Illicit Use of Prescription Stimulants in a College Student Sample: a Theory-guided Analysis

Background: The illicit use of prescription stimulants (IUPS) has emerged as a high-risk behavior of the 21st century college student. As the study of IUPS is relatively new, we aimed to understand (1) characteristics of IUPS (i.e., initiation, administration routes, drug sources, motives, experiences), and (2) theory-guided intrapersonal, interpersonal, and environmental correlates associated with use.

Methods: Using one-stage cluster sampling, 520 students (96.3% response rate) at one Pacific Northwest University completed a paper-based, in-classroom survey on IUPS behaviors and expected correlates. Aim 1 was addressed using descriptive statistics and aim 2 was addressed via three nested logistic regression analyses guided by the Theory of Triadic Influence.

Results: The prevalence of ever engaging in IUPS during college was 25.6%. The majority (>50.0%) of users reported initiation during college, oral use, friends as the drug source, academic motives, and experiencing desired outcomes. Intrapersonal correlates associated with use included identifying as White, lower grade point average, diagnoses of attention deficit disorder, and lower avoidance self-efficacy. Interpersonal correlates of use included off-campus residence, varsity sports participation, IUPS perceptions by socializing agents, and greater behavioral norms. Exposure to prescription drug print media, greater prescription stimulant knowledge, and positive attitudes towards prescription stimulants were environmental correlates associated with use. In all models, IUPS intentions were strongly associated with use.

Conclusions: IUPS was prevalent on the campus under investigation and factors from the intrapersonal, interpersonal and environmental domains were associated with the behavior. Implications for prevention and future research are discussed.