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Undergraduate students ambivalent about nonmedical use of prescription stimulants

A new, qualitative study provides insight on college students’ perceptions of prescription stimulant misuse. Participants (n = 35) were undergraduate students at one selective U.S. liberal arts college who completed semi-structured interviews with research personnel. Based on their prior prescription stimulant use, participants were classified as prescribed users (who had ADHD diagnoses and used stimulants as prescribed), combined users (who had ADHD diagnoses and used stimulants both as prescribed and illicitly), illicit users (who lacked a diagnosis and a prescription), and nonusers (who lacked diagnoses and had never used prescription stimulants).  One major theme of the interviews was students’ neoliberal logic with respect to the purpose of attending college. Students viewed college as a multiyear competition and aimed to optimize their investments of time and labor for future gain. Students also shared that using prescription stimulants both with and without a prescription was common on campus and there was no stereotypical stimulant user. One combined user reported it was easy for him to stockpile stimulant pills by taking less than his prescribed dosage or skipping doses altogether. Participants were asked whether they thought non-medical use of prescription stimulants (NMPS) was a form of academic cheating. Students were divided on this issue: 48% thought NMPS was cheating, while 43% did not. Students in the former group described the medications as “cognitive enhancers” that gave users abilities they did not deserve; several compared NMPS to steroid use in athletics. Students reported this was an unfair advantage in a college environment where they were competing to outperform each other. Only about one-third of this group acknowledged students who engage in NMPS might have a therapeutic need for medication, such as undiagnosed ADHD. Students who had never misused prescription stimulants were very likely to view NMPS as a form of cheating. All of the participants who did not believe NMPS was a form of cheating reported using stimulants at least once. Some claimed prescription stimulants were not “magic pill[s]” and; therefore, did not confer unfair academic advantage to users. They compared NMPS to caffeine use and reported academic “pressures” could push students to engage in NMPS. In addition, 40% of participants reported NMPS was morally problematic; most of them also agreed that NMPS was a form of cheating. A few students described NMPS as evidencing positive cultural values, such as highly valuing academic success.

Take away: This study found disagreement among students as to whether nonmedical use of prescription stimulants was immoral or a form of cheating. Most participants viewed the purpose of attending college through neoliberal logic, which may have influenced their opinions about stimulant use.

Citation: Cooper A & McGee L. (2017). “At such a good school, everybody needs it”: Contested meanings of prescription stimulant use in College academics, Ethos, 45(3), 289–313 doi:10.1111/etho.12167

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