Misuse of prescribed stimulant medication for ADHD and associated patterns of substance use: preliminary analysis among college students

J Pharm Pract. 2011 Dec;24(6):551-60. doi: 10.1177/0897190011426558. Epub 2011 Nov 17.


Objectives: To explore the prevalence and characteristics associated with college students who misuse their prescribed stimulants for attention-deficit hyperactivity disorder (ADHD) and examine diversion and substance use behaviors as a function of misuse.

Methods: Cohort of 55 past-year prescribed stimulant users was identified from a random sample (n = 1738) at a large Midwestern research university following the self-administration of a web-based survey. An index was created to assess misuse of prescribed stimulants (i.e., Misuse Index).

Results: Of 55 college students who reported past-year use of prescribed stimulants for ADHD, 22 (40%) endorsed at least one item on the misuse index. The most frequently endorsed misuse items were used too much (36%), self-reported misuse (19%), and intentionally used with alcohol or other drugs (19%). Misusers of prescribed stimulant medication were more likely to report cigarette smoking (p = 0.022), binge drinking (p = 0.022), illicit use of cocaine (p = 0.032), and screen positive on the Drug Abuse Screening test (DAST-10) criteria (p = 0.002). The bivariate odds ratio for the DAST-10 findings was 8.4 (95% CI: 2.0-34.6). Diversion of prescribed stimulants was common (36%) and occurred more frequently among stimulant misusers (57%; p = 0.008).

Conclusion: There is a strong relationship between misuse of prescribed stimulants for ADHD and substance use behaviors, as well as other deleterious behaviors such as diversion. These findings suggest the need for close screening, assessment, and therapeutic monitoring of medication use in the college population.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Central Nervous System Stimulants / adverse effects*
  • Cohort Studies
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Midwestern United States
  • Prescription Drugs*
  • Self Administration / psychology
  • Self Administration / statistics & numerical data
  • Students / psychology*
  • Students / statistics & numerical data
  • Substance-Related Disorders / epidemiology*
  • Surveys and Questionnaires
  • Time Factors
  • Young Adult


  • Central Nervous System Stimulants
  • Prescription Drugs