adhd stimulant abuse in college students
TRANSCRIPT
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Taylor Lott
Joel Williams
Health 2400 001
April 22, 2014
Attention-Deficit/Hyperactivity Disorer !tim"lant Dr"# A$"se in %olle#e !t"ents
%olle#e& This term has iverse notions attache to it& T'o polar ieas associate
'ith (colle#e) are the e*citement of f"n an the an*iety of stress & +eca"se partyin# an
hi#h stress levels are ever-present on a colle#e camp"s, r"# "se an a$"se is an iss"e
that is o$serve& Dr"# a$"se is 'hen an inivi"al has a ha$it of tain# aictive or
ille#al r"#s& ne partic"lar type of r"# that seems to $e reaily a$"se is stim"lant
prescriptions an non-prescriptions for attention-eficit/hyperactivity isorer, also
no'n as ADHD& ADHD is a $ehavioral isorer that is very common& .nicators of
this isorer are the inivi"als havin# tro"$le foc"sin#, hyperactivity, an actin#
'itho"t thinin# a$o"t the action o$inson, !mith, !e#al, amsey, 2014& While
these characteristics may not seem "norinary from normal chilhoo $ehavior, ADHD
may $e the res"lt if these types of iss"es occ"r over a lon# perio of time& 3rescriptions
for this attention-eficit/hyperactivity isorer help the inivi"al 'ith the isorer
(improve concentration an foc"s, plan ahea, control certain imp"lses, an follo'
thro"#h 'ith tass) o$inson et al&, 2014& What tens to ra' colle#e st"ents into
a$"sin# these types of stim"lant r"#s is the notion that these meications help st"ents
to stay "p for e*tene perios of time to either st"y or 'or on assi#nments that are
"e in a limite amo"nt of time reyann"s& Also, a$"se of these partic"lar types of
r"#s can $e to #et a type of e"phoric hi#h or lose 'ei#ht reyann"s&
The mis"se of ADHD stim"lants has not al'ays $een a concern in society& This
pro$lem is $ecomin# more an more evient in the c"lt"re of toay5s society& While this pro$lem can $e seen in cross sections of n"mero"s ifferent pop"lations an a#e #ro"ps,
the area scientists are most foc"se on are colle#e st"ents&
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Prevalence and Rate Data for Target Population
The tar#et pop"lation for this type of "nhealthy $ehavior is colle#e st"ents&
+eca"se colle#e st"ents are thr"st into a hi#hly stressf"l environment an are not
monitore as closely, stim"lant r"# a$"se in colle#e-a#e inivi"als is more evient& ne st"y one on stim"lant "se in colle#e st"ents sho's $oth lifetime prevalence an
past-year prevalence rates, these n"m$ers $ein# 6&78 an 9&:8 Teter, ;c%a$e,
Laran#e, %ranfor, +oy, 200
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$reathin# iffic"lties, an moo isorers ;c%arthy, 2010& @ven more an#ero"s sie
effects, 'hich are the ris 'ith hi#h levels or repeate "se of the r"#s, incl"e stroe,
conf"sion, el"sions, paranoia, an hall"cinations ;c%arthy, 2010& isier $ehavior of
the stim"lant-a$"sin# inivi"al can res"lt, 'hich can lea to accients or even criminal
$ehavior & ne st"y in 2010 fo"n that for all stim"lant-relate emer#ency visits, 908
'ere "e to nonmeical "se of the r"#s !"$stance A$"se an ;ental Health !ervices
Aministration, %enter for +ehavioral Health !tatistics an "ality, 2017&
With these e*treme sie effects of prescription stim"lants co"ple 'ith the
increase in n"m$ers of colle#e st"ents 'ho a$"se stim"lants, scientists an researchers
have set o"t to try an ri this pro$lem& ne partic"lar 'ay scientists are a$le to create a
'ay to trac the pro#ress $ein# mae in this area is from the o$Bectives liste in Healthy
3eople 2020&
Healthy People 2020 Objective
Healthy 3eople 2020 is a list of o$Bectives an #oals for a 10-year time perio to
improve the health of the >nite !tates pop"lation 'hile promotin# health an isease
prevention& ne o$Bective for Healthy 3eople 2020 relatin# to ADHD r"# a$"se is !A-
1:&7, 'hich is to (re"ce the past-year nonmeical "se of stim"lants) Health3eopleov,
2017& The reason this o$Bective is relevant to attention-eficit-hyperactivity isorer is
$eca"se pharmace"ticals "se to treat this common $ehavioral isorer are stim"lants
an 'iely a$"se $y the colle#e-a#e pop"lation as 'ell as other #ro"ps of the #eneral
pop"lation& The nonmeical "se of stim"lants has increase in the past years an
contin"es to remain an iss"e in o"r society& The Healthy 3eople 2020 o$Bective can $e
tar#ete s"ch that stim"lant r"# a$"se can ecline an this ne#ative health $ehavior can
vastly improve the health of o"r nation&
After researchers esta$lish #oals they 'ish to meet for the "pcomin# ecae in thearea of stim"lant a$"se, these researchers m"st evelop st"ies to iscover the "nerlyin#
or intrapersonal factors for the a$"se& .f researchers are $etter a$le to "nerstan the
reasons 'hy colle#e st"ents a$"se stim"lants prescri$e for attention-
eficit/hyperactivity isorer, then prevention pro#rams an interventions can $e
evelope to ai in eliminatin# the pro$lem&
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Beliefs !alues "ttitudes #no$ledge
A$"se of stim"lant r"#s "se for attention-eficit/hyperactivity isorer is an
ever-#ro'in# iss"e for o"r nation, partic"larly for colle#e st"ents& Altho"#h the
environment on a colle#e camp"s is a potential reason for a$"se of stim"lant r"#s, there
are other intrapersonal factors involve 'hen eciin# to participate in this type of
$ehavior& Aerall, a prescription r"# for ADHD, is one of the most a$"se stim"lants
$y the colle#e-a#e pop"lation& This r"# is cate#ori?e $y the feeral #overnment as a
sche"le .. r"#, 'hich means it has the hi#hest potential for a$"se "e to its
aictiveness %ooper, 2011& The #eneral pop"lation has an a'areness that it is ille#al
to tae r"#s 'hich are not prescri$e to them, ho'ever, this no'le#e is not eno"#h to
stop colle#e st"ents from a$"sin# these sim"lant r"#s& ;any colle#e st"ents have the
$elief that stim"lant pharmace"ticals 'ill help them to foc"s more so they are a$le to
finish an assi#nment in a short amo"nt of time& ne st"ent intervie'e for a %CC
article $elieves the stim"lant r"#, Aerall, helps him to mae hi#h #raes an ace
e*ams& 5.Em B"st in a really #oo moo ri#ht no',5 he says, leavin# a "niversity $"ilin#&
F. B"st i #reat on the test5) %ooper, 2011& A st"y con"cte to fin lins $et'een
certain attit"es an reasons 'hy colle#e st"ents mis"se ADHD stim"lants inicates
the $elief that acaemic achievement 'as the o"tcome 'hen "sin# stim"lants ille#ally
Hall, .r'in, +o'man, Granen$er#er, Je'ett, 2009& The attit"e of colle#e st"ents
to'ars stim"lants is positive Aiction Treatment .n Dr"# A$"se, 2017& +eca"se of
the positive test res"lts receive $y many colle#e st"ents 'ho have "se ADHD
stim"lants, the intrapersonal factors to eter inivi"als from the r"# "se are over
looe& ;any times st"ents rely on the $elief the stim"lants 'ill help improve test
scores, 'hen in reality this is not tr"e& A st"y one on hi#h school an mile school
st"ents sho'e that there 'as little to no correlation $et'een acaemic $enefits an "se
of prescription stim"lants Hall et al&, 2009& ;any people lac the no'le#e that
stim"lants can ca"se harmf"l effects on the pop"lation 'ho are not ia#nose 'ith
attention-eficit hyperactivity isorer& +eca"se others notice the increase
concentration for st"ents 'ith the isorer, st"ents lacin# ADHD thin the meication
'ill ca"se the same res"lt for them& They also feel as tho"#h the meication is safe to
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tae $eca"se a octor for an ADHD patient prescri$e it& The pree*istence of a positive
attit"e to'ar ADHD pharmace"ticals allo's st"ents to not see ho' etrimental it is to
one5s health 'hen tain# these types of r"#s& !t"ents loo past the potential harmf"l
an ne#ative effects of these stim"lants an $elieve there is nothin# 'ron# 'ith a little
($oost) from these pharmace"ticals&
Cot only are the intrapersonal factors e*tremely pertinent to the "nerstanin# of
the 'hy a$"sin# ADHD stim"lants have increase in the colle#e pop"lation, it is also
very important to loo at c"lt"ral an environmental factors as 'ell& Aitional factors
incl"e 'here someone lives an 'hat social or economic stat"s an tier these
inivi"als sociali?e 'ithin&
Demographics and %ocioeconomic %tatus
While attention-eficit/hyperactivity isorer meications are a$"se thro"#ho"t
the entire pop"lation, the tren of stim"lant a$"se of colle#e st"ents is more ca"se for
concern& %olle#e camp"ses are very iverse 'ith st"ents from many ifferent races,
ethnicities, lan#"a#es, $ac#ro"ns, an c"lt"res& A st"y one nationally for the 2010-
2011 school year fo"n that ro"#hly half of the B"niors an seniors on colle#e camp"ses
"se Aerall or italin ille#ally& This st"y also fo"n a$o"t 60 percent of B"niors an
seniors 'ho $elon#e to either a fraternity or sorority "se the same stim"lant r"#s
'itho"t prescriptions ;orris, 2017& Another st"y sho'e stim"lant a$"sers 'ere
more liely to $e (male, White, a mem$er of a fraternity or sorority, have a lo'er 3A,
an have m"ltiple se* partners) Arria, %aleira, 5ray, incent, Johnson, Wish,
2006& Within this st"y, ata 'as o$taine on 1297 st"ents on a colle#e camp"s& The
representation of this colle#e camp"s ha ro"#hly half of the participants $ein# female
an a little over I0 percent 'ere White 'ith (I7&9 8 inicate their mother ha attaine a
4-year colle#e e#ree or more) as representation of socioeconomic stat"s Arria et al&,
2006a&
Another area that can $e very iffic"lt to reveal finin#s is the characteristics of a
person& This can $e personality traits or an inivi"al5s $rain chemistry& The psycholo#y
of inivi"als can help scientists learn more a$o"t 'hy certain re#ions of the pop"lation
are more at ris for mis"sin# prescription stim"lants&
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Psychological or Personality &haracteristics
3ersonality traits are hi#hly inicative of 'hat types of $ehaviors people ten to
participate in& ne personality characteristic that is prevalent in n"mero"s cases is the
iea of ris-tain# or sensation seein#& ne st"y fo"n that those 'ho score hi#her
on a sensation seein# scale 'ere more liely to a$"se ADHD meications Jarin,
Loo$y, @arley'ine, 2011& After a lin 'as fo"n $et'een the iea of ris-tain# an
a$"se of stim"lant pharmace"ticals for ADHD, other st"ies 'ere one to see if a similar
lin e*iste amon# a$"se of psychostim"lants an psychiatric isorers& A recent
research st"y fo"n that (one very important psychiatric isorer that may si#nificantly
elevate the ris for psychostim"lant mis"se is an act"al ia#nosis of ADHD) Jarin et
al&, 2011& Also, those 'ho ten to mis"se stim"lant meications are more liely to
participate in the "se of mariB"ana, alcohol, an nicotine& Those 'ho 'ere ia#nose as
attention-eficit/hyperactivity isorer at a yo"n# a#e sho'e a hi#her ris for a$"sin#
har r"#s at a yo"n#er a#e Jarin et al&, 2011& 3sycholo#ical istress symptoms 'ere
evient in many of the st"ents 'ho too nonprescription stim"lants 'ho i not have
ADHD& Ho'ever, those st"ents 'ho 'ere ia#nose 'ith ADHD an "sin# their
prescri$e stim"lants 'ere less liely to e*perience psycholo#ical istress symptoms
ras#reen, 2011& Altho"#h there are many spec"lations as to 'hat the ifferent
personality an psycholo#ical characteristics are for colle#e st"ents 'ho mis"se
stim"lant r"#s, refine o$servations an (har evience) have not $een rampantly
fo"n& This is "e to the nat"re of colle#e st"ents5 $"sy sche"les an not $ein# a$le to
re#"larly $e eval"ate $y health professionals in the 3sycholo#y fiel ras#reen, 2011&
While intrapersonal factors can $e very tellin# for one5s character an motives,
the interactions an relationships st"ent5s have 'ith others can $e very infl"ential& The
s"pport of family an friens, 'hether the infl"ences are positive or ne#ative, can have a
#reat impact on 'hy the colle#e pop"lation has seen s"ch a si#nificant increase in a$"se
of stim"lants&
%ocial %upport and 'nteractions
Gor colle#e st"ents, $ein# a'ay from home is a ne' e*perience& Co lon#er o
they have parents constantly 'atchin# their every move an they are a$le to o anythin#
they 'ant, o"tsie of $reain# the la'& >nfort"nately, "e to this ne'fo"n freeom,
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many colle#e st"ents are e*pose to ille#al actions one of these ille#al actions is the
a$"se of attention-eficit/hyperactivity isorer stim"lant pharmace"ticals& This r"#
a$"se has $ecome an ever-#ro'in# pro$lem for colle#e-a#e st"ents an scientists are
'orin# to "nerstan the motivations an $ehaviors for 'hy colle#e-a#e st"ents are so
easily s"scepti$le to ADHD stim"lants& ne area that co"l potentially $rin# ans'ers
lies in the area of social s"pport& !ocial s"pport, at its core, is the perception an the
act"ality that a person is taen care of physically an emotionally& A st"y one in 200:
name t'o main areas 'here colle#e st"ents receive social s"pportK (parents an on-
camp"s peers) Anerson, +"#ayev, aet?, "#lielmina, =ire#aar, si*th a"thor,
200:& ;ost parents of colle#e st"ents have s"pporte their chilren thro"#ho"t their
life, 'hich may $e one of the reasons the st"ents are in colle#e& Altho"#h parents may
not $e 'ith their chilren at colle#e, social s"pport is still o$serve via payment of the
e"cation, phone calls, an visits& While many parents may $e "na'are of their chilren
participatin# in the mis"se of stim"lants, some parents may have some no'le#e of the
$ehavior an either loo the other 'ay or ena$le the a$"se Arria D"pont, 2010&
3arents co"l also inavertently $e s"pportin# the mis"se of ADHD meications $y
p"shin# their chilren to mae #oo #raes so they can one ay have a s"ita$le Bo$& To
try an achieve the acaemic s"ccess that parents 'ant for their chilren, stim"lants can
$e "se to achieve the esire #raes& esearchers s"##est parents e"cate themselves
on this $ehavior to $etter e"ip themselves to eter their chilren from either $e#innin#
mis"se of stim"lant r"#s or contin"in# the r"# a$"se Arria et al&, 2010&
!ocial s"pport in colle#e st"ents can also come from peers& r#ani?ations an
cl"$s are 'here a lot of infl"ence an s"pport for colle#e st"ents can $e fo"n& These
are the areas 'here st"ents $e#in to (fit in) an fin people that have thin#s in common
'ith them& !tatistics amon# colle#e st"ents 'ho a$"se ADHD pharmace"ticals sho'
that st"ents that $elon# to either a fraternity or sorority have a hi#her ris of stim"lant
mis"se Aria et al&, 2006a& +eca"se ree life is a h"#e part of many st"ents5 colle#e
e*periences, this can $e a stron# infl"ential factor on 'hether st"ents ecie to partae
in the a$"se of stim"lant pharmace"ticals& Altho"#h some st"ents amit "sin# ADHD
stim"lants for increase concentration an foc"s, stayin# a'ae an "se as a party r"# is
another reason 'hy colle#e st"ents a$"se ADHD meications Arria et al&, 2006c&
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!ocial interactions 'ith ree life, or#ani?ations, or cl"$s can ca"se st"ents to have a
esire to a$"se the r"#s& 3arties an other social #atherin#s are opport"nities for colle#e
st"ents 'ho "se ADHD stim"lants to #et a hi#h an stay a'ae for the events& These
types of social interactions are only one aspect of the a$"se of stim"lants& %olle#e an
>niversity aministrators/staff are responsi$le for the camp"ses an the st"ents& The
aministration has a lar#e scope of responsi$ility an sometimes, r"# "se or tryin# to
eliminate r"# "se #ets overlooe or i#nore Arria et al&, 2010& .f these aministrators
'ere a$le to esi#nate more attention to the area of ADHD r"# a$"se, this $ehavior
co"l potentially $e eterre&
+eca"se the tar#et pop"lation for many st"ies ealin# 'ith stim"lant mis"se is
colle#e st"ents, infl"ential or#ani?ations an social instit"tions m"st $e investi#ate
thoro"#hly $eca"se of the s"$stantial impact on st"ents& !t"ents spen a lar#e maBority
of their time 'ith these or#ani?ations/instit"tions an are easily s'aye $y the ecisions&
.f scientists can evelop strate#ies to implement 'ithin these instit"tions an
or#ani?ations, they 'ill liely $e a$le to positively impact the n"m$er of colle#e st"ents
'ho a$"se prescription stim"lants&
Organi(ations and %ocial 'nstitutions
Attention eficient/hyperactivity isorer r"# a$"se is an ever-#ro'in# pro$lem
in o"r nation ho'ever, there is one tar#et pop"lation that sho's alarmin# statistics&
!tim"lant a$"se affects a lar#e proportion of colle#e st"ents& A s"rvey of 7:0 st"ents
sho'e that 20&6 percent of st"ents 'ere mis"sin# ADHD meications ras#reen,
2011& %olle#e instit"tions, $ein# concerne 'ith other iss"es pertainin# to r"nnin# a
"niversity, are "na$le to eter an monitor the stim"lant a$"se Arria et al&, 2010& While
these instit"tions report a hi#h percenta#e of ADHD r"# mis"se in their st"ent $oy,
there are st"ent or#ani?ations that are more liely to a$"se these pharmace"ticals as
oppose to other or#ani?ations& An or#ani?ation is $asically a #ro"p of people 'ho have
similar interests 'ho share a partic"lar p"rpose& ree affiliation is a hi#h preictor of
the mis"se of stim"lant a$"se Desantis, Anthony, %ohen, 2017& This sho"l $e no
s"rprise that sororities an fraternities sho' a hi#her level of r"# mis"se $eca"se not
only o these #ro"ps have similar interests, they also traitionally involve themselves in
the party atmosphere 'here this type of $ehavior is apt to $e more rampant& Also, those
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st"ents 'ho a$"se these types of pharmace"ticals are more liely to $e 'hite males 'ho
ten to have lo'er #raes ras#reen, 2011&
While the act"al or#ani?ations an instit"tions can provie sta$ility for st"ents, it
is those relationships forme 'ithin these comm"nities that ca"se the most infl"ence&
>nerstanin# the $on forme 'ithin cl"$s an social #ro"ps 'ill $e #oo insi#ht for
researchers to evise plans on ho' to attac the #ro'in# iss"e&
Relationships Bet$een Organi(ations and &ommunities
+eca"se certain or#ani?ations, lie fraternities or sororities, are more liely to
mis"se stim"lants, the s"rro"nin# comm"nities may also feel the effect of this r"#
mis"se& ne portion of the impacte comm"nity 'o"l $e the family of colle#e-a#e
chilren& ne aspect scientists $elieve colle#e stim"lant mis"se involves is the parent or
comm"nity5s lac of no'le#e on the s"$Bect Arria et al&, 2010& .f the comm"nity 'as
$etter informe on ho' salient the iss"e of r"# mis"se for colle#e st"ents 'as, they
may $e more liely to help o somethin# a$o"t it& ;any or#ani?ations are incl"e in a
comm"nity an can $e shape $y the ieolo#ies of a comm"nity& Health centers in a
comm"nity can serve as a reso"rce for preventin# the stim"lant mis"se $y or#ani?ations
reyan"s&
%olle#e st"ents rely heavily on their peers an s"rro"nin# comm"nity to help
them to mae ecisions for them in the present an the f"t"re& Ho'ever, 'hile
or#ani?ations an cl"$s can $e ifferent for n"mero"s st"ents the physical environment
in colle#e is similar for the maBority& This physical environment can $e the reason the
a$"se has $een a$le to contin"e&
Physical )nvironment
There are n"mero"s reasons as to 'hy colle#e st"ents mis"se stim"lants
prescri$e for ADHD one is stress& !tress that st"ents "ner#o is intense an affects
every part of their life& This stress ca"ses st"ents to feel as if they nee to tae
somethin# to enhance their concentration an #ive them the a$ility to $e a$le to stay "p
thro"#h the ni#ht th"s allo'in# more time to st"y& When st"ents are "ner the press"re
to o 'ell an are stresse, they may t"rn to st"y ais s"ch as Aerall or some other
pop"lar (st"y r"#&) ne st"y sho'e that a little over I0 percent of st"ents "se
ADHD stim"lants to foc"s on school'or Arria et al&, 2006a& The physical
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environment of a colle#e camp"s also involves partyin# an stayin# o"t late 'ith friens&
%olle#e-a#e st"ents are a'ay from the s"pervision of their parents an are c"rio"s
a$o"t ifferent ille#al pro"cts that may #ive them a ris-tain# (r"sh) or hi#h& Almost
1< percent of r"# "sers from the same st"y reporte "sin# stim"lant meications for
recreation Arria et al&, 2006a& Also, $eca"se the eman is so hi#h for these (st"y
r"#s,) these stim"lants are $ecomin# more reaily availa$le an st"ents are finin#
these r"#s easy to ac"ire ras#reen, 2011&
La's an policies are mae to help eep the p"$lic safe ho'ever, colle#e
st"ents have al'ays vie'e themselves as some'hat ($"lletproof) an mi#ht $e
escri$e as thinin# they are a$ove the la' or the la' oes not apply& The iea the la'
is not fair an maes no sense also can $e a e*planation for 'hy colle#e st"ents $ypass
the la' an contin"e 'ith the ille#al activity&
Public Policy *a$ and Regulations
There are n"mero"s meications that are prescri$e to ai ADHD, an these
meications are cate#ori?e as %-.. meications& This means that these partic"lar
s"$stances (have a hi#h potential for a$"se 'ith severe psycholo#ical or physical
epenence) >niversity of Corth %arolina, 2012& Geeral la' manates that a octor
m"st prescri$e ADHD meications an no refills are permitte& 3rescriptions last "p to
:0 ays an a ate to receive another s"pply of the meication can $e o$serve on the
la$el >niversity of Corth %arolina, 2012& Also, other personal information a$o"t the
patient an prescription are provie& Aerall is one stim"lant that is commonly
prescri$e for attention eficit/hyperactivity isorer& The res"lt of possessin# even a
small amo"nt of this meication 'itho"t a prescription can res"lt in penalties or even Bail
time& .f ca"#ht sellin# s"ch r"#s, one can $e char#e 'ith a felony an #oes a#ainst
policies set $y "niversities Johnson, 2011&
The factors as to 'hy colle#e st"ents a$"se ADHD stim"lants an ho' they are
a$le to #ain access to these prescription r"#s are e*tremely tellin#& .f researchers are
a$le to tar#et ho' st"ents are #ettin# the meications an 'hat the $enefits are of tain#
the pharmace"ticals, the iss"e 'ith attention-eficit/hyperactivity isorer prescriptions
$ein# mis"se co"l $e improve&
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Predisposing )nabling and Reinforcing +actors
Dr"# a$"se, partic"larly in the colle#e-a#e pop"lation, is a complicate s"$Bect
'ith n"mero"s aspects& !pecifically, there are three istinct types of factors that
infl"ence this type of r"# $ehaviorK preisposin# factors, ena$lin# factors, an
reinforcin# factors& 3reisposin# factors precee the act"al $ehavior, 'hich can $e any
e*tent of no'le#e, attit"es, $eliefs, or motivation& Altho"#h these factors can iffer
from inivi"al to inivi"al, there are a fe' specific preisposin# factors or motivations
that seem to overlap& ne st"y that ranomly sample ro"#hly :,000 colle#e st"ents
fo"n there 'ere a$o"t fo"r reasons 'hy colle#e st"ents a$"se ADHD stim"lants& ne
of the reasons, 'hich has $een seen as a stron# eterminant of stim"lant a$"se, 'as that
the attention eficit/hyperactivity isorer meication helpe st"ents to concentrate& A
secon reason provie $y the sample "ner#ra"ates 'as that st"ents 'ere a$le to $e
more alert& T'o aitional reasons that 'ere provie from the st"y 'ere that the
stim"lants 'o"l co"nteract other r"#s an st"ents 'ere also a$le to o$tain a hi#h
Teter, ;c%a$e, %ranfor, +oy, "thrie, 2009& @na$lin# factors, in the most $asic
form, are the accessi$ility to facilitate the act"al $ehavior& +et'een fo"r an ten percent
of hi#h school a#e to colle#e a#e st"ents are ia#nose 'ith attention
eficit/hyperactivity isorer reyan"s& Access to ADHD stim"lants can come from
st"ents 'ith prescriptions, s"ch as the fo"r to ten percent state earlier, 'ho sell their
pills for e*tra money& Also, one article state, (;any st"ents amit to act"ally seein#
octors an p"rposef"lly e*a##eratin# symptoms of ADHD to ac"ire meication)
Jenins, 200I& einforcin# factors, 'hich provie a partic"lar type of fee$ac s"ch as
a re'ar, 'ere fo"n to $e st"yin# or receivin# a partic"lar acaemic #rae an
acceptance $y a social #ro"p at a party or some other social interaction Teter et al&,
2009& These three types of factors contri$"te to the "nerstanin# of 'hy st"ents tae
the ris of a$"sin# ADHD stim"lants& The preisposin# factors s"ch as 'antin# to stay
alert an have increase concentration lea st"ents to ac"ire the ADHD meications,
'hich are cate#ori?e as an ena$lin# factor& The ris is seen as ('orth it) to st"ents
$eca"se of the reinforcin# factors s"ch as receivin# hi#h acaemic mars from their
"niversity& The conse"ence of the reinforcin# factors allo's st"ents to contin"e 'ith
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the cycle $eca"se st"ents receive #oo #raes from tain# ADHD meications, s"ch as
Aerall, st"ents 'ant to o it a#ain an still have the access to the prescriptions&
The social ecolo#ical moel provies a vis"al as to the ifferent areas an
infl"ences that colle#e st"ents are $ein# affecte $y& While moels are e*tremely
helpf"l in $ein# a$le to act"ally see the factors in "estion, theories are a$le to e*plain
reasons or sho' correlations $et'een colle#e st"ents an the mis"se of ADHD
meication&
Theory of Reasoned "ction and Theory of Planned Behavior
esearchers an scientists to fin a specific correlation $et'een a person5s
attit"e an that person5s $ehavior "se the Theory of easone Action an Theory of
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3lanne +ehavior& The moel for these cohesive theories is e*tensive an provies many
constr"cts that m"st $e st"ie& The "se of ADHD stim"lants as st"y ais is a pro$lem
in the colle#e pop"lation an scientists are t"rnin# to these partic"lar theories to
"nerstan the conscio"s an "nconscio"s reasons for 'hy st"ents t"rn to these
partic"lar r"#s& ne st"y one on a sample of colle#e st"ents foc"se on sensation-
seein# characteristics an a partic"lar constr"ct of the TA/T3+K perceive
harmf"lness& The researchers 'ho con"cte this st"y 'ante to fin a correlation
$et'een characteristics "$$e sensation-seein# an 'hether these partic"lar traits
infl"ence perception an also $eca"se there has not $een another st"y one to reveal a
correlation of this nat"re Arria, %aleira, incent, 5ray, Wish, 2006& The iea
that inivi"als 'ho see an#ero"s activities are less liely to see r"# a$"se as a
serio"s iss"e $"t a potential thrill-seein# event& "estions "sin# ;TG s"rveys 'ere
"se to etermine the level of perceive harmf"lness hi#h or lo' of a$"sin#
nonprescription stim"lants Arria et al&, 2006$& @*planations an efinitions 'ere also
provie to help the participants have a clear "nerstanin# of 'hat 'as $ein# ase
Arria et al&, 2006$& To meas"re perceive harmf"lness, participants of the s"rvey 'ere
ase, (Ho' m"ch o yo" thin people ris harmin# themselves physically or in other
'ays if they tae Mr"#N occasionally nonmeicallyO) Arria et al, 2006$& The res"lts
in the st"y sho'e that
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$etter on school'or in a short amo"nt of time 'itho"t harm is e*presse& Also, (losin#
'ei#ht 'as another motivation ientifie $y "ner#ra"ate st"ents) 'ho mis"se
meications s"ch as ADHD stim"lants all"cci, 2011& .t 'as also fo"n that st"ents
'ho amit to a$"sin# these meications ha the no'le#e of this mis"se $ein# ille#al
$"t 'ere not so foc"se on this or the possi$le conse"ences of their health in relation to
stim"lant "se all"cci, 2011& "estions in this st"y aresse (11 items assessin#
attit"es, 10 assessin# s"$Bective norms, an < items relate to perceive $ehavioral
control) an a ran#e from -7 to P7 'as "se as meas"rement all"cci, 2011& verall,
the theories of easone Action an 3lanne +ehavior help researchers "nerstan the
"nerlyin# reasons as to 'hy colle#e st"ents a$"se attention-eficit/hyperactive isorer
meications&
Theory of easone Action an Theory of 3lanne +ehavior
Theory of Triadic 'nfluence
The theory of triaic infl"ence is characteri?e as a meta-theory this means it is
compose of constr"cts from n"mero"s other theories& These theories incl"e the theory
of planne $ehavior, e*pectancy-val"e theory, an social co#nitive theory +avarian,
Glay, =etcham, !mit, =oama, ;artin, !alt?, 2014& The frame'or for this theory is
compose of infl"ences on self-efficacy, $ehavioral norms, an attit"es to'ar certain
$ehaviors +avarian et al&, 2014& The p"rpose of this st"y 'as to preict the mis"se of
ADHD stim"lants in colle#e st"ents an test the theory of triaic infl"ence in relation to
this r"# mis"se +avarian et al&, 2014& To st"y this theory, scientists emaile ro"#hly
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190 "ner#ra"ate classes at a p"$lic "niversity in %alifornia +avarian et al&, 2014& A
"estionnaire incl"e items relate to $oth infl"ence an ca"sation 'ith respect to the
theory of triaic infl"ence +avarian et al&, 2014& To st"y intrapersonal factors,
researchers ase "estions associate 'ith sensation-seein#, ADHD, st"y ha$its,
acaemic concerns, an avoiance of self-efficacy +avarian et al&, 2014& The c"lt"re
an environment 'as "estione $y st"yin# if st"ents 'ere associate 'ith reli#ion
an 'hat the r"# c"lt"re 'as on camp"s +avarian et al&, 2014& .ntentions an irect
r"# $ehavior 'ere also "estione in the s"rvey to etermine the infl"ences on stim"lant
mis"se in colle#e st"ents& ;eas"rements of the st"y 'ere one $y 'ay of a 1 to 9
scales, 'hereas 1 meant the inivi"al stron#ly isa#ree 'ith the statement& The res"lts
of the st"y reveale that (appro*imately 168 of st"ents reporte en#a#in# in .>3!
illicit "se of prescription stim"lants "rin# colle#e, an the istri$"tion for the
fre"ency of "se 'as positively se'e) +avarian et al&, 2014& These statistics inicate
that there is a correlation $et'een stron# infl"ences on the st"ents, $oth intrapersonal
an interpersonal, an the mis"se of prescription stim"lants& Cot only oes this partic"lar
theory foc"s on the infl"ences on a health $ehavior, $"t level of ca"sation is also st"ie
+avarian et al&, 2014& This theory also stresses that (an inepenent varia$le 'ill $e
associate not only 'ith meas"res in its o'n stream, $"t also 'ith meas"res in the t'o
aitional streams cross stream) +avarian et al&, 2014& The st"y fo"n that lo'er
concern 'ith #raes an acaemics 'ere correlate to hi#her sensation-seein# attit"es
in the inivi"al +avarian et al&, 2014& esearchers also iscovere that the social
sit"ation stream 'as #reatly associate 'ith inivi"als 'ho s"ffere from an ADHD-
lie symptomolo#y +avarian et al&, 2014& This st"y reveale helpf"l notions on ho'
to con"ct prevention efforts for the mis"se of prescription stim"lants in the colle#e-a#e
pop"lation& Tar#et areas for preventin# this .>3! in colle#e st"ents are $ehavioral
norms, attit"es to'ar the stim"lant mis"se, an avoiance of self-efficacy +avarian et
al&, 2014&
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Theory of Triaic .nfl"ence
Theories are very helpf"l in eterminin# relationships $et'een ifferent aspects
of st"ents5 personal lives an the comm"nity that is infl"encin# them& All of the
theories, factors, moels, relationships, an st"ies can $e com$ine to ai in the
evelopment of interventions& With these interventions, scientists 'ill $e a$le to $etter
"nerstan 'hy colle#e st"ents a$"se ADHD meications an they 'ill $e $etter
e"ippe in solvin# the pro$lem&
'ntervention Plan
.n recent years, more an more of the pop"lation is $ein# ia#nose 'ith
attention-eficit/hyperactivity isorer, 'hich res"lts in $ein# prescri$e stim"lants to
help treat the conition& >nfort"nately, 'ith the increase of ADHD ia#noses comes the
increase cases of mis"se an a$"se of these prescription stim"lants& ;ost nota$ly, the
colle#e pop"lation is s"fferin# from this iss"e& !t"ents are "sin# these meications as
(st"y r"#s) 'itho"t necessarily reali?in# the harmf"l effects& The role of scientists an
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Lott 1I
researchers in this nation'ie iss"e is to evise interventions an strate#ies to hiner the
a$"se of ADHD stim"lants& The first step for evelopin# a strate#y to help iminish the
#ro'in# iss"e is to efine the a$"se of the ADHD pharmace"ticals reyan"s& This
a$"se can $e characteri?e $y not havin# a prescription for the partic"lar meication or
"sin# it $eyon 'hat the prescription la$el states& Also, o$servation of prevalence 'ill
help to etermine 'hat type of intervention or on 'hat scale the intervention m"st $e
evelopin#& (Conmeical "se of prescription meications represents the secon most
common form of illicit r"# "se in the colle#e pop"lation) reyan"s& A st"y one in
2002 sho'e similar res"lts, $"t note that males are more liely to mis"se prescription
stim"lants than females reyan"s&
Altho"#h this stim"lant a$"se pro$lem has eviently increase in the pop"lation
more recently, interventions or strate#ies have $een esta$lishe in the past& The theory of
reasone action an theory of planne $ehavior have $oth $een "se to pinpoint a
correlation $et'een the attit"es an $ehavior of a person& These theories also elve into
the perception of prescription stim"lants $y colle#e-a#e st"ents& This is ey in tryin#
to eter colle#e st"ents from t"rnin# to ADHD stim"lants for a (st"y r"#&) +eca"se
scientists have etermine that many st"ents "se ADHD meications ille#ally to st"y
for e*tene amo"nts of time, researchers are $etter e"ippe at taclin# the iss"e of this
partic"lar type of r"# a$"se& The preisposin#, ena$lin#, an reinforcin# factors are
also items scientists loo at to help evelop strate#ies to eliminate the r"# pro$lem
associate 'ith colle#e st"ents& The preisposin# factors or motivations that 'ere
sho'n in colle#e st"ents 'ho a$"se prescription stim"lants 'as to help 'ith
concentration, attain a hi#h, $e more alert, an co"nteraction of other r"#s Teter et al&,
2009& The accessi$ility of r"#s is e*tremely pertinent as 'ell as the reinforcin# factors&
+eca"se ro"#hly fo"r to ten percent of hi#h school a#e an colle#e a#e st"ents are
ia#nose as havin# attention eficit/hyperactivity isorer, st"ents are more capa$le of
ac"irin# the r"#s reyann"s& The reinforcements for this type of $ehavior 'o"l $e
the acaemic #raes res"ltin# from st"ents "sin# the ADHD pharmace"ticals Teter et
al&, 2009&
The constr"ction of a strate#y as an intervention for ADHD stim"lant a$"se in
colle#e st"ents can $e a very complicate process "e to n"mero"s factors amon#st
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Lott 16
ifferin# inivi"als& Ho'ever, it is al'ays #oo to (try a han) at re"cin# the iss"e&
!ome areas of the social ecolo#ical moel that . thin 'o"l $e most helpf"l at tar#etin#
'o"l $e the interpersonal an intrapersonal levels& These re#ions foc"s on the
no'le#e, attit"es, an $eliefs of the inivi"al an they also foc"s on the
relationships these inivi"als have 'ith friens an family& .f colle#e st"ents ne'
'hat act"ally happens to inivi"als 'ho "se prescription stim"lants $"t are not
ia#nose 'ith ADHD, . thin st"ents 'o"l $e less liely to tae the meication& .
thin may$e ain# a section a$o"t the effects of s"ch r"#s on the h"man $oy to the
e"cation classes a$o"t alcohol co"l help #et that information to the st"ents& .f the
iea that tain# prescription stim"lants helps improves #raes si#nificantly 'as no lon#er
reinforcement, colle#e st"ents 'o"l most liely $e incline to cease the "se of ADHD
pharmace"ticals& The com$ination of o"tsie relationships p"ttin# less press"re on
inivi"als a$o"t #raes an create more of a social sti#ma #eare to'ars the mis"se
of stim"lants, . $elieve a ecline co"l $e seen in the research for this #ro'in# pro$lem&
Tar#etin# the preisposin#, ena$lin#, an reinforcin# factors for this type of $ehavior
co"l also ai in the elimination of ADHD stim"lant mis"se an a$"se& The com$ination
of "sin# previo"s theories s"ch as the theory of reasone action an theory of planne
$ehavior, looin# at preisposin#, ena$lin#, an reinforcin# factors, as 'ell as e*aminin#
certain levels of the social ecolo#ical moel 'o"l help to ecrease the ever-#ro'in#
statistics on stim"lant mis"se in colle#e st"ents&
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Lott 1:
Wors %ite
Aiction Treatment in Dr"# A$"se 2017, Covem$er 2:& Deterring college
students from stimulant, study drug abuse& etrieve from
httpK//'''&aictiontreatmentma#a?ine&com/aiction/r"#-a$"se/eterrin#-
colle#e-st"ents-from-stim"lant-st"y-r"#-a$"se/
Anerson, &, +"#ayev, 3&, aet?, &, "#lielmina, %&, =ire#aar, =&, si*th a"thor&
200:, Decem$er 16& Peer and parental support among college students&
etrieve from httpK//'p&stolaf&e"/sociolo#y/peer-an-parental-s"pport-amon#-
colle#e-st"ents/
Arria, A& ;&, %aleira, =& ;&, 5ray, =& @&, incent, =& +&, Johnson, @& 3&, Wish, @&
D& 2006, Ge$r"ary& Conmeical "se of prescription stim"lants amon# colle#e
st"entsK associations 'ith ADHD an polyr"# "se& Pharmacotherapy, 282&
19
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Lott 20
De!antis, A& D&, Anthony, =& @&, %ohen, @& L& 2017, !eptem$er 2:& .lle#al colle#e
ADHD stim"lant istri$"torsK characteristics an potential areas of intervention&
Substance %se & 'isuse, (8niversity of Ala$ama,
Ala$am$a&
ras#reen, A& 2011, A"#"st 1:& *ho misuses prescription drugs& etrieve from
httpK//'''&insiehi#here&com/ne's/2011/06/1:/americanQpsycholo#icalQassoci
ationQpresentationQsho'sQho'QahQinfl"encesQprescriptionQr"#Qa$"se
reyann"s, D& @& !tim"lant mis"seK strate#ies to mana#e a #ro'in# pro$lem& %se
and 'isuse of Stimulants+ etrieve from
httpK//'''&acha&or#/%ontin"in#Q@"cation/ocs/A%HAQ>seQ;is"seQofQ!tim"l
antsQArticle2&pf
Hall, =& ;, .r'in, ;& ;&, +o'man, =& A&, Granen$er#er, W&, Je'ett, D& %& 2009,
Jan"ary 1& .llicit "se of prescri$e stim"lant meication amon# colle#e st"ents&
Journal of merican "ollege $ealth, 34& 1
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Lott 21
Jenins, =& 200I, April 1I& dderall- college students0 best friend/or .orst enemy1
etrieve from httpK//serenip&$rynma'r&e"/e*chan#e/noe/7
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Lott 22
Teter, %& J, ;c%a$e, !& @&, Laran#e, =&, %ranfor, J& A&, +oy, %& J& 200niversity of Corth %arolina 2012, J"ne 2I& DDD$D "/II medications policy &
procedure- %5" internal medicine clinic& etrieve from
httpK//'''oo#le&com/"rlO
saRtrctRBResrcRsso"rceR'e$cR7veR0%D6GBA%"rlRhttp87A
82G82G'''&me&"nc&e"82Gim82Gstaff82Gclinic82Gfiles82Gah-policy-
an-proce"re-0.>-
TTAor"eD4D#+A"s#RAGB%CG4c4'iT#I7QelcT2+rr+'-
%A$vmR$v&