence of use; and 3. The relatively high proportion of Greek students in the student body may have contributed to the higher prevalence rate. In relation to explanation 2, it was also noted that this study took place in a st ate that has been ranked as one of the top three states in the nation for ADHD diagnosis.To estimate the proportion of individuals who used illicit stimulants by demographic category, the number of users in each category was divided by the total number surveyed in each category. Using results displayed by demographic category use and non-stimulant use, data was cross tabulated by the same demographics factors and a chi-square analysis was conducted to examine statistically significant differences. The resulting data suggested that illicit prescription stimulant use was more common in men, white students, upperclassmen, and members of Greek organizations. Most other studies have published similar results (DeSantis, 2008).The study, Illicit Use of Specific Prescription Stimulants Among College Students: Prevalence, Motives and Routes of Administration found that there is a significantly higher prevalence of use in Caucasian and Hispanic students. These two ethnic groups reported rates of use at 8. 5% and 7%, respectively. Use for African Americans students was only 1. 9%. Another notable difference related to ethnicity was that while over 20% of Hispanic and Caucasian students reported one of the motives of using prescription stimulants was to get high; 0% of African American students reported that motivation (Teter, 2006).Quantitative data showed students’ primary motive for taking ADHD medication was to earn better grades in school. With the augmentation o the qualitative data, researchers discovered a myriad of more subtle motives defining when and why these students took stimulants. Researchers found that most students used prescription stimulants during finals week or periods of high academic stress. They also discovered some what some of the non-academic motives were such as staying up all night for parties, getting drunk quicker, and to be more social (DeSantis, 2008).Other studies have revealed similar findings with other non-academic motives bein g to help with losing weight, to get high, to experiment and to counteract the effects of other drugs (Teter, 2006). As discussed, the possible biases of this study were the fact that there was a high number of students in Greek organizations in the student body and that the study focuses on one campus noting the prevalence of use can vary greatly depending on the region the university is located in as well as other factors such as the competiveness of the school.The authors did not attempt to control these biases in their study, but in future studies an oversampling of students not involved in Greek organizations as well as a sample from several schools across the country could help control these biases (DeSantis, 2008). Each of these studies identifies the prevalent, increasing illicit use of stimulant medications for nonmedical uses, primarily motivated by academic reasons. It is apparent that most students do not know the dangers or risks of taking these medications and prescrip tion stimulants are more socially acceptable than other drugs.Many students appear rationalize their use because it is for academic reasons rather than recreational reasons. This is a terrifying trend that can result in many unwanted outcomes, the worst being death. References: Arria, A. M. , Calderia, K. M. , Vincent, K. B. , O'Grady, K. E. , & Wish, E. D. (2008, July 17). Perceived harmfulness predicts nonmedical use of prescription drugs among college students: Interactions with sensation-seeking. In National Institutes of Health. Retrieved November 10, 2011, from http://www. ncbi. nlm. nih. gov/pmc/articles/PMC2574828/ Ashley Children's Psychology Center. (n. d. . New Findings on the Misuse of ADHD Medications by College Students. In Ashley Psychology. Retrieved December 2, 2011, from http://ashleypsychology. com/Articles/010608. html [pic] DeSantis, A. D. , Webb, E. M. , & Noar, S. M. (2008, November). Illicit Use of Prescription ADHD Medications on a College Campus: A Multimet hodological Approach. Journal of American College Health, 51(3), 315-325. Retrieved November 12, 2011, from EBSCOhost. Hall, K. M. , Irwin, M. M. , Bowman, K. A. , Frankenberger, W. , & Jewett, D. C. (2005, January). Illicit Use of Prescription Stimulant Medication Among College Students.Journal of American College Health, 53(4), 167-174. Retrieved November 30, 2011, from EBSCOhost. Judson, R. , & Langdon, S. W. (2009, January). Illicit Use of Prescription Stimulants Among College Students: Prescription Status, Motives, Theory of Planned Behaviour, Knowledge and Self Diagnostic Tendencies. Psychology, Health & Medicine, 14(1), 97-104. doi:10. 1080/13548500802126723. Low, G. K. , & Gendaszek, A. E. (2002, August 1). Illicit Use of Psychostimulants Among College Students: A Preliminary Study. Psychology of Health and Medicine, 7(3), 283-287. doi:10. 1080/13548500220139386Teter, C. J. , McCabe, S. , LaGrange, K. , Cranford, J. A. , & Boyd, C. J. (2006, October 26). Illicit Use of Speci fic Prescription Stimulants Among College Students: Prevalence, Motives and Routes of Administration. The Journal of Human Pharmacology and Drug Therapy, 26(10), 1501-1510. doi:10. 1592/phco. 26. 10. 1501 Woodworth, T. (2000, May 16). DEA Congressional Testimony. Presented to the Committee on Education and the Workforce: Subcommittee on Early Childhood, Youth and Families. Retrieved November 13, 2011 from http://www. dea. gov/pubs/cngrtest/ct051600. htm.