Blog | Tuesday, August 13, 2013

QD: News Every Day--Stimulant use prevalent during medical school

Almost one in five medical students has used psychostimulants with or without a prescription at least once in their lifetime, with more than one in 10 doing so in medical school, an online survey revealed.

Researchers surveyed 2,732 actively enrolled medical students at three private and one public medical schools in the greater Chicago area. Cathy J. Lazarus, MD, FACP, and co-authors published results in the August print edition of the Journal of General Internal Medicine.

Overall, 18% (198/1,115) of the medical students had used prescription psychostimulants at least once in their lifetime, with first use most often in college. Of these, 11% of students reported use specifically during medical school, most often to help them study (69%) and to aid with concentration (65%).

The rate of psychostimulant use ranged widely. Among those who reported use in the past 30 days, 23% reported only one use, 54% between two and 25 uses, 19% reported daily use, and 4% reported 60 to 90 uses. Stimulant users reported their median frequency was 10 to 12 separate occasions in the previous 30 days.

Students were using barbiturates, ecstasy and tranquilizers, and the preferred psychostimulants were most often amphetamine salts (Adderall; 75%) or methylphenidate (Ritalin, Concerta, Metadate and Methylin; 41%).

Users were more likely to be men, and were more likely to attend a school that determined class rank. Students were less likely to use psychostimulants if they grew up outside of the U.S.

Frequency by year of medical school was 41% among first years, 66% among second years, 60% among third years, 71% among fourth years and 50% among fifth years or beyond. Medical school students during years with USMLE steps 1 and 2 reported the highest use of stimulants.

Among those who had used a stimulant at least once, 63% reported getting them from a friend, relative, classmate or acquaintance. Among those students who had a prescription for them, 23% had given or sold them at least once. Researchers noted that giving or selling these drugs may put in harm’s way students with contraindications, such as undiagnosed cardiac disease, hyperthyroidism, or mood disorders, and that psychostimulant use was significantly associated recreational drugs.

“Medical students are at a unique juncture in their medical and professional endeavors,” the authors wrote. “Their pre-medical career takes place in an intensely competitive academic environment, in which many have adapted methods that ensure academic success, such as the use of cognitive-enhancing medications to supplement study habits. Once students enter medical school, additional stresses to obtain competitive residencies or to maintain high academic performance in an even more competitive environment can reinforce continued drug use by becoming an additional coping mechanism to tackle academic challenges.”