title: Impact of alcohol and alcohol mixed with energy drinks on non-medical prescription stimulant use in a nationally representative sample of 12th-grade students.
abstract: Approximately 30% of high school students use energy drinks. Alcohol use and alcohol mixed with energy drink use (AmED) is associated with risky behavior, including non-medical prescription stimulant use. We assessed alcohol-only, AmED and non-medical prescription stimulant use among 12th grade students in the U.S. using a nationally representative secondary data from the 2012 Monitoring the Future Study.
  
  
  
  Wilcoxon-Mann-Whitney tests and logistic regression analyses were used to determine differences in non-medical prescription stimulant use by students who used alcohol-only versus AmED and to identify covariates of non-medical prescription stimulant use. Pearson-product moment coefficients were used to determine strength of variable relationships.
  
  
  
  Significant differences were found in frequency of Ritalin (p < .001, Cohen's d = .23) and Adderall (p < .001, Cohen's d = .32) use between alcohol-only students and AmED students. Greater frequency of AmED use was also associated with greater frequency of Ritalin use (r = .293, p < .001) and Adderall use (r = .353, p < .001). Males (b = .138, OR = 1.148) were more likely to use prescription stimulants non-medically than females.
  
  
  
  This study highlights the need to better understand influences on non-medical prescription stimulant, energy drink and AmED use, as the combined effects of stimulants contained in energy drinks and the depressant effects of alcohol appear to be associated with increased non-medical prescription stimulant use.
  
  
  
  Research on the influential factors related to energy drinks, alcohol, and non-medical prescription stimulants will help practitioners to more appropriately design prevention and intervention strategies addressing these high-risk behaviors. (Am J Addict 2016;25:378-384).
authors.affiliation: Department of Health and Human Performance, Texas State University, San Marcos, Texas.
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Housman
authors.affiliation: Department of Health and Human Performance, Texas State University, San Marcos, Texas.
authors.forename: Ronald D
authors.initials: RD
authors.lastname: Williams
authors.affiliation: University of Western States, Northwest Center for Lifestyle and Functional Medicine, Portand, Oregon.
authors.forename: Conrad L
authors.initials: CL
authors.lastname: Woolsey
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000517:prevention & control / Q000523:psychology; D000434:Alcoholic Beverages / Q000009:adverse effects*; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D061215:Energy Drinks / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D012309:Risk-Taking; D013334:Students / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000523:psychology
chemical_list: D000697:Central Nervous System Stimulants