Sean Esteban McCabe

Illicit Use of Specific Prescription Stimulants Among College Students: Prevalence, Motives, and Routes of Administration

Objectives. To explore the illicit use of specific prescription stimulants among college students and add to our understanding of reasons (motives) and routes of administration associated with illicit use of these drugs.

Dimensions of Sexual Orientation and the Prevalence of Mood and Anxiety Disorders in the United States

OBJECTIVES We used data from a nationally representative sample to examine the associations among 3 dimensions of sexual orientation (identity, attraction, and behavior), lifetime and past-year mood and anxiety disorders, and sex. METHODS We analyzed data from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. RESULTS Mental health outcomes differed by sex, dimension of sexual orientation, and sexual minority group. Whereas a lesbian, gay, or bisexual identity was associated with higher odds of any mood or anxiety disorder for both men and women, women reporting only same-sex sexual partners in their lifetime had the lowest rates of most disorders. Higher odds of any lifetime mood or anxiety disorder were more consistent and pronounced among sexual minority men than among sexual minority women. Finally, bisexual behavior conferred the highest odds of any mood or anxiety disorder for both males and females. CONCLUSIONS Findings point to mental health disparities among some, but not all, sexual minority groups and emphasize the importance of including multiple measures of sexual orientation in population-based health studies.

Prevalence and motives for illicit use of prescription stimulants in an undergraduate student sample.

To assess the prevalence and motives for illicit use of prescription stimulants and alcohol and other drugs (AODs), associated with these motives, the authors distributed a self-administered Web survey TO a random sample of 9,161 undergraduate college students. Of the study participants, 8.1% reported iifetime and 5.4% reported past-year illicit use of prescription stimulants. The most prevalent motives given for illicit use of prescription stimulants were to (1) help with concentration, (2) increase alertness, and (3) provide a high. Although men were more likely than women were to report illicit use of prescription stimulants, the authors found no gender differences in motives. Regardless of motive, illicit use of prescription stimulants was associated with elevated rates of AOD use, and number of motives endorsed and AOD use were positively related. Students appear to be using these prescription drugs non-medically, mainly to enhance performance or get high.

Sexual orientation, substance use behaviors and substance dependence in the United States

AIMS To assess past-year prevalence rates of substance use behaviors and substance dependence across three major dimensions of sexual orientation (identity, attraction and behavior) in a large national sample of adult women and men in the United States. DESIGN Data were collected from structured diagnostic face-to-face interviews using the Alcohol Use Disorder and Associated Disabilities Interview Schedule DSM-IV version IV (AUDADIS-IV). SETTING Prevalence estimates were based on data collected from the 2004-2005 (wave 2) National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). PARTICIPANTS A large national sample of 34 653 adults aged 20 years and older: 52% female, 71% white, 12% Hispanic, 11% African American, 4% Asian and 2% Native American. FINDINGS Approximately 2% of the population self-identified as lesbian, gay or bisexual; 4% reported at least one life-time same-sex sexual partner and 6% reported same-sex sexual attraction. Although non-heterosexual orientation was generally associated with a higher risk of substance use and substance dependence, the majority of sexual minority respondents did not report substance use or meet criteria for DSM-IV substance dependence. There was considerable variation in substance use outcomes across sexual orientation dimensions; these variations were more pronounced among women than among men. CONCLUSIONS Results support previous research findings of heightened risk of substance use and substance dependence among some sexual minority groups and point to the need for research that examines the reasons for such differences. Results also highlight important gender differences and question previous findings indicating uniformly higher risk for substance dependence among sexual minorities. Risks appear to vary based on gender and how sexual orientation is defined. Findings have implications for more effective prevention and intervention efforts that target subgroups at greatest risk.

Medical Use, Illicit Use, and Diversion of Abusable Prescription Drugs

The authors investigated the medical use, illicit use, and diversion of 4 distinct classes of abusable prescription medication (sleeping medication, sedative or anxiety medication, stimulant medication, and pain medication) in a random sample of undergraduate students. In spring 2003, 9, 161 undergraduate students attending a large, public, midwestern research university in the United States self-administered a Web-based survey. The prevalence rate for illicit use within the past year was highest for pain medication, followed by stimulant medication, sedative or anxiety medication, and sleeping medication. Women generally reported higher past-year medical use rates. However, undergraduate men reported higher illicit use rates. The illicit use-medical use ratio for stimulant medication was the highest among the 4 classes of prescription drugs. Medical users of stimulants for attention deficit hyperactivity disorder were the most likely to be approached to divert their medication. Multivariate results indicated that illicit users of prescription drugs were more likely to use other drugs than were students who did not use prescription drugs illicitly. The authors provide evidence that prescription drug abuse is a problem among college students.

The relationship between discrimination and substance use disorders among lesbian, gay, and bisexual adults in the United States.

OBJECTIVES We examined the associations between 3 types of discrimination (sexual orientation, race, and gender) and substance use disorders in a large national sample in the United States that included 577 lesbian, gay, and bisexual (LGB) adults. METHODS Data were collected from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, which used structured diagnostic face-to-face interviews. RESULTS More than two thirds of LGB adults reported at least 1 type of discrimination in their lifetimes. Multivariate analyses indicated that the odds of past-year substance use disorders were nearly 4 times greater among LGB adults who reported all 3 types of discrimination prior to the past year than for LGB adults who did not report discrimination (adjusted odds ratio = 3.85; 95% confidence interval = 1.71, 8.66). CONCLUSIONS Health professionals should consider the role multiple types of discrimination plays in the development and treatment of substance use disorders among LGB adults.

Medical Use, Illicit Use and Diversion of Prescription Stimulant Medication

Abstract The objective of this study was to examine the prevalence and factors associated with the illicit use of prescription stimulants and to assess the relationship between the medical and illicit use of prescription stimulants among undergraduate college students. A Web survey was self-administered by a random sample of 9,161 undergraduate students attending a large public midwestern university in the spring of 2003. A total of 8.1% reported lifetime illicit use of prescription stimulants and 5.4% reported past year dlicit use. The number of undergraduate students who reported illicit use of prescription stimulants exceeded the number of students who reported medical use of prescription stimulants for ADHD. The leading sources of prescription stimulants for illicit use were friends and peers. Multivariate logistic regression analyses revealed several risk factors for illicit use of prescription stimulants such as being male, White, member of a social fraternity or sorority, Jewish religious affiliation, and lower grade point average. All of these characteristics were also related to medically prescribed use of prescription stimulants. Those who initiated medically prescribed use of prescription stimulants for ADHD in elementary school were generally not at increased risk for illicit use of prescription stimulants or other drugs during college as compared to those who were never prescribed stimulant medication. The present study provides evidence that the illicit use of prescription stimulants is a problem among undergraduate college students, and certain subgroups appear to be at heightened risk.

Subtypes of nonmedical prescription drug misuse

This study used three characteristics (i.e., motive, route of administration, and co-ingestion with alcohol) of nonmedical prescription drug misuse across four separate classes (i.e., pain, sedative/anxiety, sleeping, and stimulant medications) to examine subtypes and drug related problems. A Web survey was self-administered by a randomly selected sample of 3639 undergraduate students attending a large midwestern 4-year U.S. university. Self-treatment subtypes were characterized by motives consistent with the prescription drugs pharmaceutical main indication, oral only routes of administration, and no co-ingestion with alcohol. Recreational subtypes were characterized by recreational motives, oral or non-oral routes, and co-ingestion. Mixed subtypes consisted of other combinations of motives, routes, and co-ingestion. Among those who reported nonmedical prescription drug misuse, approximately 13% were classified into the recreational subtype, while 39% were in the self-treatment subtype, and 48% were in the mixed subtype. There were significant differences in the subtypes in terms of gender, race and prescription drug class. Approximately 50% of those in subtypes other than self-treatment screened positive for drug abuse. The odds of substance use and abuse were generally lower among self-treatment subtypes than other subtypes. The findings indicate subtypes should be considered when examining nonmedical prescription drug misuse, especially for pain medication.

Illicit Methylphenidate Use in an Undergraduate Student Sample: Prevalence and Risk Factors

Study Objectives. To assess the prevalence of illicit methylphenidate use among undergraduate college students at a large university, and to identify alcohol and other drug use behaviors, as well as the negative consequences and risk factors, associated with illicit methylphenidate use.

Drinking Like a Guy: Frequent Binge Drinking Among Undergraduate Women

The purpose of this exploratory study was to examine why there has been an increase in frequent binge drinking among the most recent generation of female undergraduate students. Specifically, we examined whether female undergraduate women associated being able to “drink like a guy” (e.g., drink large amounts of alcohol, drinking competitively) with gender equality. Focus groups were conducted in March of 2003 with 42 female undergraduate women who consumed alcohol. Participants were recruited from respondents of a random sample survey of undergraduate students attending a large, public university and reflected the demographic characteristics of this population: traditional-age college students (i.e., attending college between 18 and 22 years of age), who were primarily white from middle or upper middle class families and living on or near the college campus. Focus groups were based on drinking trajectories during college (Stable High, Stable Low, Decreasers, Increasers) and sorority status. While women of all drinking levels reported feeling pressure to drink “heavily” because of the favorable impression they could make on their male peers, primarily women who were frequent binge drinkers throughout college felt that “drinking like a guy” described their own drinking behaviors. While women reported that being able to “drink like a guy” provided them with a sense of equality with their male peers, analysis of the transcripts suggests that “drinking like a guy” had less to do with gender equality and more to do with emphasizing womens (hetero)sexuality. Findings are discussed in terms of how “heavy alcohol consumption” affords college women positive attention from their male peers, but likely increases their vulnerability to sexual assault and alcohol use related health problems.