Prescription drug abuse among students in U.S. colleges and universities has been rising for several years. The 2004 Monitoring the Future (MTF) Survey of College Students and Adults—the most recent data available—estimated that 7.4 percent of college students used the painkiller hydrocodone (Vicodin) without a prescription in that year, up from 6.9 percent in 2002, with similar increases for other opioid medications, stimulants, and sedatives. Three new NIDA-funded studies reveal which students and campuses have the highest rates of abuse and connect such abuse to other unhealthy behaviors. According to the research, rates of collegiate prescription stimulant abuse are highest among men, Whites, fraternity/sorority members, and at schools in the Northeast.
Binge Drinking, Marijuana Abuse Are Elevated Among Students Who Obtain Painkillers From Peers. At one university, students who obtained prescription painkillers from peers reported higher levels of binge drinking and marijuana abuse than nonabusers or those who received painkillers from family.Stimulant Abuse Nationwide
Dr. Sean Esteban McCabe and colleagues at the University of Michigan and Harvard University analyzed the answers from the Harvard School of Public Health College Alcohol Study, which in 2001 surveyed 10,904 randomly selected students enrolled at 119 colleges across the United States. Overall, 4 percent of the respondents reported having taken a stimulant medication without a prescription at least once during the previous year. Men were twice as likely as women (5.8 percent versus 2.9 percent) to have abused methylphenidate (Ritalin), dextroamphetamine (Dexedrine), and amphetamine/dextroamphetamine (Adderall). Stimulant medication abuse was also more prevalent among students who were:
- White (4.9 percent versus 1.6 percent for African-Americans and 1.3 percent for Asians);
- Members of fraternities or sororities (8.6 percent versus 3.5 percent for nonmembers); and
- Earning lower grades (5.2 percent for grade point average of B or lower versus 3.3 percent for B+ or higher).
Students who abused prescription stimulants reported higher levels of cigarette smoking; heavy drinking; risky driving; and abuse of marijuana, MDMA (Ecstasy), and cocaine. Compared with other survey respondents, for example, they were 20 times as likely to report past-year cocaine abuse and 5 times as likely to report driving after heavy drinking.
The campus prevalence of past-year stimulant abuse ranged from 0 percent at 20 colleges—including the three historically African-American institutions included in the survey—to 25 percent. The prevalence was 10 percent or higher at 12 colleges. Students attending colleges in the Northeast, schools with more competitive admission standards, and noncommuter schools reported higher rates of abuse.
One University's Painkiller Picture
At a large Midwestern university, about 9 percent of 9,161 undergraduates surveyed had taken a prescription pain medication without a doctor's order at least once during the past year; 16 percent reported such abuse in their lifetime. Of the latter, 54 percent said they had obtained the drugs from peers, while 17 percent said their source was a family member. Dr. McCabe and colleagues at the University of Michigan Substance Abuse Research Center found that students who obtained medications from peers were more likely to smoke and drink heavily and to have abused other substances—including marijuana, cocaine, and other illegal drugs—than those who obtained them from family members.
Stimulant Abuse Varies by Campus Characteristics
| Selected Characteristics | Past-year Stimulant Abuse Rates, % |
|---|---|
|
Admission criteria More competitive Competitive Less competitive |
5.9 4.5 1.3 |
|
Geographical region Northeast South West North Central |
6.3 4.6 3.2 2.8 |
|
Commuter Status Noncommuter school Commuter school |
4.6 1.2 |
Students enrolled in the most selective colleges reported relatively high levels of past-year stimulant abuse, as did those attending schools in the Northeast. Residential schools reported higher rates than commuter colleges.
The researchers found that exposure to prescription pain medication early in life increased the likelihood of abuse in college. Women who had received prescriptions for pain relievers in elementary school were more than four times as likely as those with no prescribed use to report abuse in the past year. Men with early prescribed use were twice as likely as those without to report such abuse. In addition:
- Women students were more likely to be prescribed pain medication, while men were more likely to be approached to sell or give away prescribed medication.
- More men obtained the drugs from peers while more women obtained them from family members.
- Past-year prescription painkiller abuse was higher among fraternity members than nonmembers (17 percent versus 9 percent) and among sorority members compared with nonmembers (9.6 percent versus 8.6 percent).
"Students abuse prescription drugs to get high, to self-medicate for pain episodes, to help concentrate during exam time, and to try to relieve stress. Regardless of the motivation, people need to know the risks of abuse and the dangers of mixing drugs," says Dr. Lynda Erinoff, formerly of NIDA's Division of Epidemiology, Services and Prevention Research. Most people assume that if a medication is available on the market, it must be safe—even if it has not been prescribed for them, says Dr. Erinoff, "but a drug or dose that a doctor orders for one person is not necessarily appropriate for another, and prescription abusers are potentially taking a serious risk." NIDA continues to work with doctors and pharmacists and to link prevention specialists with researchers focusing on the problem. "Educating the public remains a critical challenge," says Dr. Erinoff.
Membership Matters
Based on responses from more than 5,000 young people who participated in the MTF when they were high school seniors in 1988 to 1997, and also when they were in college, Dr. McCabe and his Michigan colleagues found that active members of college fraternities or sororities engage in more heavy episodic, or "binge," drinking, cigarette smoking, and marijuana abuse than nonmembers.
The students who joined fraternities or sororities in college were the same ones who reported the highest levels of substance abuse in high school. Moreover, cigarette smoking, binge drinking, and drug abuse increased for all survey participants as they progressed through college. Fraternity and sorority members showed greater elevations in binge drinking and marijuana abuse over time compared with nonmembers. The picture that emerges is of students who are already heavy drinkers when they come to college selecting fraternities and sororities with a reputation for "partying" and then, as members, further increasing their drinking in an environment that supports the behavior.
"It's important for each student to explore, perhaps with counseling, a possible mismatch between his or her college environment and individual needs. Some students benefit from settings that emphasize socialization outside of the party scene; these might include group living arrangements based on shared academic or extracurricular interests," Dr. McCabe says.
Sources
- McCabe, S.E., et al. Non-medical use of prescription stimulants among US college students: Prevalence and correlates from a national survey. Addiction 100(1):96-106, 2005. [Abstract]
- McCabe, S.E., et al. Selection and socialization effects of fraternities and sororities on US college student substance use: A multi-cohort national longitudinal study. Addiction 100(4):512-524, 2005. [Abstract]
- McCabe, S.E.; Teter, C.J.; and Boyd, C.J. Illicit use of prescription pain medication among college students. Drug and Alcohol Dependence 77(1):37-47, 2005. [Abstract]