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For college students, improving grades is a main motivator for the nonmedical use of prescription stimulants

Little research has examined the benefit-to-risk tradeoffs undergraduate students perceive when engaging in the nonmedical use of prescription stimulants (NPS). A new study examined the variation in college students’ perceived risks and benefits for NPS. Participants (N = 259) were college students from six public universities, between the ages of 18 to 25 who had engaged in NPS in the past year. Participants completed an online survey, which included questions regarding demographics as well as history of ADHD, prescribed stimulant use, NPS, and use of other substances. The survey also included a best-worst scaling (BWS) instrument to assess the participants’ relative importance of twelve perceived benefits and risks of NPS. The authors used descriptive statistics to summarize participants’ demographics, academics, history of ADHD and prescribed stimulant use, NPS, and use of other substances. Furthermore, mean importance scores for each attribute from the BWS instrument for the overall sample and latent preference subgroups were estimated using Latent Class Analysis (LCA). Results showed that more than half of participants reported engaging in NPS during the past month and one-third of participants reported more than 10 instances of NPS in the past year. The average age of first NPS use was 17.9. Furthermore, 22% of participants were ever prescribed a stimulant. Twenty-two percent of participants non-medically used their own prescription, 74% reported that a friend had given them prescription stimulants to use non-medically, and 49% reported purchasing them from a friend or family member. As for motives for engaging in NPS, most important were getting better grades (SE = 0.10) and meeting deadlines (SE = 0.08), followed by the risk of being expelled from college (SE = 0.07) and the risk of limiting future career opportunities (SE = 0.07). The four latent classes found were labeled assuredly performance-driven (25%), cautiously grade/career-oriented (45%), risk-averse (25%), and recreational (5%). Participants in the assuredly performance-driven group were most concerned with getting better grades (SE = 0.29), meeting deadlines (SE = 0.24), and fulfilling nonacademic responsibilities (SE = 0.21). Participants in the risk-averse group were most concerned with the risk of college expulsion (SE = 0.18), followed by getting better grades (SE = 0.17). The cautiously grade/career-oriented group was most concerned with getting better grades (SE = 0.23) followed by meeting deadlines (SE = 0.13). The recreational group was most influenced by having more fun partying (SE = 0.33), but also the risk of being arrested (SE = 0.28) or expelled from college (SE = 0.29). Moreover, participants in the risk-averse group had a slightly earlier age of first NPS use (p = 0.02) than the other groups. More participants in the assuredly performance-driven group engaged in NPS in the past month (p = 0.04) and more frequently in the past month (p = 0.04) and the past year (p = 0.01) than other groups. The assuredly performance-driven group was most likely to have purchased a prescription stimulant from friends or family (p = 0.04) or a stranger (p = 0.01). The recreational group was most likely to engage in NPS for the purpose of socializing or partying in the past (p < 0.0001) and least likely to report academic motives for NPS (p < 0.0001).

Take away: This study identified four different subgroups of college students based on their benefit-to-risk tradeoff profiles for engaging in NPS. The strongest motivators for engaging in NPS were to get better grades and to meet deadlines.

Ross, M. M., Arria, A. M., Brown, J. P., Mullins, C. D., Schiffman, J., & Simoni-Wastila, L. (2017). College students’ perceived benefit-to-risk tradeoffs for nonmedical use of prescription stimulants: Implications for intervention designs. Addictive Behaviors.

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