Psychosocial functioning associated with prescription stimulant and opioid misuse versus illicit drug use among college students

Abstract

Objective: College students’ prescription stimulant and opioid misuse (PSM and POM) share psychosocial risks with other substance use. We sought to extend a prior study of these issues. Methods: National College Health Assessment (2015–2016) participants ages 18–24 years (n = 79,336) reporting 12-month PSM (defined as use of a drug not prescribed to them), 30-day other illicit drug use (non-cannabis), both, or neither, were compared on other substance use, psychopathology, academic adjustment, attention deficit hyperactivity disorder, and chronic pain. Models were repeated for POM. Results: Relative to those who only misused the prescription drug, those who used other illicit drugs had lower odds of chronic pain and academic problems, but higher odds on nearly every other outcome especially if they also misused the prescription drug. Conclusions: Findings suggest PSM and POM are on a continuum of risk shared with illicit drug use, but also are linked to outcomes specific to these drugs’ perceived medical purposes.

Keywords:

• ADHD
• alcohol
• cannabis
• college students
• nicotine
• opioids
• pain
• prescription drug misuse
• stimulants
• young adults

Conflict of interest disclosure

The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of United States of America The authors received approval from the American College Health Association (ACHA). However, the opinions, findings and conclusions presented/reported in this paper are those of the authors, and are in no way meant to represent the corporate opinions, views or policies of the American College Health Association (ACHA). ACHA does not warrant nor assume any liability or responsibility for the accuracy, completeness or usefulness of any information presented in this article.

Funding

No funding was used to support this research and/or the preparation of the manuscript.

Notes

1 We did not include use of cannabis, anabolic steroids, or misuse of antidepressants, erectile dysfunction drugs, or prescription sedatives as illicit drug use.

2 Weights also accounted for other ethnic group representation (e.g., Hispanic, white nonHispanic, multiracial), though these groups were not significantly underrepresented.

3 We did not pose a priori hypotheses about group differences on covariates. However, a reviewer highlighted this pattern and its potential implications.