Nonmedical Prescription Drug Use by College Students for Recreational and Instrumental Purposes: Assessing the Differences

• Author: Nathan W. Pino,Chad L. Smith,William DeSoto,Hassan Tajalli
• Date: 01 October 2017
• Published date: 01 October 2017
• DOI: 10.1177/0022042617714459
• Subject Matter: Articles

https://doi.org/10.1177/0022042617714459

Journal of Drug Issues

2017, Vol. 47(4) 606 –621

© The Author(s) 2017

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DOI: 10.1177/0022042617714459

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Article

Nonmedical Prescription Drug

Use by College Students for

Recreational and Instrumental

Purposes: Assessing the Differences

Nathan W. Pino1, Hassan Tajalli1, Chad L. Smith1,

and William DeSoto1

Abstract

Nonmedical prescription drug use (NMPDU) is a serious issue on college campuses. We

examine the factors affecting instrumental and recreational NMPDU within the same sample,

and test the efficacy of learning and strain theories in predicting NMPDU for both instrumental

and recreational use. This cross-sectional study utilizes survey data gathered from a convenient

but representative sample (n = 2,466) of students attending a large public university in the

Southwestern United States. There is support for learning theory, but not for strain theory, in

predicting both recreational and instrumental use. Logistic regression analyses also show that

while marijuana smokers, illicit street drug users, and those possessing less of an academic ethic

are more likely to partake in NMPDU for both recreational and instrumental purposes, the

predictors for recreational and instrumental NMPDU differ in interesting ways with regard to

race, gender, binge drinking, living arrangement, and Greek organization membership.

Keywords

nonmedical prescription drug use, college students, academic ethic, learning theory, strain

theory, benzodiazepines, prescription stimulants, opiates

Introduction

The nonmedical prescription drug use (NMPDU) is something to be concerned about on college

campuses. NMPDU is the second most common form of illicit drug use among college students,

behind only marijuana (Johnston, O’Malley, & Bachman, 2003). Many prescription drugs such

as central nervous system (CNS) stimulants (Adderall, Ritalin, Vyvanse, and Concerta), prescrip-

tion opiates (Hydrocodone, Oxycontin), and benzodiazepines (Xanax, Ativan, and Valium) have

a high abuse potential, and their use has been increased (Bavarian, Flay, & Smit, 2014; Ford,

2008; Martinez, D’Amico, Kral, & Bluthenthal, 2012; National Institute on Drug Abuse, 2010;

Teter, McCabe, Boyd, & Guthrie, 2003; White, Becker-Blease, & Grace-Bishop, 2006).

1Texas State University, San Marcos, TX, USA

Corresponding Author:

Nathan W. Pino, Department of Sociology, Texas State University, 601 University Drive, San Marcos, TX 78666,

USA.

Email: np11@txstate.edu

714459JODXXX10.1177/0022042617714459Journal of Drug IssuesPino et al.

research-article2017

Pino et al. 607

Unfortunately, prescription drugs are perceived to be safer than street drugs because of their

legitimated medical uses (Mui, Sales, & Murphy, 2014).

It is important to assess the motives for NMPDU so that we can better inform prevention and

treatment efforts. While there have been numerous studies on stimulant or opioid use, there have

been considerably fewer studies concerning the use of benzodiazepines. It is also the case that the

vast majority of studies fail to examine NMPDU for both recreational (to get high) and instru-

mental (to enhance academic performance) purposes in the same study or sample: Ford and

Blumenstein (2013) noted this lack of differentiation as a limitation of their measure of prescrip-

tion drug use. We seek to help fill this gap in the literature by separately testing reasons for

instrumental and recreational use of CNS stimulants, opiates, and benzodiazepines within the

same sample. In addition, as the literature on NMPDU is still largely atheoretical (Bavarian et al.,

2014), we examine whether learning and/or strain theory are efficacious in predicting instrumen-

tal and recreational use.

Literature Review

Prescription drugs other than methamphetamine comprise most of the misuse of stimulants in the

United States, and stimulant abuse is most common among those aged 25 years and younger

(Kroutil et al., 2006), making it an important issue for colleges and universities. Researchers

have revealed varying rates of NMPDU across samples. One study found that past month use of

prescription stimulants was 4.1% (McCabe, Knight, Teter, & Wechsler, 2005), but most studies

examine differences between past year and lifetime use. Teter, McCabe, Cranford, Boyd, and

Guthrie (2005) found that 5.4% of college students reported past year nonmedical prescription

stimulant use. However, Bavarian et al. (2014) discovered that almost 11% of college students in

their multicampus sample had used stimulants in the past year. McCabe, Boyd, and Teter (2009)

found that 2.5% of college students in their sample reported past year use of sedative/anxiety

medication (benzodiazepines), while 7% of a national sample of college students reported past

year use of opioids (McCabe, Teter et al., 2005).

With regard to lifetime use of stimulants, McCabe, Knight, et al. (2005) found that 6.9% of

college students reported lifetime use, while 8.1% reported lifetime use in another study (Teter

et al., 2005). In another sample, however, 16% of students reported lifetime misuse or abuse of

prescription stimulants, with most preferring Ritalin (White et al., 2006). Rates of stimulant use

decline after students leave college (Underhill & Langdon, 2013). McCabe et al. (2009) found

that 4% of college students in their sample reported lifetime use of benzodiazepines, while

McCabe, Teter et al. (2005) found in their national sample that 12% reported lifetime use of pre-

scription opioids.

NMPDU occurs for both instrumental and recreational purposes: Instrumental users are moti-

vated by the pharmaceutical properties of the drug, such as for studying or pain management,

while recreational users partake for the side effects such as getting high (McCabe et al., 2009).

Reasons college students provide for using stimulants include improving concentration, atten-

tion, and alertness; to get high or party; and to improve academic performance (Teter et al., 2005;

White et al., 2006) though instrumental reasons for NMPDU are cited more often than for recre-

ational reasons (McCabe et al., 2009). Given that college student instrumental use centers around

academic performance, our study focuses on this form of instrumental use, while recreational use

in our study focuses on using prescription drugs to get high.

Some interesting social patterns have been found with regard to stimulant use. McCabe et al.

(2009) found that NMPDU of stimulants and sedative/anxiety drugs increases the risk of drug

and alcohol abuse in general. The use of other drugs such as alcohol, cigarettes, marijuana, and

cocaine are significantly correlated with stimulant NMPDU (Bavarian et al., 2014; McCabe,

Knight et al., 2005; Teter et al., 2005) and other types of prescription medications such as pain,