Beyond Performance Enhancement: Polypharmacy among Collegiate Users of Steroids

Abstract

The extremely low prevalence of steroid use among college students makes it virtually impossible to conduct analyses on any single college campus. By studying a cohort of 58,625 college students from 78 institutions that administered the Core Alcohol and Drug Survey in 1990 and 1991, a critical mass of 175 users on which it was possible to conduct statistical analyses was identified. Compared with a randomly selected group of nonusers, the steroid users reported consuming dramatically more alcohol and demonstrated higher rates of binge drinking. In addition, a significantly higher percentage of steroid users reported using tobacco, marijuana, cocaine, amphetamines, sedatives, hallucinogens, opiates, inhalants, and designer drugs. A higher percentage of steroid users than nonusers also reported experiencing negative consequences as a result of substance abuse, and a greater percentage of the steroid users reported family histories of abuse of alcohol and other drugs. Implications from the standpoint of student development are discussed.     

Perceptions of Substance Abuse on College Campuses: Proximity to the Problem,Stigma, and Health Promotion

For college students recovering from substance addiction, the path to sobriety is fraught with challenges. Many campuses offer recovery support resources, but students indicate stigma associated with recovery prevents them from using these services. This problem could be ameliorated through communication campaigns addressing misperceptions of substance abuse and recovery. The purpose of this study was to understand how students’ perceptions of addiction and recovery vary based on their experience and background. A quantitative survey was employed to examine stigma beliefs among 2 subpopulations of college students at a large Southwestern university. Findings indicate students with exposure to issues surrounding substance abuse and recovery held fewer stigmatized beliefs, emphasizing the importance of identifying and researching a target audience before developing a health promotion campaign.     

Evidence for significant polydrug use among ecstasy-using college students

Ecstasy (MDMA) has been added to the spectrum of illicit drugs used by college students. In this study, the authors estimated the prevalence of ecstasy use within a large college student sample and investigated the polydrug-use history of those ecstasy users. They administered an anonymous questionnaire to college students (N = 1,206) in classrooms at a large university in the mid-Atlantic United States. The overall student response rate was 91%. Nine percent of the sample reported lifetime ecstasy use. Because 98% of ecstasy users had used marijuana, the authors compared polydrug use between ecstasy users and individuals who had used marijuana but not ecstasy. Ecstasy users, as compared with these marijuana users, were significantly more likely to have used inhalants (38% vs. 10%), LSD (38% vs. 5%), cocaine (46% vs 2%), and heroin (17% vs 1%) in the past year. Significant polydrug use among college student ecstasy users has important implications for their substance abuse treatment.     

Psychosocial Correlates of Methamphetamine Use

Methamphetamine (MA) abuse is a devastating problem that has been sweeping the United States from west to east and has reached epidemic proportion in many areas. Literature on the drug itself, its history, and its effects are reviewed. The current project aimed to examine the psychosocial correlates of MA use using Hudson's Multi-Problem Screening Inventory (MPSI). The MPSI was given to a control group consisting of undergraduate social work students (n = 17) and a group of past-year MA users (n = 15). Differences between users and non-users were examined across the 27 domains of the MPSI, and subscales for which MA users exceeded the clinical cutting score were noted. In addition, the correlation between severity of craving for MA and MPSI scores was examined. MA users differed significantly from non-users on the depression, partner, child and neighbor problems, aggression, fearfulness, ideas of reference, phobias, guilt, disturbed thinking, memory loss, and drug abuse subscales. MA users exceeded clinical cutting scores on all of these scales except child problems; fearfulness; ideas of reference; self-esteem; sexual discord; personal stress; friend, school and coworker problems; and confused thinking. Severity of craving was correlated with MPSI score on all MPSI scales except self-esteem; sexual discord; mother, father, friend, coworker, school and family problems; suicide; non-physical abuse; and alcohol abuse. Interesting findings regarding the control group are also discussed.     

Coping with Competitors Coast to Coast

Abstract. Ecstasy (MDMA) has been added to the spectrum of illicit drugs used by college students. In this study, the authors estimated the prevalence of ecstasy use within a large college student sample and investigated the polydrug-use history of those ecstasy users. They administered an anonymous questionnaire to college students (N = 1,206) in classrooms at a large university in the mid-Atlantic United States. The overall student response rate was 91%. Nine percent of the sample reported lifetime ecstasy use. Because 98% of ecstasy users had used marijuana, the authors compared polydrug use between ecstasy users and individuals who had used marijuana but not ecstasy. Ecstasy users, as compared with these marijuana users, were significantly more likely to have used inhalants (38% vs. 10%), LSD (38% vs. 5%), cocaine (46% vs 2%), and heroin (17% vs 1%) in the past year. Significant polydrug use among college student ecstasy users has important implications for their substance abuse treatment.     

Correlates of ecstasy use among students surveyed through the 1997 College Alcohol Study

Anecdotal reports have suggested that the use of 3,4-methylenedioxymethamphetamine (MDMA or "ecstasy") is a growing problem across the United States, primarily among college students and rave attendees. To assess this contention, the drug-using behaviors of 14,520 college students were examined with data collected through the 1997 College Alcohol Study (CAS). Prevalence estimates of ecstasy use were generated and associations between ecstasy use, demographic characteristics, and alcohol and other drug (AOD) use were explored. Six percent of the sample reported lifetime ecstasy use, 3 percent reported use within the past 12 months, and 1 percent reported use within the past 30 days. Compared to non-users, 12-month ecstasy users were significantly more likely to be white, to be a member of a fraternity/sorority, and to have used all other drugs of abuse during the past 12 months. Implications for these findings are discussed.     

Childhood Sexual Abuse Severity Reconsidered: A Factor Structure of CSA Characteristics

To address the lack of empirically grounded measures of childhood sexual abuse severity, a survey of self-report items was developed following a thorough review of the childhood sexual abuse literature. An exploratory factor analysis was conducted using data collected from a convenience sample of college students that included 275 females and males with a history of childhood sexual abuse. The solution produced seven factors interpreted as the following: (a) less intrusive forms of childhood sexual abuse (e.g., sexual invitations, kissing), (b) more intrusive forms of childhood sexual abuse (e.g., oral sex, intercourse), (c) humiliation/fear, (d) childhood sexual abuse involving photography, (e) familiarity with the perpetrator, (f) physical force/rape, and (g) active digital penetration. Correlations among these factors further suggested the existence of two relatively independent second-order factors, one based on the levels of physical intrusiveness and the other composed of the psychological/emotional factors. While arguably the most common measurement of severity, physical intrusiveness had little association with critical factors such as humiliation, fear, and association with the perpetrator. Consequently, physical intrusiveness appears to be an inadequate stand-alone measure of childhood sexual abuse severity. These results are proposed to lay the groundwork for an improved, more comprehensive measure of childhood sexual abuse severity.     

Smokeless tobacco use among American college students

This study sought to delineate patterns of smokeless tobacco use among college students in the United States. A national sample (N = 5,894) of approximately equal numbers of men and women from 72 colleges and universities participated in the study. Eight percent of the college students in the Northeast used smokeless tobacco, whereas 15% in the South Central United States were using it. Seventeen percent of the American Indian, 14% of Mexican-American, 12% of white, and 4% of black students reported they had dipped or chewed. Smokeless tobacco users were more likely to have family and friends who also used smokeless tobacco. Almost two thirds (63%) of current users plan to continue to dip or chew. More than half (57%) the users consumed less than two cans or pouches per week. Smokeless tobacco is a serious problem in American colleges and universities. Unless prevention and cessation efforts target this group, the problem will continue to increase and ultimately could result in an oral cancer epidemic.     

Prevalence of Sexual Trauma History Using Behaviorally Specific Methods of Assessment in First Year College Students

There are several challenges associated with evaluating the prevalence of sexual trauma, including child sexual abuse and adult sexual assault. The aim of this study was to assess sexual trauma prevalence rates among first year college students (N = 954) using behaviorally specific questions and a more representative recruitment sample that did not rely on self-selection. Participants completed a list of sexual trauma questions, including general questions containing labels such as “rape” or “abuse” as well as behaviorally specific questions that describe specific behaviors that qualify as sexual trauma without labels. Results indicated that 6.7% of the sample reported at least one incident of child sexual abuse, with similar rates for men and women. Women were more likely to report a history of adult sexual assault, which was reported by 12.4% of the total sample. Participants were also more likely to endorse a history of sexual trauma when answering behaviorally specific rather than general “label” questions. Women survivors in particular were more likely than men to identify their experiences as abuse/assault (66.7% versus 21.1% for child sexual abuse), which may help explain prevalence differences between men and women in prior research. Men may be less likely than women to label their experiences as abuse and may be underidentified in sexual trauma research without the use of behaviorally specific questions. Overall, the results of this study suggest that the prevalence of sexual trauma is better assessed using behaviorally specific questions and that this is an important topic of study among both men and women.     

The Political,Social, and Public Health Problems of Binge Drinking in College

Abstract

Despite extensive efforts to decrease alcohol abuse among college students, prevention approaches have had limited success. This study attempted to clarify reasons for this limited success and to identify directions for future interventions by directly interviewing college students on this topic. Five issues were discussed in the focus group interviews: (1) reasons for drinking alcohol, (2) reasons for not drinking alcohol, (3) circumstances surrounding overconsumption of alcohol, (4) topics and methods for prevention, and (5) gender differences in drinking patterns.

The focus group interviews were found to be a valid tool for elucidating sensitive aspects of these issues and the relative importance of these issues to each other. The students revealed how susceptible they are to societal pressures to drink alcohol and how the limitations of their intrapersonal skills affect their alcohol consumption, most notably regarding sexuality issues. The authors contend that improving intrapersonal skills should be a major focus of programs to prevent alcohol abuse.     

Coping Strategies and Depression Among College Students Following Child Sexual Abuse in Turkey

The objective of this study was to investigate the relationship between type of coping style and depression in college students with child sexual abuse experience. A total of 1,055 college students completed self-report measures to assess depressive symptoms, coping strategies, and child sexual abuse history. This study was conducted with a subset of 125 college students who reported that they had been sexually abused in childhood. They were divided into depressive and nondepressive groups according to their depressive symptoms. Data was collected with the Childhood Sexual Abuse Measurement, the Beck Depression Inventory, and the Coping Styles of Stress Scale. Family characteristics were measured with a demographic questionnaire. Analyses involved multiple regression to test for predictive effects. Among college students with child sexual abuse histories, parental education level and both problem-focused and emotion-focused strategies significantly explained depression scores.     

Stimulant Medication Use,Misuse, and Abuse in an Undergraduate and Graduate Student Sample

In this study, the authors investigated the characteristics of use, misuse, and abuse of stimulant medication (primarily methylphenidate and variants) among students at a northeastern US university. Researchers sent an invitation to take an Internet survey to student e-mail addresses and passed 150 paper surveys in undergraduate classes, analyzing 1,025 (975 electronically) returned surveys. Sixteen percent of respondents reported abusing or misusing stimulant medication. Ninety-six percent of respondents who specified a medication preferred to abuse or misuse Ritalin. Men and women reported similar use patterns. Most respondents who abused or misused stimulant medication swallowed pills; 40% used intranasally. Reasons for abusing or misusing stimulant medication included improving attention, partying, reducing hyperactivity, and improving grades. Consistent with previous studies, results suggest that abuse of stimulant medication is a concern on college campuses. The results point to various reasons for and methods of abusing and misusing stimulant medication that may direct future research, prevention, and intervention.     

The Emerging Problems of Alcohol and Substance Abuse in Late Life

Treatment of substance abuse among older adults will become increasingly important as the number of aged Americans increases. The abuse of psychoactive substances is a major contributor to excess morbidity, mortality, and homelessness among persons of all ages and socioeconomic strata regardless of race or ethnicity. Alcohol and tobacco accountfor the majority of substance abuse-related death and disability in the United States; the former through cerebrovascular and hepatic disease, accidents and violence, the latter through chronic pulmonary disease and malignancy. Patterns of substance abuse in late life are substantially different from those observed among younger adults. However, treatment may be less challenging. Effective diagnosis and treatment requires a nonpunitive, supportive, but persistent approach. This means the capacity to collect a substance intake history and the ability to formulate a treatment plan or referral strategy to an addiction specialist or residential treatment setting. It is also important for the practitioner to manage negative feelings toward patients who decline treatment or who are chronic abusers.     

The Emerging Problems of Alcohol and Substance Abuse in Late Life

Treatment of substance abuse among older adults will become increasingly important as the number of aged Americans increases. The abuse of psychoactive substances is a major contributor to excess morbidity, mortality, and homelessness among persons of all ages and socioeconomic strata regardless of race or ethnicity. Alcohol and tobacco account for the majority of substance abuse-related death and disability in the United States; the former through cerebrovascular and hepatic disease, accidents and violence, the latter through chronic pulmonary disease and malignancy. Patterns of substance abuse in late life are substantially different from those observed among younger adults. However, treatment may be less challenging. Effective diagnosis and treatment requires a nonpunitive, supportive, but persistent approach. This means the capacity to collect a substance intake history and the ability to formulate a treatment plan or referral strategy to an addiction specialist or residential treatment setting. It is also important for the practitioner to manage negative feelings toward patients who decline treatment or who are chronic abusers.     

The implementation of buprenorphine/naloxone in college health practice

Opiate abuse and dependence have become important concerns for college healthcare providers. The passage of the Drug Addiction Treatment Act of 2000 and the approval of the combination buprenorphine/naloxone for office-based treatment of opiate dependence have increased the options available for college students and their healthcare providers. The authors review the pharmacology of buprenorphine/naloxone and discuss how it can be implemented in college health practice. They also present a case report.     

Psychological Abuse in Family Studies

Abstract

One of the first documented psychoeducational programs to educate college students about the perils of psychological abuse is described. The intervention was designed to help students examine their personal experiences of psychological abuse and consider how the information could be used in their careers. The process of creating the intervention and publicizing it to the campus community is discussed. The content of the intervention, participants, implementation, and evaluation processes are described. Operational definitions and dramatic skits of psychological abuse are described along with historical context and current research findings. Ways of working through psychological abuse, and services available to recover from it, are presented. Evaluation data, immediately after workshop completion and one week later, indicated that participants positively evaluated this intervention and reported both positive attitudinal and behavioral outcomes. Limitations and implications of this psychoeducational program for the prevention of interpersonal violence are discussed.     

Estimating Age: College Males Versus Convicted Male Child Sex Offenders

Two samples, male college students and convicted male child sex offenders, are compared on their abilities to accurately estimate the age group of a series of photographs of a sole female ranging in age from 11 to 29. Both samples tend to overestimate the age group of the subject photos, and no significant difference was found between college students and convicted child sex offenders in their ability to estimate the age of females. Both groups are compared demographically, and only limited differences were found. The implications are discussed in regard to theory and prevention of child sexual abuse.     

ADHD,depression, and substance abuse risk among beginning college students

Abstract

Objective: This study examined differences in substance use, depression, and academic functioning among ADHD and non-ADHD college students. Participants: Included 1,748 students (ages 18–25; women 68.4%; Caucasian 71.3%) with and without history of ADHD. Methods: We assessed the relationship of ADHD to substance use variables, controlling for depressive symptoms and examined relationships with GPA. Results: ADHD students were more likely to have engaged in frequent alcohol use, binge drinking, regular marijuana use and to have used other drugs in the last year. They reported higher depression symptoms than non-ADHD students, although substance abuse risk remained high even when controlling for depressive symptoms. ADHD students had lower overall GPA than those without ADHD. However, this difference was no longer significant when controlling for depression and marijuana use. Conclusions: College campuses should consider programing aimed at identifying ADHD students at risk for developing substance abuse problems and emotional difficulties.