April 7, 2009

Nonmedical Use of Adderall^® among Full-Time College Students

Nonmedical use of Adderall^® is of special interest to policymakers because, as an amphetamine, Adderall^® is among the group of legally approved drugs classified as having the highest potential for dependence or abuse.¹ A prior study of nonmedical use of stimulants such as Adderall^® by college students reported considerably higher rates of frequent binge alcohol use, marijuana use, and cocaine use among students who used stimulants nonmedically in the past year compared with their counterparts who had not.² Use of both cocaine and stimulants is problematic because each increases the risk for heart attack or stroke.^3,4

This issue of The NSDUH Report examines the rates of nonmedical use of Adderall^® in the past year among full-time college students aged 18 to 22 and comparably aged persons who were not full-time college students.^5,6 All findings presented in this report are annual averages based on combined 2006 and 2007 data.

Full-time college students aged 18 to 22 were twice as likely as their counterparts who were not full-time college students to have used Adderall^® nonmedically in the past year (6.4 vs. 3.0 percent) (Figure 1). This pattern was found for both males and females and for persons aged 18 to 20 as well as for those 21 or 22 years old.

Figure 1. Nonmedical Use of Adderall^® in the Past Year among Full-Time College Students and Other Persons Aged 18 to 22, by Age Group and Gender: 2006 and 2007

Among full-time college students, those who had used Adderall^® nonmedically in the past year were more likely than those who had not used Adderall^® nonmedically to have used illicit drugs or to have used other prescription drugs nonmedically in the past year. Full-time college students who were nonmedical users of Adderall^® were almost 3 times as likely as those who had not used Adderall^® nonmedically to have used marijuana in the past year (79.9 vs. 27.2 percent), 8 times more likely to have used cocaine in that period (28.9 vs. 3.6 percent), 8 times more likely to have been nonmedical users of prescription tranquilizers (24.5 vs. 3.0 percent), and 5 times more likely to have been nonmedical users of prescription pain relievers (44.9 vs. 8.7 percent) (Figure 2).

Figure 2. Other Drug Use in the Past Year among Full-Time College Students Aged 18 to 22, by Past Year Nonmedical Use of Adderall^®: 2006 and 2007

Among full-time college students aged 18 to 22, those who used Adderall^® nonmedically in the past year were more than 1.5 times as likely as their counterparts to have used alcohol in the past month (95.4 vs. 63.0 percent), more than twice as likely to have been binge alcohol users (89.5 vs. 41.4 percent), and more than 3 times as likely to have been heavy alcohol users (55.2 vs. 15.6 percent) (Figure 3). Similar patterns were observed for underage full-time college students (i.e., those aged 18 to 20) who used Adderall^® nonmedically in the past year and for nonmedical Adderall^® users of legal drinking age compared with their counterparts who had not used it nonmedically (data not shown).

Figure 3. Alcohol Use in the Past Month among Full-Time College Students Aged 18 to 22, by Past Year Nonmedical Use of Adderall^®: 2006 and 2007

Among full-time college students aged 18 to 22, nonmedical use of Adderall^® in the past year was more likely among whites (8.6 percent) than blacks (1.0 percent), Asians (2.1 percent), Hispanics (2.2 percent), or persons of two or more races (2.7 percent) (Table 1). Nonmedical use of Adderall^® among full-time college students was highest among students whose annual family incomes were less than $20,000 (8.9 percent), followed by those with annual family incomes of $75,000 or more (6.0 percent). Rates were lower for students with annual family incomes of $20,000 to $49,999 (3.0 percent) or $50,000 to $74,999 (4.0 percent).

The higher rate of nonmedical use of Adderall^® among full-time college students than among others in the same age range is a public health concern because of this drug's potential for dependence or abuse. Educators, counselors, and others who work with students also need to be aware that polydrug use was prevalent among full-time college students who used Adderall^® nonmedically in the past year. As noted previously, both cocaine and stimulants such as Adderall^® increase a person's risk for heart attack or stroke. Students who use Adderall^® nonmedically also may need to take central nervous system depressants such as pain relievers or tranquilizers—which carry their own risks of dependence or abuse—to counteract the stimulant effects of Adderall^®. Finally, high rates of binge and heavy alcohol use among full-time college students who used Adderall^® nonmedically in the past year are a cause for concern because of the well-documented associations between excessive drinking among college students and the adverse consequences for students' physical and mental health, safety, and environment.⁷