title: Nonmedical use of stimulants among medical students.
abstract: BACKGROUND
  Proliferation of the use of psychopharmacologic drugs for the treatment of individuals with attention and behavior disorders has promoted discussion of the illicit use of such drugs to enhance academic performance. Previous research has focused on the use of such drugs by undergraduate students; however, inquiry into the nonmedical use of prescription stimulants by medical students is warranted because of the unique qualities of the medical school environment (including academic pressure, stress, and competition with peers) and the demographic characteristics common to many medical students.
  
  
  OBJECTIVE
  To examine the nonmedical use of prescription stimulants among osteopathic medical students, focusing on such key associated variables as academic stress, social network connections, and use of other substances.
  
  
  METHODS
  In 2012, first- and second-year students at a large osteopathic medical school were surveyed on the nonmedical use of prescription stimulants, stress, social networks, perceptions of drug use, and related topics. Data were compared with national data and assessed using analysis of variance and χ(2) statistical tests.
  
  
  RESULTS
  A total of 380 students completed the survey. Of those, 56 (15.2%) reported using prescription stimulants nonmedically to help them study in medical school. This percentage is significantly higher than the national estimated rate of diagnosis of attention-deficit/hyperactivity disorder in similar populations (t=3.72, P<.001). Both positive perceptions of the nonmedical use of stimulants (F=14.89, P<.001) and the use of other substances (χ(2)=18.00, P<.001) were positively associated with the nonmedical use of stimulants. Social network connections did not positively predict use by medical students, and certain types of social connectivity had a negative association with use.
  
  
  CONCLUSIONS
  In contrast with research on undergraduate populations, addressing academic stress and feelings of competitiveness may not be viable strategies for mitigating nonmedical use of stimulants among medical students.
authors.affiliation: From the Department of Biomedical Sciences at Oakland University William Beaumont School of Medicine in Rochester, Michigan (Dr Wasserman), and the departments of institutional effectiveness and accreditation (Dr Cole), physiology (Dr Suminski), and clinical affairs (Dr Dougherty) at the Kansas City University of Medicine and Biosciences in Missouri. Drs Fitzgerald and Sunny were osteopathic medical students at the Kansas City University of Medicine and Biosciences College of Osteopathic Medicine in Missouri at the time of this study. They hold master's degrees in bioethics.
authors.forename: Jason Adam
authors.initials: JA
authors.lastname: Wasserman
authors.affiliation: From the Department of Biomedical Sciences at Oakland University William Beaumont School of Medicine in Rochester, Michigan (Dr Wasserman), and the departments of institutional effectiveness and accreditation (Dr Cole), physiology (Dr Suminski), and clinical affairs (Dr Dougherty) at the Kansas City University of Medicine and Biosciences in Missouri. Drs Fitzgerald and Sunny were osteopathic medical students at the Kansas City University of Medicine and Biosciences College of Osteopathic Medicine in Missouri at the time of this study. They hold master's degrees in bioethics.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Fitzgerald
authors.affiliation: From the Department of Biomedical Sciences at Oakland University William Beaumont School of Medicine in Rochester, Michigan (Dr Wasserman), and the departments of institutional effectiveness and accreditation (Dr Cole), physiology (Dr Suminski), and clinical affairs (Dr Dougherty) at the Kansas City University of Medicine and Biosciences in Missouri. Drs Fitzgerald and Sunny were osteopathic medical students at the Kansas City University of Medicine and Biosciences College of Osteopathic Medicine in Missouri at the time of this study. They hold master's degrees in bioethics.
authors.forename: Merlin A
authors.initials: MA
authors.lastname: Sunny
authors.affiliation: From the Department of Biomedical Sciences at Oakland University William Beaumont School of Medicine in Rochester, Michigan (Dr Wasserman), and the departments of institutional effectiveness and accreditation (Dr Cole), physiology (Dr Suminski), and clinical affairs (Dr Dougherty) at the Kansas City University of Medicine and Biosciences in Missouri. Drs Fitzgerald and Sunny were osteopathic medical students at the Kansas City University of Medicine and Biosciences College of Osteopathic Medicine in Missouri at the time of this study. They hold master's degrees in bioethics.
authors.forename: Maria
authors.initials: M
authors.lastname: Cole
authors.affiliation: From the Department of Biomedical Sciences at Oakland University William Beaumont School of Medicine in Rochester, Michigan (Dr Wasserman), and the departments of institutional effectiveness and accreditation (Dr Cole), physiology (Dr Suminski), and clinical affairs (Dr Dougherty) at the Kansas City University of Medicine and Biosciences in Missouri. Drs Fitzgerald and Sunny were osteopathic medical students at the Kansas City University of Medicine and Biosciences College of Osteopathic Medicine in Missouri at the time of this study. They hold master's degrees in bioethics.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Suminski
authors.affiliation: From the Department of Biomedical Sciences at Oakland University William Beaumont School of Medicine in Rochester, Michigan (Dr Wasserman), and the departments of institutional effectiveness and accreditation (Dr Cole), physiology (Dr Suminski), and clinical affairs (Dr Dougherty) at the Kansas City University of Medicine and Biosciences in Missouri. Drs Fitzgerald and Sunny were osteopathic medical students at the Kansas City University of Medicine and Biosciences College of Osteopathic Medicine in Missouri at the time of this study. They hold master's degrees in bioethics jdougherty@kcumb.edu.
authors.forename: John J
authors.initials: JJ
authors.lastname: Dougherty
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity; D000697:Central Nervous System Stimulants; D003163:Competitive Behavior; D005260:Female; D006801:Humans; D008297:Male; D012944:Social Support; D013315:Stress, Psychological; D013337:Students, Medical / Q000523:psychology* / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D000697:Central Nervous System Stimulants