Systematic Review: Nonmedical Use of Prescription Stimulants: Risk Factors, Outcomes, and Risk Reduction Strategies.
Level 3 - non-randomized controlled study
Systematic review of predominantly observational and survey studies rather than randomized trials
PubMed 31326580 · doi:10.1016/j.jaac.2019.06.012
What was done
Authors systematically searched PubMed, PsycINFO, and SCOPUS from inception to May 2018 (along with author-identified references) for empirical studies evaluating the nonmedical use (NMU), diversion, characteristics, risk factors, outcomes, and risk-reduction strategies regarding prescription stimulants.
What was found
A total of 111 studies met inclusion criteria, with the majority focusing on college students. Self-reported NMU prevalence across population samples ranged from 2.1% to 58.7%, while diversion rates ranged from 0.7% to 80.0%. Most use was oral, though non-oral routes occurred and carried greater risk for severe adverse outcomes, including death. While academic and occupational enhancement was the primary self-reported motivation, there was little evidence demonstrating improved academic performance among individuals without ADHD.
Why it matters
This review synthesizes the scope of stimulant misuse and dispels the common assumption that nonmedical stimulant use boosts academic performance in healthy individuals. It highlights the need for consistent institutional policies, standardized definitions, and targeted harm-reduction strategies.
Limits
Studies relied heavily on self-reported data with wide variance in prevalence rates, and were largely restricted to college student populations. The underlying literature suffered from inconsistent terminology defining nonmedical use and heterogeneous methodology, precluding meta-analytic pooling.
Cited by
- contradicts Approximately 80% of college students have taken prescription stimulants without a prescription.