A Qualitative Study of Nonmedical Prescription Stimulant Use

Principal Investigator: Sheigla Murphy, PhD
Co-Principal Investigator: Paloma Sales, PhD
Supported by a grant from the National Institute on Drug Abuse (R01 DA 033594)
We are conducting a 36-month qualitative/quantitative mixed methods study of adult non-medical prescription stimulant users in the San Francisco Bay Area. We define “non-medical prescription stimulant use” (NPSU) as the use of prescription stimulants in a manner other than prescribed, including use for cognitive performance enhancement, recreational purposes, or to self-medicate for ADHD-type or other problems. NPSU among college students has been well documented. The college environment may influence NPSU because the acute stimulant effect of the drug is effective for staying up late to cram for exams or late-night partying. To date, research studies ignore an entire population of non-students who use non-medical prescription stimulants (NPS) as performance enhancers for work or for recreation. There are indications that adults older than 25 also use prescription stimulants. It is estimated that 60 percent of children with ADHD will continue to display symptoms of ADHD into their adulthood. It is also estimated that 4 percent of adults in the U.S. have ADHD. What we do not know is how older adults use prescription stimulants non-medically to self-medicate, to help them get through the workday, or for recreational purposes. Thus, we will conduct an in-depth investigation of the experiences of NPS users in three age cohorts.
Using an adaptive intersectionality theoretical and methodological framework, we will conduct in-depth qualitative interviews with 150 participants. Fifty will be between 18 – 25 years of age, fifty 26 – 45 year olds who make up the first cohort of recipients of ADHD medications (the oldest of whom would have been 18 in 1994), and fifty who are 46 and older. All participants will have used prescription stimulants non-medically at least 6 times in the twelve months prior to interview. We will examine the types of prescription stimulants and their use of other prescription drugs and/or street drugs or alcohol to counter or enhance the effects of prescription stimulants. We will explore the intersection of individual factors, including life stage and social location that contribute to decisions to use prescription stimulants non-medically, motivations to use, knowledge about risks and benefits of prescription stimulant use, any adverse health or social consequences experienced, availability and diversion of prescription stimulants, differences in attitudes and behaviors relating to NPSU and differences among the various age groups concerning all of the above.
The proposed research addresses a gap in our knowledge of NPSU across various life stages. Findings will contribute to our understandings of users’ experiences, including motivations to use, decision-making processes, perceptions of risk, health and social consequences of use, sources of prescription stimulants, and impact of age cohort on all of the above. The proposed research will also pinpoint the most important intersecting factors that contribute to the initiation and continuation of NPSU. Findings from this proposed study will be the first step in the development of large-scale studies to test emergent hypotheses and will aid in the development of effective and age appropriate education, prevention, and treatment interventions for NPSU through the identification of appropriate targets and the most effective pathways for prevention information delivery.