Objectives: To determine misuse of prescription stimulant medications among future health care providers at an Academic Health Sciences Center. Method: Data were collected via a 62-item anonymous online survey distributed to medical, pharmacy, and rehabilitative health (RT) students at a large Academic Health Sciences Center. The survey instrument collected demographic information related to the respondent’s healthcare discipline, year(s) in professional program, and if the participant had been diagnosed with a disorder requiring a prescription stimulant medication. Nonmedical prescription stimulant use, motivation for nonmedical use, deceptive practices, frequency of use, consequences of nonmedical use, and peer group nonmedical use were also collected. Results: In aggregate, 11.3% of responders reported misuse of prescription stimulants. The rate of misuse was similar for pharmacy (9.7%) and medicine (10.9%) students with a trend towards an increased rate of misuse in RT students (26.3%) (p 5 0.08) The response rates were 70.5% (225/319) for pharmacy, 47.6% (128/269) for medical, and 54.3% (19/33) for respiratory therapy students. The most common reasons for misusing prescription stimulants were to improve academic performance (25/44; 56.7%) and increase alertness/energy (29/44; 65.9%). The most commonly reported adverse reactions were lack of appetite (30/44; 68.2%) and difficulty sleeping (24/44; 54.5%). Implications: Given the stigma associated with prescription stimulant misuse, it is difficult to assess the breadth and depth of this problem. Physical and/or psychological dependence, altered clinical judgment, and violation of misconduct policies and laws are possible consequences of prescription stimulant misuse. This is the first survey to assess misuse by multiple disciplines on a single Academic Health Sciences campus.

This study investigates the misuse of prescription stimulants among undergraduates for a variety of different purposes, including: academic, other instrumental, and recreational. This research is important as existing literature as well as national level surveillance data indicates a substantial increase in this type of prescription drug misuse, especially among young adults aged 18-25. Drawing from several theoretical frameworks, this research focuses on how academic strain, social norms, and gender influence prescription stimulant misuse among undergraduates. Roughly 900 quantitative surveys were collected that specifically address undergraduate prescription stimulant misuse. The results indicate that college students are at an increased likelihood of misusing prescription stimulants if they experienced academic impediments and/or grade strain during the past academic year. Additionally, the findings show that undergraduates who have accepting attitudes of prescription stimulant misuse and who have peers that misuse prescription stimulants are also at an increased likelihood of misusing prescription stimulants. Furthermore, males were at an increased likelihood of prescription stimulant misuse for academic purposes if they had experienced grade strain during the past academic year in comparison to their female counterparts. Female undergraduates, on the other hand, were four times more likely than male undergraduates to obtain prescription stimulants from their close friends for free.

The non-medical use of prescription drugs is an important public health concern. Non-medical use of prescription stimulants (NMUPS), specifically medications used to treat Attention Deficit Hyperactivity Disorder (ADHD), is particularly concerning. One timely concern regarding NMUPS, especially among young adults, is their role in appetite suppression/weight loss. Indeed, some individuals are motivated to misuse such drugs for the purpose of losing weight. Engaging in NMUPS for weight loss has been examined only minimally in the research literature. However, extant data demonstrate that this behavior is associated with other unhealthy behaviors and poor psychosocial health. Limitations of prior research include the exclusive use of college student samples and little attention to relevant health behavior theory. The current study investigated NMUPS for weight loss in a national, young adult sample (n = 1526), ages 18-25 years, utilizing Amazon’s Mechanical Turk. Motivations and attitudes about NMUPS were evaluated, within the framework of the Theory of Planned Behavior (TPB). A structural equation model (SEM) was analyzed, which included attitudes; social norms; and perceived behavioral control (PBC) to lose weight without stimulants, as predictors of engaging in past year NMUPS for weight loss. Approximately 12.0% of participants reported lifetime NMUPS for weight loss, and of these, 48.4% reported past year use. Findings demonstrate that use is related to disordered eating and unhealthy weight loss behaviors, including vomiting; high rates of other substance use; and psychological concerns, including body dissatisfaction and depressive symptomatology. These results suggest that NMUPS for weight loss is associated with a variety of negative consequences and users are not well-informed regarding medication knowledge. The SEM provided adequate overall fit to the data; two of the four social norms and both PBC factors were significantly associated with NMUPS for weight loss. This study extends the literature on the utility of the TPB in examining NMUPS, and provides the first research on utilizing the TPB to examine NMUPS for weight loss. Methods aimed at increasing PBC regarding stimulant use and weight loss, and emphasizing healthful and sustaining weight loss strategies, improving mental health, and educating about polysubstance use are potential intervention targets.