A new study examined the prevalence, characteristics, and utility of ecological theory in explaining prescription stimulant misuse. Participants (N = 499) included undergraduate students from a southern California public university who were at least 18 years old. Participants completed a survey, which was a paper-based version of the Behaviors, Expectancies, Attitudes and College Health Questionnaire (BEACH-Q). The survey asked illicit use of prescription stimulants (IUPS) questions related to behavioral initiation (e.g., college), routes of ingestion (e.g., oral), monetary costs per pill, motives for use (e.g., academic or recreational), and whether the experience they gained was in line with the desired outcome. The BEACH-Q instrument was also used to assess different constructs such as intrapersonal, social situation and environment as well as different levels of causation such as ultimate, distal, proximal, and immediate precursor. The authors measured the prevalence of IUPS by calculating how many students reported use without a prescription, use for non-medical reasons, and use in excess of what has been prescribed by a health care professional. For the participants who reported IUPS, descriptive statistics were calculated for each characteristic of IUPS (i.e., initiation, routes, cost, motives, and experience). Lastly, structural equation model (SEM) was used for estimating the correlations of the remaining variables. Results showed that 20.77% of participants, who responded to the IUPS behavior items (n = 103), reported engaging in one or more of the behaviors classified as IUPS during college. For instance, 92 of the 103 illicit users reported using prescription stimulants for non-medical purposes and 30 of them 103 illicit users reported using in excess of what they had been prescribed. Furthermore, while the majority of illicit users orally ingested the drug, other common routes of ingestion included smoking (44.19%) and snorting (29.27%). Moreover, almost 76% of participants reported receiving the drug at no cost and 25% reported their willingness to pay more than US$10 per pill. In addition, the main source of prescription stimulants was friends (90.63%). As for motives, although the top two reported motives were to improve concentration (75.28%) and focus (75.00%), 65.48% of participants reported engaging in the behavior to experiment. Among the many SEM results, there was a significant and direct relationship between ADHD-like symptomology and academic concern, friend endorsement of IUPS, and positive IUPS expectancies. There was also a significant and direct association with perceived drug culture and friend endorsement of IUPS, and IUPS expectancies.
Take away: This study provides additional evidence that the illicit use of prescription stimulants (IUPS) among college students remains prevalent. Friend endorsement of IUPS had significant associations with avoidance self-efficacy, friends IUPS norms, and IUPS attitudes.