Misuse of Prescription Stimulant Medication Among College Students: Summary of the Research Literature and Clinical Recommendations

Summary of the Literature

The following summary is based on a comprehensive search of the existing research literature on misuse of stimulant medication among college students, which ultimately identified 30 relevant studies using 21 unique samples. A study was included if: (1) the main focus of the study was misuse of stimulant medication, (2) it was a peer-reviewed, empirical study using quantitative data analytic techniques, (3) it was written in English, (4) only undergraduate students were included in the sample, (5) it did not focus on only one type of stimulant medication (eg, methylphenidate only), and (6) if the article discussed multiple prescription drug categories (eg, stimulants, opiates), the data must have been analyzed separately for each category. An extensive meta-analytic review of this literature will be published elsewhere (contact the corresponding author to request a reprint). The following is a brief summary of our findings.

Prevalence, Availability, and Demographic Characteristics

Among prevalence rates reported, lifetime rates of stimulant medication misuse were the most frequently reported, ranging from 8.1% [8] to 43% [7]. Rates of misuse of stimulant medications within the last year ranged from 5.3% [9] to 35.3% [10]. A number of the studies asked students how they obtained stimulant medications for misuse; peers were overwhelmingly the most common source for obtaining the medications. For example, DeSantis, Webb, and Noar [11] found that 91% of the undergraduates who were interviewed obtained stimulant medications from friends or significant others.

Perceived availability of stimulant medications was also measured in several studies. DeSantis, Webb, and Noar [11] found that 82% of students thought it was somewhat or very easy to obtain stimulant medication; however, Sharp and Rosén [12] found that only 55% of students thought it was somewhat or very easy to obtain stimulant medication. In another study that examined perceived availability, 37% of men and 29.2% of women agreed that they knew students who would provide them with stimulant medications [13].

Many of the studies reviewed examined the relation between particular demographic characteristics (eg, gender, race, socioeconomic status, religious affiliation, year in college, sorority or fraternity membership) and misuse of stimulant medication among college students. The vast majority of studies that examined gender as related to misuse of stimulant medication found that significantly more males misused stimulant medication than females. For example, one study found that 26% of males and 17.3% of females reported misusing stimulant medication [14]; another study found that 39% of males versus 30% of females reported misuse [11].

It is also clear from the existing literature that members of fraternities and sororities appear to be more at-risk for misuse of stimulant medication than non-Greek students. In multiple studies, Greek students had rates of misuse twice that of non-Greeks. For instance, 48% of Greeks misused in their lifetime compared to 22% of non-Greeks [11]; 12% of Greeks misused in the past year compared to 5% of non-Greeks [15]; and Greeks were 2.32 times more likely to initiate use than non-Greeks [9].

Unfortunately, results from studies examining other demographic characteristics (eg, race, socioeconomic status, religious affiliation, year in college) as related to misuse of stimulant medication are much less conclusive and these correlates therefore require further investigation.