Prescription stimulant misuse (PSM) is the use of medications for attention-deficit hyperactivity disorder (ADHD) without a prescription or in methods not prescribed. Prescription stimulants increase focus and concentration and are being misused by young adults to improve academic performance. In addition, a third to over half of college graduates who misused stimulants in college continued after college. PSM can result in a variety of negative consequences including insomnia, palpitations, depression, and substance use disorders later in life. Therefore, understanding intrapersonal, interpersonal, and sociocultural factors that influence PSM is important. This study examines PSM prevalence, motives, and predictors of PSM persistence among college graduates two years after graduation.
The study’s sample consisted of 103 college seniors who reported past-year PSM, current stimulant prescription, or past-year cannabis, cocaine, or hallucinogen use or misuse of an anti-anxiety or painkiller medication and any intention to engage in PSM. Participants completed a baseline survey and then a follow-up survey one and two years after graduation. The baseline survey assessed impulsivity and exposure to prescription drug advertisements. The baseline and follow up surveys measured negative affect in the past week, social norms for PSM (descriptive and injunctive norms), positive and negative consequences anticipated from PSM, workload, and past-year drug and alcohol use. Data was analyzed using generalized estimating equations with binomial distribution and logit link.
Results of the data analysis showed a decrease in PSM use over time with 51% misuse during senior year, 31% misuse at year 1 and 16% misuse at year 2. Motivations for PSM use were consistent across time and included desire to improve to focus, to stay awake, and to improve concentration. Additionally, lack of premeditation and time at baseline was associated with being less likely to reduce PSM following college graduation. There were no significant effects of anxiety, depression, stress, injunctive norms, or workload on PSM across time. However, there was a significant positive within-person and between-person effect of descriptive norms, meaning if participants’ friends endorsed PSM participants were more likely to report PSM. Lastly, use of other substances was associated with PSM use.
Takeaway: Impulsivity, perceived peer norms, and other substance use may serve as predictors of prescription stimulant misuse persistence after college graduation.