Predictors of Prescription Stimulant Misuse in U.S. College Graduates

Abstract

Background: Research has shown that prescription stimulant misuse (PSM) is prevalent among college students and that full-time college attendance is associated with PSM following graduation. Few studies, however, have examined predictors of PSM in college graduates. Objectives: We examined constructs from the Theory of Triadic Influence (TTI) to determine predictors of PSM in this population. Methods: We utilized Amazon’s Mechanical Turk and snowball sampling in 2018–2019 to anonymously survey 219 adults in the United States (56% male, M_age = 32.5) with a college degree and history of college PSM. We assessed sensation seeking, ADHD symptoms, negative affect, social norms, workload, positive beliefs and perceived safety, other substance use, PSM motivations, and source(s) of prescription stimulants. Measures were administered online. Results: Over half (55%) of participants reported PSM after college; 36% used in the previous year. Ordinal logistic regressions for each domain of the TTI (i.e. intrapersonal, social/normative, cultural/attitudinal) showed that college graduates engaging in PSM in the previous year were younger and reported higher sensation seeking, more friends/coworkers who engaged in PSM, a heavier workload, and more positive beliefs about PSM. Chi-square analyses showed that college graduates engaging in PSM in the previous year also were more likely to use other substances (e.g. prescription opioids, tobacco/nicotine, cocaine) and to have misused stimulants in college to socialize or to get high. Conclusions: Preventive interventions could target college students and recent graduates who engage in PSM and who demonstrate the aforementioned risk factors, with the goal of curbing PSM and possibly other substance use.

Keywords:

• Prescription
• stimulants
• opioids
• sensation seeking
• anxiety
• stress
• perceived safety
• social norms
• college graduates

Notes

1 To determine whether including participants who abstained after college but were still classified as recent or semi-recent users influenced our key findings, we re-ran the analyses excluding participants who abstained from PSM after college. The interpretation of the findings was similar with exceptions in two areas: (1) There were additional group differences for college motives. Specifically, recent users were more likely to report using in college to feel better about themselves; people with no recent use were less likely to report using to feel more energetic; and semi-recent users were more likely to report using in college to lose weight. (2) There was a greater than expected percentage of recent users of PSM who endorsed marijuana use.