Skip to main content
Log in

Perceived Harmfulness Predicts Nonmedical Use of Prescription Drugs Among College Students: Interactions with Sensation-Seeking

  • Published:
Prevention Science Aims and scope Submit manuscript

Abstract

This study describes the level of perceived harmfulness of nonmedical prescription stimulant and analgesic use in a sample of college students, and examines the prospective relationship between perceived harmfulness and subsequent nonmedical use. In addition, we explore whether the association between perceived harmfulness and nonmedical use varies by level of sensation-seeking. Personal interviews, including questions on sensation-seeking and drug use, were conducted with 1,253 first-year college students. Participants were then followed-up twice at 6-month intervals. Perceived harmfulness of nonmedical use of prescription drugs was assessed at 6 months via a web-based survey. At the 12-month follow-up interview, drug use was again assessed. Students who never had the opportunity to use prescription drugs nonmedically were excluded from all analyses. Results revealed that one in four students perceived a great risk of harm from occasional nonmedical use of prescription stimulants (25.2%) and analgesics (27.8%). As expected, low perceived harmfulness and high sensation-seeking were independently associated with increased risk of nonmedical use, holding constant demographic characteristics. The protective effect of high perceived harmfulness could be seen at all levels of sensation-seeking with one important exception: Among high sensation-seekers, perceived harmfulness was not related to nonmedical use of prescription analgesics. Perceived harmfulness appears to distinguish nonmedical users from non-users, given the opportunity to use. Increasing perceived harmfulness may be a viable prevention strategy for most students, but alternative approaches might need to be developed that are tailored to high sensation-seekers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Anthony, J. C., Warner, L. A., & Kessler, R. C. (1994). Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: Basic findings from the National Comorbidity Survey. Experimental and Clinical Psychopharmacology, 2, 244–268. doi:10.1037/1064-1297.2.3.244.

    Article  Google Scholar 

  • Arria, A. M., Caldeira, K. M., O’Grady, K. E., Vincent, K. B., Fitzelle, D. B., Johnson, E. P., et al. (2008a). Drug exposure opportunities and use patterns among college students: Results of a longitudinal prospective cohort study. Substance Abuse, 29.

  • Arria, A., O’Grady, K., Caldeira, K., Vincent, K., & Wish, E. (2008b). Nonmedical use of prescription stimulants and analgesics: Associations with social and academic behaviors among college students. Journal of Drug Issues, 38.

  • Arria, A. M., & Wish, E. D. (2005). Nonmedical use of prescription stimulants among students. Psychiatric Annals, 35, 228–235.

    Google Scholar 

  • Bachman, J. G., Johnston, L. D., & O’Malley, P. M. (1990). Explaining the recent decline in cocaine use among young adults: Further evidence that perceived risks and disapproval lead to reduced drug use. Journal of Health and Social Behavior, 31, 173–184. doi:10.2307/2137171.

    Article  PubMed  CAS  Google Scholar 

  • Bachman, J. G., Johnston, L. D., & O’Malley, P. M. (1998). Explaining recent increases in students marijuana use: Impacts of perceived risks and disapproval 1976–1996. American Journal of Public Health, 88, 887–892.

    Article  PubMed  CAS  Google Scholar 

  • Bachman, J. G., Johnston, L. D., O’Malley, P. M., & Humphrey, R. H. (1988). Explaining the recent decline in marijuana use: Differentiating the effects of perceived risks, disapproval, and general lifestyle factors. Journal of Health and Social Behavior, 29, 92–112. doi:10.2307/2137183.

    Article  PubMed  CAS  Google Scholar 

  • Barrett, S. P., Darredeau, C., Bordy, L. E., & Pihl, R. O. (2005). Characteristics of methylphenidate misuse in a university student sample. Canadian Journal of Psychiatry, 50, 457–461.

    Google Scholar 

  • Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Carroll, B. C., McLaughlin, T. J., & Blake, D. R. (2006). Patterns and knowledge of nonmedical use of stimulants among college students. Archives of Pediatrics & Adolescent Medicine, 160, 481–485. doi:10.1001/archpedi.160.5.481.

    Article  Google Scholar 

  • Catalano, R., & Hawkins, J. D. (1996). The Social Development Model: A theory of antisocial behavior. In J. D. Hawkins (Ed.), Delinquency and crime: Current theories (pp. 149–197). New York: Cambridge University Press.

    Google Scholar 

  • Chambers, R. A., Taylor, J. R., & Potenza, M. N. (2003). Developmental neurocircuitry of motivation in adolescence: A critical period of addiction vulnerability. The American Journal of Psychiatry, 106, 1041–1052. doi:10.1176/appi.ajp.160.6.1041.

    Article  Google Scholar 

  • Chassin, L., Presson, C. C., Rose, J. S., & Sherman, S. J. (2001). From adolescence to adulthood: Age-related changes in beliefs about cigarette smoking in a midwestern community sample. Health Psychology, 20, 377–386. doi:10.1037/0278-6133.20.5.377.

    Article  PubMed  CAS  Google Scholar 

  • Donohew, L., Helm, D. M., Lawrence, P., Shatzer, M. J., & Watson, R. R. (1990). Sensation seeking, marijuana use, and responses to prevention messages: Implications for public health campaigns. In Watson, R. (Ed.) Drug and alcohol abuse prevention (pp. 73–93). Totowa, NJ: Humana.

  • Drug Abuse Warning Network (2007). DAWN, 2005: National estimates of drug-related emergency department visits. Rockville, MD.

  • Duistman, D. M., & Colbry, S. L. (1995). Perceived risk and use as predictors of substance use among college students. Health Values: The Journal of Health Behavior. Education & Promotion, 19, 44–52.

    Google Scholar 

  • Friedman, R. A. (2006). The changing face of teenage drug abuse: The trend toward prescription drugs. The New England Journal of Medicine, 354, 1448–1450. doi:10.1056/NEJMp068010.

    Article  PubMed  CAS  Google Scholar 

  • Fuster, J. M. (2002). Frontal lobe and cognitive development. Journal of Neurocytology, 31, 373–385. doi:10.1023/A:1024190429920.

    Article  PubMed  Google Scholar 

  • Gonzalez, G. M., & Haney, M. L. (1990). Perceptions of risk as predictors of alcohol, marijuana, and cocaine use among college students. Journal of College Student Development, 31, 313–318.

    Google Scholar 

  • Hall, K. M., Irwin, M. M., Bowman, K. A., Frankenberger, W., & Jewett, D. C. (2005). Illicit use of prescribed stimulant medication among college students. Journal of American College Health, 53, 167–174. doi:10.3200/JACH.53.4.167–174.

    Article  PubMed  Google Scholar 

  • Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112, 64–105. doi:10.1037/0033–2909.112.1.64.

    Article  PubMed  CAS  Google Scholar 

  • Herman-Stahl, M. A., Krebs, C. P., Kroutil, L. A., & Heller, D. C. (2007). Risk and protective factors for methamphetamine use and nonmedical use of prescription stimulants among young adults aged 18 to 25. Addictive Behaviors, 32, 1003–1015. doi:10.1016/j.addbeh.2006.07.010.

    Article  PubMed  Google Scholar 

  • Johnston, L. D., O’Malley, P. M., & Bachman, J. G. (2004). Monitoring the future: National results on adolescent drug use. Overview of key findings, 2003. Ann Arbor, MI: University of Michigan Institute for Social Research.

    Google Scholar 

  • Krawczyk, D. (2002). Contributions of the prefrontal cortex to the neural basis of human decision making. Neuroscience and Biobehavioral Reviews, 26, 631–664. doi:10.1016/S0149-7634(02)00021-0.

    Article  PubMed  Google Scholar 

  • Low, K. G., & Gendaszek, A. E. (2002). Illicit use of psychostimulants among college students: A preliminary study. Psychology Health and Medicine, 7, 283–287. doi:10.1080/13548500220139386.

    Article  Google Scholar 

  • McCabe, S. E., Knight, J. R., Teter, C. J., & Wechsler, H. (2005a). Non-medical use of prescription stimulants among US college students: Prevalence and correlates from a national survey. Addiction, 100, 96–106. doi:10.1111/j.1360-0443.2005.00944.x.

    Google Scholar 

  • McCabe, S. E., Teter, C. J., & Boyd, C. J. (2005b). Illicit use of prescription pain medication among college students. Drug and Alcohol Dependence, 77, 37–47. doi:10.1016/j.drugalcdep.2004.07.005.

    Article  PubMed  Google Scholar 

  • McCabe, S. E., Teter, C. J., & Boyd, C. J. (2006a). Medical use, illicit use and diversion of prescription stimulant medication. Journal of Psychoactive Drugs, 38, 43–56.

    PubMed  Google Scholar 

  • McCabe, S. E., Teter, C. J., & Boyd, C. J. (2006b). Medical use, illicit use, and diversion of abusable prescription drugs. Journal of American College Health, 54, 269–278. doi:10.3200/JACH.54.5.269-278.

    Article  PubMed  Google Scholar 

  • McCabe, S. E., Teter, C. J., Boyd, C. J., Knight, J. R., & Wechsler, H. (2005c). Nonmedical use of prescription opioids among U.S. college students: Prevalence and correlates from a national survey. Addictive Behaviors, 30, 789–805. doi:10.1016/j.addbeh.2004.08.024.

    Article  PubMed  Google Scholar 

  • Miller, N. S. (2004). Prescription opiate medications: Medical uses and consequences, laws and controls. The Psychiatric Clinics of North America, 27, 689–708. doi:10.1016/j.psc.2004.07.004.

    Article  PubMed  Google Scholar 

  • Nelson, C. B., Bloom, F. E., Cameron, J. L., Amaral, D., & Pine, D. (2002). An integrative multidisciplinary approach to the study of brain-behavior relations in the context of typical and atypical development. Development and Psychopathology, 14, 499–520. doi:10.1017/S0954579402003061.

    Article  PubMed  Google Scholar 

  • Palmgreen, P., Donohew, L., Lorch, E. P., & Rogus, M. (1991). Sensation seeking, message sensation value, and drug use as mediators of PSA effectiveness. Health Communication, 3, 217–227. doi:10.1207/s15327027hc0304_4.

    Article  Google Scholar 

  • Prudhomme-White, B., Becker-Blease, K. A., & Grace-Bishop, K. (2006). Stimulant medication use, misuse, and abuse in an undergraduate and graduate student sample. Journal of American College Health, 54, 261–268. doi:10.3200/JACH.54.5.261-268.

    Article  Google Scholar 

  • Reyna, V. F., & Farley, F. (2006). Risk and rationality in adolescent decision making: Implications for theory, practice, and public policy. Psychological Science in the Public Interest, 7, 1–44. doi:10.1111/j.1529-1006.2006.00026.x.

    Article  Google Scholar 

  • Rolison, M. R., & Scherman, A. (2002). Factors influencing adolescents’ decisions to engage in risk-taking behavior. Adolescence, 37, 585–596.

    PubMed  Google Scholar 

  • Romer, D., & Hennessy, M. (2007). A biosocial-affect model of adolescent sensation seeking: The role of affect evaluation and peer-group influence in adolescent drug use. Prevention Science, 8, 89–101. doi:10.1007/s11121-007-0064-7.

    Article  PubMed  Google Scholar 

  • Spear, L. P. (2000). The adolescent brain and age-related behavioral manifestations. Neuroscience and Biobehavioral Reviews, 24, 417–463. doi:10.1016/S0149-7634(00)00014-2.

    Article  PubMed  CAS  Google Scholar 

  • Substance Abuse and Mental Health Services Administration (2001). Results from the 2001 National Household Survey on Drug Abuse: Volume III. Detailed Tables. Retrieved December 17, 2007 from http://www.drugabusestatistics.samhsa.gov/nhsda/2k1nhsda/vol3/FrontMatter_W.pdf.

  • Substance Abuse and Mental Health Services Administration (2003). 2002 National Survey on Drug Use and Health Questionnaire. Retrieved September 26, 2006 from http://www.drugabusestatistics.samhsa.gov/nhsda/2k2MRB/2k2CAISpecs.pdf.

  • Substance Abuse and Mental Health Services Administration (2007a). Results from the 2006 National Survey on Drug Use and Health: National Findings (No. DHHS Publication No. SMA 7-4293).

  • Substance Abuse and Mental Health Services Administration (2007b). Treatment Episode Data Set (TEDS): 1995–2005: National admissions to substance abuse treatment services. Rockville, MD, USA.

  • Teter, C. J., McCabe, S. E., Boyd, C. J., & Guthrie, S. K. (2003). Illicit methylphenidate use in an undergraduate student sample: Prevalence and risk factors. Pharmacotherapy, 23, 609. doi:10.1592/phco.23.5.609.34187.

    Article  PubMed  Google Scholar 

  • United States Food and Drug Administration (2005). Patient information sheet: Adderall and Adderall XR Extended-Release Capsules.

  • United States Food and Drug Administration (2007a). Medication guide: Adderall® CII.

  • United States Food and Drug Administration (2007b). Medication Guide: Concerta® (kon SER-ta) (methylphenidate HCl) Extended-release Tablets CII.

  • United States Food and Drug Administration (2007c). Medication Guide: Ritalin LA® (methylphenidate hydrochloride) extended-release capsules CII.

  • Vincent, K. B. (2005). The ecstasy and methamphetamine drug epidemics: Implications for policy and control. Unpublished thesis. University of Maryland, College Park, MD, USA.

  • Zickler, P. (1999). NIDA launches initiative to combat club drugs. NIDA Notes, 14(6), 2.

    Google Scholar 

  • Zuckerman, M. (1994). Behavioral expressions and biosocial bases of sensation seeking. New York: Cambridge University Press.

    Google Scholar 

  • Zuckerman, M. (2002). Zuckerman–Kuhlman Personality Questionnaire (ZKPQ): An alternative five-factorial model. In B. de Raad & M. Perugini (Eds.), Big Five assessment (pp. 377–396). Seattle: Hogrefe & Huber.

    Google Scholar 

  • Zuckerman, M., & Kuhlman, D. M. (2000). Personality and risk taking: Common biosocial factors. Journal of Personality, 68, 999–1029. doi:10.1111/1467–6494.00124.

    Article  PubMed  CAS  Google Scholar 

  • Zuckerman, M., Neary, R. S., & Brustman, B. A. (1970). Sensation-Seeking Scale correlates in experience (smoking, drugs, alcohol, ‘hallucinations,’ and sex) and preference for complexity (designs). Proceedings of the Annual Convention of the American Psychological Association, 5, 317–318.

    Google Scholar 

Download references

Acknowledgements

The investigators would like to acknowledge funding from the National Institute on Drug Abuse (R01DA14845, Dr. Arria, PI). Special thanks are given to our Lead Interviewer, Elizabeth Zarate, our Graduate Assistant, Laura Garnier, the interviewing team, and the participants.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amelia M. Arria.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Arria, A.M., Caldeira, K.M., Vincent, K.B. et al. Perceived Harmfulness Predicts Nonmedical Use of Prescription Drugs Among College Students: Interactions with Sensation-Seeking. Prev Sci 9, 191–201 (2008). https://doi.org/10.1007/s11121-008-0095-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11121-008-0095-8

Keywords

Navigation