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JOURNAL OF AMERICAN COLLEGE HEALTH, VOL. 54, NO. 5 Stimulant Medication Use, Misuse, and Abuse in an Undergraduate and Graduate Student Sample Barbara Prudhomme White, PhD, OTR/L; Kathryn A. Becker-Blease, PhD; Kathleen Grace-Bishop, MHSA ‘Abstract. In this study, the authors investigated the charactris- tics of use, misuse, and abuse of stimulant medication (primarily ratiylphenidate and variants) among students at a novtheastera US university, Researchers seut an invitation to take ant Intenet survey f0 student e-mail addresses and passed 150 paper surveys in undorgraduate classes, analyzing 1,025 (975 electronically) returned surveys. Sixteen percent of respondents reported abusing fr misusing stimulant medication, Ninety-six percent of respon: emis who specitied a medication preferred t abuso or misuse Ritsin, Men and women reported similar use patterns. Most spondenss who abused or misused simulant medication swat wed pills, 40% used intranasally. Reasoas for abusing or ing stimulant medication included improving stention, partying, redveing hyperactivity, and improving grtdes. Consistent with previous studies, results suggest that abuse of simulant madica= tion s a concem on college campuses. The results point to various reasons for and methods of abvsing and mistsing stimulant med ‘cation that may diect future reseereh, prevention, and interven Key Words: college students, methyiphenidate, prescription drag ing the abuse and misuse of these medications.'* There has paramere ere ers,! has been influenced by increased production of and 1 increase in stimulant medication prescriptions All of the authors are affiliated with the Universiey of New Hampshire ia Durkan. Barbara Prudiomme White is an assis- fant professor at the School of Health and Human Services: Kathryn A. Becker-Blease is a research associate atthe Family Research Laboratory; and Kathleen Grace-Bishop is the Associate Director af Health Services. Copyright © 2006 Heldref Publications imethyiphenidate.\**" Since 1993, there has been an esti- mated 40% increase in medicinal amphetarnine production within the United States.™4*-"' Recent reports from the US Drug Enforcement Administration (DEA) show that methylphenidate has been the fourth most presexibed drug in the United States since at least 2003, behind hydrocodone, oxycodone, and codeine." The primary use for methylphenidate is for the trestment of attention dis- orders in children. 41516 Metnyiphenidate is a schedule Il drug under the Controlled Suibstances Act and therefore careflly regulated and moni- tored by the DEA"? Although Ritalin (methyl pphenidate hydrochloride) and Concerta (metirylphenidato hydrochloride) ae the most commonly prescribed stimulant ‘medications based on methylphenidate, several others inthe stimulant class are aiso common, including prescription amphetamines Adderall (Jextroamphetamine sulfate dex- teoamphetamine saccharate amphetamine aspartate monohy- ‘rare amphetamine sulfete), Dexedrine (dextroarphetamine sulfate), and Cylert (pemoline) * Methylphenidate is recognized as having a high sbuse potential and produces many of the same effects as cocaine ‘or amphetamines.™"!9732? Because itis a schedule TI pre- scription medication, the rate of methylphenidate distribution foreach state, state area by zip code, and the county is mon- itored by the DEA.''“" The only ways to procure the drug are through either legitimate prescription or illegal sources thus, the rate of drug sales and distribution into a state is concer because prescription drugs may be diverted for ile- gal use by distributors, prescribers, thieves, or patients who give away or sell their drugs illegally” Drug distribution rates also bring into question whether possible differences exist within certain popolations that set them apart from other popalations or whether diagnosis and prescription protocols ‘ary substantially from area to area.*0234 PRUDHOMME WHITE ET AL Although prescribed use of methylphenidate appenrs to bbe relatively safe, misuse or abuse of any stimulant medies- tion can have adverse, if not deadly, consequences. When these drugs are taken in high doses, either intranasally or orally, the risk of addiction increases, and physical side effects include cardiovascular complications, increased blood pressure, and headache.?925:#25-27 Additional com- plications associated with high doses include panic episodes, aggressive behavior, and suicidal of homicidal tendencies; overdose of methylphenidate has been associat- ed with death. Moreover, according to the DEA, injecting ‘methylphenidate, a less common altemative intake method, is additionally problematic because fillers in the pills block stoall blood vessels, causing lung and eye damage.” Although much ofthe concern regarding the extent of abuse or misuse of stimulant medications in high schools and on college campnses has been documented in a vatiety of sources," recent reports have been emerging from state- and federally funded projects According to results from the University of Michigan's annual Monitoring the Future study, nonmedical use of methylphenidate averaged nearly 49% of students in the 8, 10th, and 12th grades in 2002. Recently, 3 stadies have been published that offer ‘more information about stimulant misuse and abuse on col lege campuses, Babcock and Byme® reported findings from a study investigating methylphenidate abuse and misuse in 4 small New England college, Results suggest that approx- imately 16% of the student population had used the drug for recreational purposes and that 12.7% had used the drug intranasally, The authors reported that stimulant medication ‘misuse and sbuse was most common among treitionally aged college students (sindents aged 18-24 years) Teter and colleagues" seported findings from a larger study done in Michigan, using a student life survey with stadeats at the University of Michigan, Their results suggest that 3% of the students all of whom responded anonymously, bad misused oF abused methylphenidate within the year che survey was completed. Men and women reported similar misuse and abuse histories, and misuse and abuse was significantly associated with partying." The authors also reported an ‘apparent relation between the incidences of misuse and abuse of stimulant medications within residence halls where ‘other students held legitimate prescriptions versus residence halls in which no staclents with prescriptions resided." This suggests that one of the ways survey respondents obtained ‘methylphenidate for abuse purposes was by purchase, con- ferment, or theft from students who held legitimate pro- scriptions, as researchers have documented,’ Hell and cot. leagues? used a questionnnire to investigate the extent to which students at a midwestem university used stimulant ‘medications illicitly. Their findings suggest that approxi- ately 14% of women and men at that school misused or abused stimulant medications. Our purpose in this study was to collect information regarding use, misuse, and abuse of stimulant medications at ‘2 medium-sized university in New Hampshire. For the pur- ‘Poses ofthis study, we used the terms misuse and abuse to 262 describe intake of stimulant medications either without 3 legitimate prescription or with a prescription but in unin- tended doses for partying, studying, test taking, ot increas- ing aitemtion. One of us had heard anocdotally from students that stimolant medication abuse existed on campus, but the ‘extent of the problem was unknown. As part of an effort to ‘rack methylphenidate use in the country, the DEA reported that the greatest emount of methylphenidate distribution by