Medicate to Graduate: Academic Strain and Nonmedical Prescription Stimulant Use Among Graduate and Undergraduate Students

• Author: John M. Eassey,James N. Hurst,Julie Marie Baldwin,Tusty ten Bensel
• Published date: 01 January 2021
• DOI: 10.1177/0022042620961358
• Date: 01 January 2021
• Subject Matter: Articles

https://doi.org/10.1177/0022042620961358

Journal of Drug Issues

2021, Vol. 51(1) 196 –217

© The Author(s) 2020

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DOI: 10.1177/0022042620961358

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Article

Medicate to Graduate: Academic

Strain and Nonmedical

Prescription Stimulant Use

Among Graduate and

Undergraduate Students

James N. Hurst1, John M. Eassey2, Julie Marie Baldwin2,

and Tusty ten Bensel1

Abstract

The nonmedical use of prescription stimulants has been prevalent on college campuses in

recent years. Previously, nonmedical prescription stimulant use (NMPSU) has been associated

with increased use of other illicit substances, drug abuse, school dropout, and arrest. It is,

therefore, imperative to understand the etiology of NMPSU for prevention, intervention, and

harm reduction purposes. This study builds upon previous research on the role of academic

strain in NMPSU by (a) considering a measure of strain that is more consistent with strain

theory and (b) extending the examination to include graduate students. By utilizing an original

data set of 1,121 undergraduate and graduate students at a Southern urban university, our

overall results are consistent with general strain theory but mixed with respect to the role of

academic strain in particular. The implications of our study for academic strain are discussed.

Keywords

nonmedical prescription stimulant use, prescription stimulant misuse, strain, academic strain,

general strain theory, graduate students

Introduction

While the use of most illicit drugs has generally declined over the course of the previous decade

(Johnston et al., 2016), nonmedical prescription stimulant use (NMPSU) has grown and now

remains at a disproportionately high rate among college students in comparison to their noncol-

lege peers, young adults in general, and high school seniors nationwide (e.g., Johnston et al.,

2016; McCabe et al., 2018; Substance Abuse and Mental Health Services Administration

[SAMHSA], 2019; Wilens et al., 2008).1,2 Contributing to these trends is the observation that

prescription stimulants are readily available for nonmedical use on many college campuses

1University of Arkansas at Little Rock, Little Rock, AR, USA

2American University, Washington, DC, USA

Corresponding Author:

John M. Eassey, Justice Programs Office, American University, 4801 Massachusetts Avenue NW, Suite 508,

Washington, DC 20016, USA.

Email: jeassey@american.edu

961358JODXXX10.1177/0022042620961358Journal of Drug IssuesHurst et al.

research-article2020

Hurst et al. 197

(McCabe, Boyd, & Teter, 2006; McCabe et al., 2018; Rabiner et al., 2008; SAMHSA, 2019;

Wilens et al., 2008) likely due, in part, to the fact that the psychopharmacological effects are

believed to aid in the achievement of conventional academic goals and objectives (Arria &

DuPont, 2010).

Along these lines, instrumental motivations for misuse appear common. As described by

Goode (2019), individuals who use substances for instrumental reasons do so under the belief

that they will be able to more effectively achieve some goal or greater purpose rather than for any

desirable or pleasurable effect of the substance per se. Studies have identified misuse as a means

that students may adopt to cope with the stressors and demands of the academic environment

(Arria & DuPont, 2010) or to alleviate potential stress or negative emotions (e.g., anxiety, despair)

associated with inadequate study habits, such as cramming, procrastinating all but for the night

before an exam (e.g., DeSantis et al., 2008). In addition, the desire to gain an academic edge over

peers is another often-cited instrumental motive for misuse. For example, students who have

previously misused prescription stimulants report that they were motivated to use to outperform

peers, improve academic performance, stay awake longer, and increase concentration

(“Enhancing, Not Cheating,” 2007; Johnston et al., 2016; Teter et al., 2005).

Taken together, these findings underscore a potential relationship between common types of

stressors and strains and the misuse of prescription stimulants as a means to cope with said

strains, consistent with general strain theory (Agnew, 2002, 2009). As such, it is not surprising

that a number of recent studies have sought to further examine general strain theory by elucidat-

ing the role of strain in stimulant misuse by examining the extent to which negative affective

states, such as depression, mediates the relationship between academic-related strain, or aca-

demic strain, and NMPSU (Ford & Schroeder, 2009; Maahs et al., 2016; Norman & Ford, 2019;

Pate & Bolin, 2018).3 While the results of these studies have been generally consistent with

hypotheses derived from strain theory, they have generally overlooked graduate students. As oth-

ers have noted, graduate students are frequently under immense stress and academic pressure

(Grady et al., 2014), which may increase the likelihood of coping in instrumental ways.

Previous research suggests that graduate students differ in a number of important ways from

undergraduates, including with respect to stress and preferred coping mechanisms (Ickes et al.,

2015). For example, a recent study by Norman & Ford (2019) finds that, under some conditions,

the intent to pursue graduate education among undergraduate students was associated with a

greater likelihood of stimulant misuse. The study, however, was limited to undergraduates who

reported intentions for graduate school, not graduate students. At the same time, there is evidence

to suggest that caffeine consumption and inadequate sleep are potentially more prevalent among

graduate compared with undergraduate students (Ickes et al., 2015). As prescription stimulants

compliment or offer similar effects, it is possible that graduate students may also be more likely

to misuse stimulants compared with undergraduate students. Although results such as these are

suggestive, the extent to which academic strain processes actually operate in graduate student

samples is unclear; thus, further examination remains necessary.

With these considerations in mind, the current study seeks to further the understanding of

NMPSU by utilizing self-report data from a sample of undergraduate and graduate students (n =

1,121) attending a Southern urban university. More specifically, our goal is to understand the

relationship between academic strain and NMPSU among different college student groups:

undergraduate and graduate. It is expected that graduate students will experience negative affec-

tive states to a greater degree as a result of academic strain and, therefore, be more likely to report

NMPSU compared with undergraduates (Ford & Schroeder, 2009; Norman & Ford, 2018; Prosek

et al., 2018). It is important to note that many of the most relevant and informative studies on this

topic have employed rudimentary or otherwise flawed measures of academic strain. Therefore,

the current study also considers the operationalization of academic strain in the course of this

examination.