Motives for Prescription Stimulant Misuse in a College Sample: Characteristics of Users, Perception of Risk, and Consequences of Use

A qualitative systematic thematic review of motivations for medical use of prescription stimulants among adults with ADHD

Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by inattention, hyperactivity, and impulsivity. Stimulant use among adults has increased, yet their motivations remain underexplored. This systematic thematic review synthesizes qualitative research on why adults use prescription stimulants for ADHD. A systematic search of five databases yielded 47 qualitative studies published between 1994 and 2023, each examining adult ADHD populations and their experiences with medical stimulant use. Data was thematically synthesized to identify recurring patterns of motivations, decision-making, and perceived outcomes. Four themes emerged: (1) Initial Motivation and Diagnosis: participants sought treatment to address tangible impacts on academic, occupational, and social functioning. (2) Benefits of Medication: stimulants improved focus, emotional regulation, and daily functioning. (3) Context of Use: medication was tailored to specific tasks or times. (4) Barriers: stigma, cost, and dependency concerns influenced adherence. Findings underscore the multifaceted motivations and barriers shaping adults' stimulant use. They highlight the need for patient-centred clinical practices that address personal goals, incorporate psychosocial support, and consider tailored medication regimens. Further research should explore how contextual factors, such as stigma and social expectations, influence adherence. Improving access to non-pharmacological interventions and updating treatment guidelines remain essential. A multi-modal approach is required to optimize outcomes for adults with ADHD.

Self-reported neurostimulant use among university students in Santa Maria, Rio Grande do Sul, Brazil

University students frequently resort to psychostimulants to enhance their physical and mental performance and manage academic pressures. However, these substances can lead to dependence and other undesired symptoms, and little empirical data are available for relevant stakeholders, raising significant concerns in health care. Therefore, this study aims to characterize neurostimulant use among university students in Rio Grande do Sul, Brazil. We collected from 880 students' data using anonymous self-administration. The questionnaire included consumption patterns of caffeine, nicotine, ecstasy, methamphetamine, "merla" (coca base), methylphenidate, cocaine, crack, and ketamine. Additionally, participants shared information on demographic and socioeconomic factors. Use of at least one neurostimulant was reported by89.2% of the participants. Among nonusers, the most frequently cited reason was "previous information about harmful effects of these drugs." Caffeine, followed by nicotine, ecstasy, and methylphenidate were the most consumed substances, with main reasons being "improving academic performance" and "recreation." Women more often consumed caffeine (72.7%), while other psychostimulants were more consumed by men (42.2%) and individuals of other genders (0.5%). Students who consumed other substances had higher family incomes than that of families of caffeine users. In addition, 60.4% of caffeine users resided with family members, whereas 63.3% of users of other substances did not. Our findings can offer essential data on the reasons and symptoms associated with the use of neurostimulants among university students. This information could aid in raising awareness among students, universities, and health-care agencies about this often-neglected subject.

Negative Urgency Linked to Craving and Substance Use Among Adults on Buprenorphine or Methadone

Despite the effectiveness of medication-assisted treatment (MAT), adults receiving MAT experience opioid cravings and engage in non-opioid illicit substance use that increases the risk of relapse and overdose. The current study examines whether negative urgency, defined as the tendency to act impulsively in response to intense negative emotion, is a risk factor for opioid cravings and non-opioid illicit substance use. Fifty-eight adults (predominately White cis-gender females) receiving MAT (with buprenorphine or methadone) were recruited from online substance use forums and asked to complete self-report questionnaires on negative urgency (UPPS-P Impulsive Behavior Scale), past 3-month opioid cravings (ASSIST-Alcohol, Smoking, and Substance Involvement Screening Test), and non-opioid illicit substance use (e.g., amphetamines, cocaine, benzodiazepines). Results revealed that negative urgency was associated with past 3-month opioid cravings, as well as past month illicit stimulant use (not benzodiazepine use). These results may indicate that individuals high in negative urgency would benefit from receiving extra intervention during MAT.

Prescription Stimulant Misuse Among Nursing Students: A Systematic Review

ABSTRACT

Nonmedical prescription stimulants are used to reduce symptoms of inattention, impulsivity, and hyperactivity in children and adults with attention-deficit hyperactivity/disorder. They are Schedule II controlled substances because of their high potential for dependence, and individuals who misuse them without a valid prescription are subject to criminal charges. Stimulant medications are also associated with common side effects (e.g., insomnia) as well as more serious but less common side effects (e.g., arrhythmias). Despite the potential health and legal consequences, misuse of prescription stimulants has become a public health crisis on college campuses in the United States. Neurocognitive enhancement is the primary reason that college students report misusing prescription stimulants, despite no enhancement of cognitive functioning when taken by healthy adults. Nursing students may be at risk for misuse because of their high levels of academic and clinical demands and because many start misusing in nursing school. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the databases PubMed, Science Direct, EBSCOhost, and Academic OneFile were systematically searched to investigate the (a) percentage of prescription stimulant misuse studies that have included nursing students, (b) prevalence of prescription stimulant misuse among nursing students, (c) motivations for prescription stimulant misuse among nursing students, and (d) demographic factors associated with increased use among nursing students. Results revealed that of the 197 studies conducted within the past decade (2010-2021), only 1.02% (two) included nursing students. Future studies must investigate the prevalence and nature of prescription stimulant misuse among nursing students.

Prescription drug and alcohol simultaneous co-ingestion in U.S. young adults: Prevalence and correlates

Simultaneous co-ingestion of prescription medication (e.g., opioid, tranquilizer/sedative, stimulant) and alcohol is associated with overdose and elevated substance use, but no studies have examined prescription drug misuse (PDM) and alcohol co-ingestion in U.S. young adults (18-25 years), despite the high rates of PDM in this age group. We used the 2015-19 National Survey on Drug Use and Health (young adult N = 69,916) to examine prevalence of past-month PDM-alcohol co-ingestion, PDM characteristics, and sociodemographic, physical health, mental health, and substance use correlates. Logistic regression examined correlates, comparing those without past-year PDM, those with past-year but not past-month PDM, those with past-month PDM without alcohol co-ingestion, and those with past-month PDM and alcohol co-ingestion. An estimated 585,000 young adults engaged in any past-month PDM-alcohol co-ingestion, or between 32.7% (opioids) and 44.6% (tranquilizer/sedatives) of those who were engaged in past-month PDM. Co-ingestion varied by educational status and was more common in males and white or multiracial young adults. All PDM-involved groups had elevated odds of suicidal ideation and other psychopathology, but substance use and substance use disorder (SUD) odds were significantly higher in young adults with co-ingestion, versus all other groups. To illustrate, 41.1% with opioid-alcohol co-ingestion had multiple past-year SUDs, versus 2.0% in those without past-year PDM. Young adults with co-ingestion are particularly likely to have problematic alcohol use and higher rates of SUD. Counseling about the risks of PDM-alcohol co-ingestion and screening for co-ingestion among those at risk are warranted to limit poor outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Negative Consequences Related to Nonmedical Prescription Stimulant Use: Development and Psychometric Validation of the Prescription Stimulant Consequences Questionnaire

Nonmedical prescription stimulant use (NPS) is prevalent among undergraduates and associated with several negative consequences. However, no validated measures exist assessing NPS-related consequences. The present study aimed to develop and psychometrically validate a Prescription Stimulant Consequences Questionnaire (PSCQ) for use among college students. A multisite sample of college students endorsing NPS ( N = 715, 68.4% female) completed the PSCQ and measures of NPS frequency and correlates of NPS via an online survey. Exploratory factor analysis supported a 27-item measure, with three factors (i.e., Compulsive Behavior, Risky Behaviors, and Physical and Mental Health) and a total score. Each PSCQ factor and total score demonstrated good internal consistency, and were significantly positively associated with all NPS frequency indicators, route of administration, alcohol-related problems, sleep problems, and depressive/anxiety symptoms. Findings demonstrate support for the psychometric validity and reliability of the newly developed PSCQ, which may demonstrate potential as a screening and outcome measure for intervention.

Outcomes and Predictors of Stimulant Misuse in College Students with and Without ADHD

In recent years, rates of prescription stimulant misuse have increased among young adults ages 18 to 25 along with increases in dispensing rates of these medications. Preliminary studies suggest that college students with Attention-Deficit Hyperactivity Disorder (ADHD) may be more likely to misuse their stimulant medication than their non-ADHD peers. Research is needed to further explore possible rates, correlates, and outcomes of prescription stimulant misuse among college students with and without ADHD. Data regarding study strategies, psychological functioning, stimulant misuse, and GPA were collected from students from universities within the US (N = 144), showing significantly higher rates of misuse among college students with ADHD. With depression and anxiety entered into the predictive model, inattentive symptoms were the only significant predictor of misuse in the full sample. The present findings have implications for academic interventions aimed at supporting the success of college students with and without ADHD and inform academic outcomes of prescription stimulant misuse.

“Where There Are Stars, There Is Also Darkness”: Young Icelandic Men’s Experience of Prescription Drug Misuse

Misuse of prescription drugs is a public health problem in many places around the world, including Iceland. It is considered most common among 18- to 25-year-olds, various risk factors and motives explain this trend. The purpose of this study was to examine young Icelandic men’s experience of prescription drug misuse. Participants in this study were seven Icelandic males, 18–26 years old, mean age was 20.9. Data were collected through 14 interviews and then processed using a qualitative methodological approach based on Vancouver’s school of phenomenology. The overriding theme of the study “ Where there are stars, there is also darkness” refers to the common thread in participants’ experiences of misuse of prescription drugs that were initially positive but quickly turned negative. Four main themes were identified: influence factors, reasons, onset, and continued drug misuse. The influencing factors were social influence, social group, lack of knowledge, and curiosity. The main reasons for the drug misuse were to suppress distress, improve capacity and efficiency, or have fun and avoid boredom. The onset of prescription drug misuse was characterized by quick fixes, misuse of one’s own medication or medication from a friend/family member. Continued misuse was characterized by a vicious circle, black market, medical visits on false pretenses, and symptoms of dependence and addiction. It is necessary to highlight this public health problem that prescription drug misuse among young Icelandic males appear to be and it needs to be considered as a multifarious problem as the results indicate that its nature is truly complex.

Different drugs come with different motives: Examining motives for substance use among people who engage in polysubstance use undergoing methadone maintenance therapy (MMT)

BACKGROUND

Substance use motives (i.e., reasons for using a substance) are thought to be the most proximal variable leading to substance use. These motives have been described by various typologies, the most well known being the four-factor drinking motives model which separates motives into enhancement, social, coping, and conformity (Cooper, 1994). Although extensively studied in adult community samples, motives for use have less commonly been investigated among populations at a later stage of addiction, where polysubstance use is more common. Moreover, because the motives literature has largely focused on drinking motives, it is not clear whether existing findings can also be applied to other substances (Cooper et al., 2016).

METHODS

Using Zero-inflated beta Bayesian linear mixed modeling, we investigated the stability of seven distinct substance use motives (enhancement, social, expansion, coping with anxiety, coping with depression, coping with withdrawal, and conformity) across six different drug categories (tobacco, alcohol, cannabis, opioids, stimulants, and tranquilisers) to determine the extent to which drug class can influence motive endorsement. One-hundred-and-thirty-eight methadone maintenance therapy (MMT) clients (F = 34.1%; M = 65.9%; age = 40.18 years) completed a novel short-form polysubstance motives questionnaire.

RESULTS

External motives (i.e., conformity and social motives) were the most stable across drug categories, while all internal motives (i.e., enhancement, expansion, and all three coping motives) demonstrated varying levels of inter-drug variability.

CONCLUSIONS

These findings have important implications for prevention and intervention strategies among people who engage in polysubstance use, highlighting the importance of both universal and substance-specific programming.

Do nursing and pharmacy students practice what they preach on safe drug storage and disposal? A cross-sectional study

BACKGROUND

Research has confirmed a lack of knowledge regarding the risks of unused medications including diversion, misuse, or accidental overdose among health care professionals (Abdulmajeed, 2020). Nurses and pharmacists are often who patients interact with the most regarding medications; therefore, early education on proper storage and disposal is vital (Bowen, Rotz, Patterson, & Sen, 2017; Celio, Ninane, Bugnon, & Schneider, 2018).

OBJECTIVES

The study's objective is to explore safe drug storage and disposal knowledge, attitudes, and practices of professional pharmacy (Pharm.D.) and nursing students.

DESIGN

This research is an exploratory cross-sectional study from May to September 2019.

METHODS

An anonymous online survey was administered to a purposive sample of Pharm.D. and nursing students who were 18 years and older and enrolled in the site's accredited Pharm.D. and nursing programs (N = 210). Responses were analyzed using descriptive statistics.

RESULTS

Common disposal methods reported by students of their personal medications such as pills and liquids included discarding medications with the household trash (range 30% to 55%) and medication disposal products/bag (range 19% to 28%). More than half of the participants (50.4%) had unused prescription medication at home, 35% kept the medication for later use, and almost 20% of the participants reported sharing personal medications with others.

CONCLUSION

Although the majority of student participants had adequate knowledge of the appropriate methods for safe drug disposal, few reported using them for their own personal medications. The findings suggest there is a disconnect between the participants' knowledge of the appropriate methods of safe drug storage and disposal in a professional setting and their own practices. Further research is needed to explore and address the reasons for this disconnect. Additionally, findings from this research will assist in the development of and/or the improvement of interdisciplinary educational materials among pharmacy and nursing students.

Prescription Stimulant Misuse and Diversion Events Among College Students: A Qualitative Study

Prescription stimulant misuse and diversion are interrelated behaviors: diversion increases the availability of stimulants for misuse, and persons who misuse are also more likely to divert. To date, research has examined these behaviors using a primarily quantitative lens. We led a qualitative investigation to better understand misuse and diversion events. Data are from a diverse southern California campus where we interviewed students who misuse and/or divert prescription stimulants (32 total interviews: 16 interviews with students who had a history of misuse, and 16 different interviews with students who had a history of diversion). We analyzed interview data inductively. We identified the following themes about misuse and diversion events, several of which intersected during interviews: medication surplus, diversion and misuse hubs, ease of behavior performance, academic stress, and other drugs commonly involved. For diversion, altruism and monetary gain were juxtaposed themes. Across themes, friends and family were influential figures. Implications for prevention, intervention, and future research directions are discussed.

Attitudes of medicine, pharmacy, and dentistry students about psychostimulant use to enhance cognition

INTRODUCTION

The use of psychostimulant drugs to increase academic success is common among young people. There is no study examining this issue in Turkish population. In this study, the prevalence, attitudes, knowledge, and ethical evaluations of Pharmacological Cognitive Enhancement (PCE) in university students were investigated.

METHOD

A structured online survey was carried out with 1148 undergraduate and postgraduate (master, PhD and residency) students in different faculties of Medicine, Dentistry and Pharmacy in Turkey. Comparisons between groups, correlation and regression analysis about associated variables were made.

RESULTS

The general prevalence of PCE in our study was found to be 7.4%. The highest prevalence was seen in the faculty of medicine (8.4%), among the residency students (15.5%). There was no significant difference prevalence of PCE between the faculties. Education level, smoking, study performance satisfaction, and knowledge level were found to be factors associated with PCE. Around 40% of PCE users stated that they used it with the recommendation of their friends. PCE users had a lower perception of harm and risk, and rated the use of it as more acceptable and normal behaviour.

CONCLUSION

PCE is a method used by young with high knowledge, low study performance satisfaction, to increase their academic success, especially during exam periods. Peer effect is an important factor in increasing prevalence.

Associations of prescription stimulant misuse with subsequent methamphetamine use among a U.S. cohort of HIV-vulnerable sexual and gender minorities who have sex with men

INTRODUCTION

Prescription stimulants and methamphetamine have similarities in chemical structure and impact on biological functioning. However, there is limited literature on prescription stimulant misuse among sexual and gender minorities as well as how prescription misuse may impact later methamphetamine use.

METHODS

We used data collected from a HIV prevention cohort to describe (e.g., frequencies, percentages) prescription stimulant use/misuse and methamphetamine use at baseline and 12-month follow-up (n = 4857). We then used multivariable logistic regression models to determine the impact of baseline prescription stimulant misuse and methamphetamine use on 12-month prescription stimulant misuse and methamphetamine use.

RESULTS

At baseline, 10.2 % of participants misused prescription stimulants and 12 % of participants used methamphetamine in the past 3 months, while at 12-month follow-up 11.6 % of participants misused prescription stimulants and 11.2 % of participants used methamphetamine in the past 3 months. Multivariable regression analyses indicated that participants who misused prescription stimulants (in the absence of methamphetamine) at baseline had 2.51 (95 % CI: 1.44-3.59, ref. no stimulant or methamphetamine use) times the odds of using methamphetamine at 12-month follow-up.

DISCUSSION

Findings suggest that prescription stimulant use is a risk factor for continued meth use. Therefore, earlier and targeted public health interventions could reduce methamphetamine use by disrupting the progression from prescription stimulant misuse to methamphetamine use through early screening and interventions for prescription stimulant misuse.

Using a theoretical approach to predict college students' non-medical use of prescription drugs - a survival analysis

This study assesses students' non-medical use of prescription drugs (NMUPD) from college entrance to graduation, and examines factors that predict NMUPD. Participants: The study was conducted between May 2011 and September 2015 with 338 students. Methods: Longitudinal cohort study design was used to examine NMUPD across time, and NMUPD-related attitudes and subjective norms. Five yearly interviews were conducted to collect data. Cox proportional hazards regression analysis was used to examine time to NMUPD. Results: Thirty-five percent of study participants reported NMUPD; the majority of those initiated non-medical use before their third year in college. Analyses indicated that more positive attitudes towards NMUPD (HR = 1.73, p < 0.001), increased subjective norms regarding NMUPD (HR = 1.01, p < 0.01), and gender (male) (HR= 1.89, p < 0.001) were significantly associated with sooner NMUPD. Conclusions: Findings suggest that NMUPD prevention efforts that target mutable factors such as attitudes and subjective norms should be implemented early during students' college careers.

Feigning ADHD and stimulant misuse among Dutch university students

The increasing number of university students seeking diagnosis of attention-deficit/hyperactivity disorder (ADHD), and findings of an increased stimulant misuse among university students, has raised concerns regarding the credibility of the symptoms of those students. However, most of our current knowledge refers to university students in North America and less is known about this issue on European campuses. The present survey aimed to collect opinions on feigning ADHD and to estimate the prevalence of stimulant misuse among 1071 university students in the Netherlands. The majority of students expressed liberal attitudes towards feigning ADHD. Also, a substantial number of respondents considered feigning ADHD themselves or know someone who feigns ADHD. Furthermore, 68% of students assumed benefits of taking stimulants without prescription and 16% have indeed already taken stimulants without prescription. Feigning ADHD and misuse of prescription medication are prevalent issues among Dutch students. The results underline the need for a careful diagnostic evaluation of individuals for ADHD. Furthermore, efforts are required in order to prevent stimulant drug trafficking and misuse among university students.

Patterns, Consequences, and Motives in Simultaneous Use of Prescription Stimulant Medication with Alcohol and Marijuana

Nonmedical use of prescription stimulants (NPS) continues to be a concern on college campuses. Previous research demonstrates a strong link between NPS and use of other substances, particularly alcohol and marijuana among college students. Simultaneous use of NPS with other substances has become an increasing concern. Given the high rates of NPS and simultaneous NPS with other substances, research examining substance use patterns and motives among students is warranted. Method: This study evaluated group differences in alcohol and marijuana use patterns, consequences, and motives among college students: a) with no NPS history (No NPS); b) engaged in NPS with no simultaneous use (Non-Sim NPS); and c) engaged in simultaneous NPS with alcohol and/or marijuana (Sim NPS). Participants included 1,108 students from three universities who reported past-year marijuana and alcohol use. Results: Overall, 32.8% reported lifetime NPS with 12.5% indicating NPS in the previous 3 months, of which 51.1% reported simultaneous NPS with alcohol and 40.2% with marijuana. Significant group differences for all drinking and marijuana outcomes were found, with heaviest rates among the Sim NPS group, followed by the Non-Sim NPS group, and the No NPS group. The Sim NPS group reported greater motives for using marijuana to alter the effects of other substances. Conclusions: College students engaged in simultaneous NPS with alcohol and marijuana are a high-risk group that should be the focus of prevention and intervention programs in the campus setting.

Enhancement motivations for using prescription drugs among young adults in Nigeria

BACKGROUND

The desire for enhancement is a common motive for non-medical use of prescription drugs in Western countries. Little is known about the factors that motivate use in non-Western contexts.

METHODS

The study explores access to prescription drugs and the motivations for using them among educated young adults in a city located in Anambra State, South-Eastern Nigeria. Semi-structured interviews were conducted with 23 participants aged 23-29 years. Data were thematically analysed using NVivo 12 Software.

RESULTS

The data indicate that prescription drugs are widely available and easy to access without a prescription in the unregistered 'pharmacies' and medicine shops that form part of Nigeria's informal healthcare system. Social networks are also a source of drugs. Participants shared detailed perspectives on their use of prescription drugs, revealing that codeine, Rohypnol, and high doses of tramadol are used to enhance performance in several social life domains. These drugs were described as enhancing performance and productivity in the workplace, and were taken by participants working as labourers and sales representatives. Male participants also shared accounts of using high doses of tramadol to improve stamina and skill in sports. Some participants took Rohypnol to enhance their creative and academic performance. Participants stated that drug use enabled them to meet the pressures associated with work, academia, and parental expectations.

CONCLUSION

The findings suggest that prescription drugs are being strategically and instrumentally deployed by users to enhance different domains of social life. This is driven by users' experiences of the drugs' bodily effects, and it is supported by a context in which self-medication and informal healthcare are common. Participants' reasons for seeking drug-induced enhancement reflect sociocultural factors within Nigeria and some West African countries, such as employment scarcity and the championing of sporting prowess. The findings can be used to inform the design of tailored approaches to reduce the harms presented by the non-medical use of pharmaceuticals among young adults.

"Study Natural" without Drugs: An Exploratory Study of Theory-Guided and Tailored Health Campaign Interventions to Prevent Nonmedical Use of Prescription Stimulants in College Students

Nonmedical use of prescription stimulants (NMUPS) among college students continues to rise. While some anti-NMUPS campaigns are available, little is known about the campaign development process and how well college students evaluate these messages. To bridge this gap, we developed theory-guided anti-NMUPS campaign interventions that are tailored to college students’ characteristics and evaluated students’ response towards them. A total of 445 college students (74.4% female; Mean_age of 20; 18 to 35 years old) reviewed the campaign interventions and offered their evaluation via an online survey. Findings indicate that students responded to the campaigns positively. Results also indicate that female students are more likely to perceive the campaigns as effective than their male counterparts. Overall, the findings of this study suggest that theory-guided and tailored anti-NMUPS campaigns have great potential in changing students’ attitudes and behavior towards NMUPS. While this study fills critical gaps in the literature, considering the progress needed to strengthen the research field, more research is needed to further identify effective strategies that could prevent college students’ participation in NMUPS activities.

Prevalence of ADHD symptom malingering, nonmedical use, and drug diversion among college-enrolled adults with a prescription for stimulant medications

Malingering of ADHD symptoms is a potential means of nonmedical use of prescription stimulants (NMUPS). The Subtle ADHD Malingering Screener (SAMS) provides a potential avenue for identification of symptom malingering. However, no real world evidence of this scale has been published to date. The goal of this study was to examine patterns of use of stimulant prescriptions and to evaluate the ability of the SAMS to identify NMUPS. This study employed a cross-sectional observational design to administer an online, self-administered survey instrument in a convenience sample of college-enrolled young adults with a prescription for stimulant medications at a campus pharmacy. Respondents were asked about their prescription characteristics, nonmedical use and drug diversion behavior, along with ratings on the SAMS. Over 33% of respondents self-reported past-year NMUPS and 18% reported past-year drug diversion. Over 35% of respondents rated NMUPS as being slight or no risk and 55% were classified by the SAMS as likely to be malingering or exaggerating their symptoms. Individuals reporting past-year NMUPS or diversion consistently scored higher on the SAMS. The SAMS showed potential for future application in the pharmacy setting. Further research is needed to evaluate the relationship of SAMS to NMUPS or drug diversion. The results of this study also highlight several growing issues with the diagnosis and treatment of ADHD among young adults enrolled in college. Addressing perception of risk, social norms, and providing healthcare professionals with tools to prevent misdiagnosis is critical to the management of this issue.

Prescription Drug Misuse: Taking a Lifespan Perspective

Prescription drug misuse (PDM), or medication use without a prescription or in ways not intended by the prescriber, is a notable public health concern, especially in the United States. Accumulating research has characterized PDM prevalence and processes, but age-based or lifespan changes in PDM are understudied. Given age-based differences in the medical or developmental concerns that often underlie PDM, it is likely that PDM varies by age. This review summarizes the literature on PDM across the lifespan, examining lifespan changes in prevalence, sources, motives and correlates for opioid, stimulant, and tranquilizer/sedative (or benzodiazepine) PDM. In all, prevalence rates, sources and motives vary considerably by age group, with fewer age-based differences in correlates or risk factors. PDM prevalence rates tend to decline with aging, with greater use of physician sources and greater endorsement of self-treatment motives in older groups. Recreational motives (such as to get high) tend to peak in young adulthood, with greater use of peer sources or purchases to obtain medication for PDM in younger groups. PDM co-occurs with other substance use and psychopathology, including suicidality, across age groups. The evidence for lifespan variation in PDM is strongest for opioid PDM, with a need for more research on tranquilizer/sedative and stimulant PDM. The current literature is limited by the few studies of lifespan changes in PDM within a single sample, a lack of longitudinal research, little research addressing PDM in the context of polysubstance use, and little research on minority groups, such as sexual and gender minorities.

Undergraduate Prescription Stimulant Misuse and Academic Strain: The Role of College Major and Graduate School Plans

The literature has shown that undergraduates engage in the misuse of prescription stimulants in large part to meet academic demands and as an attempt to alleviate academic stress. The current study examined the relationship between misusing prescription stimulants for academic purposes and academic strains (academic stress, grade strain, and academic impediments) to determine whether prescription stimulant misuse (PSM) and the types of academic strains experienced by undergraduates differed based on their college major and postgraduate education plans. We utilized survey data that had been collected from 924 students at a large southeastern university in 2014, which specifically assessed for PSM. Results indicated significant differences in the misuse of prescription stimulants based on the types of academic strains experienced, college major, and postgraduate education plans. Implications and suggestions for future research are discussed.

Cognitive factors and addiction

The present paper provides a brief review of cognitive factors related to addiction. Five representative cognitive constructs were selected from the current literature. These include the distinction between implicit and explicit cognitions; metacognitions; expectancies; motives; and social norms. For each of these a general overview is provided along with specific findings from selected recent studies. The intention is to provide the reader with a succinct but reasonable view of how each construct is currently studied in relation to the use of alcohol and other substances and to become aware of some of the strengths and limitations corresponding to the study of these constructs.

Nonmedical use of prescription drugs during sexual activity as a predictor of condom use among a sample of college students

Objective: To examine the impact of nonmedical use of prescription drugs (NMUPD) during sexual activity on the frequency of condom use among a sample of college students. Participants: Students attending a large Midwestern University (N = 4284) during April 2015. Methods: Retrospective cross-sectional analysis of survey data using logistic regression. Results: Respondents and/or their sexual partners who engaged in NMUPD during sexual activity were significantly less likely to use condoms during 75% or more of past 12-month sexual encounters compared to respondents who had not engaged in lifetime and past 12-month NMUPD. Although not statistically significant, trends suggest that respondents who engaged in NMUPD during sexual activity may be less likely to use condoms than those who engaged in lifetime or past 12-month NMUPD but not during sexual activity. Conclusions: Findings suggest a need for specific strategies for reducing risk behaviors related to prescription drugs and sexual activity.

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.