The normalization of non-medical prescription stimulant use (NPSU) among college students has emerged as a significant phenomenon requiring deeper ethnographic understanding. In 2018, the Monitoring the Futures survey found Adderall misuse to be higher among college students (11.1%) than non-college peers (8.1%), with stimulant medications reported as the second most commonly used illicit drug among this population. This trend reflects how students increasingly turn to stimulants to cope with the dual pressures of academic success and economic survival in higher education. Rising tuition and living costs have led more students to work while attending classes, creating a “time famine” (Vuckovic, 1999)—a chronic shortage of time that prompts pharmaceutical self-medication as a coping strategy. Within this context, students increasingly conceptualize NPSU not as recreational drug use, but as a productivity tool necessary for meeting academic demands. While existing studies have documented the prevalence of stimulant use on campuses, there remains a critical need for ethnographic insight into students’ lived experiences and cultural understandings of NPSU to inform effective educational interventions that address the structural pressures driving this behavior.
The study employed a Participatory Action Research (PAR) approach with twenty upper-level undergraduate anthropology students serving as trained researchers who, as members of the study population, could access hard-to-reach participants through established social networks. Data collection utilized a mixed-methods design including participant observation at campus AOD workshops, an online Qualtrics survey distributed in two waves (spring 2019: n=1,145; fall 2019: n=2,181) to assess substance use prevalence, and qualitative data gathered through respondent-driven sampling (RDS) to conduct 33 semi-structured ethnographic interviews and two focus group discussions with 8 participants who had pre-existing relationships and equal status.
The study yielded several key findings that informed practical changes to campus substance use programming. Initial insight revealed that students did not recognize the original office name “ACES,” leading to rebranding as “Alcohol and Other Drug (AOD) Services” for better campus recognition. Student feedback identified barriers to workshop attendance, including intimidating presence of uniformed police officers and judgmental workshop titles like “Marijuana: Truth, Lies, and Consequences,” prompting changes to neutral language and civilian-dressed officer attendance. Quantitative data showed alcohol, marijuana, and tobacco as the most commonly used substances, with study drug use reported at 14.1% (higher than the national average of 11.1%) when properly categorized in the survey design. Qualitative findings revealed that students did not perceive non-medical prescription stimulant use (NPSU) as “drug” use but rather as productive tools for academic success, with Adderall being the most commonly mentioned stimulant sold openly on campus. This perception was driven by productivity purposes, where students used stimulants not to get “high” but to extend focus and working hours to meet academic and work obligations in the context of “time famine.” Additionally, students’ perceived safety of NPSU—where they viewed these substances as helpful rather than harmful—led to normalization and social expectations that “everyone should be using all available tools” for college success.
Takeaway: Student perceptions of stimulants as productivity tools rather than drugs, led to widespread normalization of nonmedical prescription stimulant use, demonstrating that effective campus interventions must address underlying structural demands and reframe educational messaging rather than rely on traditional substance abuse prevention approaches.