Around 17% of college students have misused prescription stimulants (Adderall, Ritalin, Concerta). Prescription stimulant misuse (PSM) is defined as using a medication in a way that the prescriber did not intend. PSM is often motivated by a desire to heighten concentration, but its misuse has also been associated with a range of adverse effects especially when combined with other substances. Many believe that prescription stimulants enhance alertness thereby leading to grade improvements. However, PSM has actually been correlated with poorer academic outcomes. This study examines prescription stimulant acquisition and associated substance and psychiatric issues among college students using a person-centered approach.  

The study’s sample consisted of 538 undergraduate students from seven universities in six US states who endorsed prescription stimulant use in the past year. Participants completed an online survey that assessed prescription stimulant use and the source of the prescription stimulant. Participants were also asked about alcohol and cannabis use and related problems. Lastly, mental health symptoms were measured using criteria from the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). Data was analyzed using a latent class analysis (LCA) which utilized binomial regression models and logistic regression analyzes.  

Results of the data analysis showed that students obtained prescription stimulants from a peer/dealer (39%), friend (27.5%), own prescription (16.5%), lower multiple sources (infrequent endorsement of multiple sources; 13.2%), and any method (3.7%). Students with their own prescription reported lower past 30-day cannabis and simultaneous alcohol and cannabis use. The own prescription group also had a lower prevalence of alcohol and cannabis-related consequences when compared to the friend group. On the other hand, the peer/dealer group reported a higher rate of alcohol related consequences. Lastly, respondents who obtained prescription stimulants from a friend had the lowest prevalence of mental health outcomes. The lower multiple sources group had higher odds of screening positive for depression, anxiety, anger, and suicidality. Similar results were seen for the own prescription class with more positive screenings for anger, anxiety, and suicidality. 

Takeaway: Substance related problems and psychiatric symptoms may be influenced by how prescription stimulants are obtained among college students who misuse prescription stimulants. 

Holt, L.J., Looby, A., Schepis, T.S.; Stimulant Norms and Prevalence (SNAP) Study Team. Sources for prescription stimulant misuse: A person-centered approach to understanding links to substance use and psychiatric impairment [published online ahead of print, 2022 Jul 11]. Experimental and Clinical Psychopharmacology. 2022;10.1037/pha0000586. doi:10.1037/pha0000586