Other momentary substance behaviors as predictors of college students’ prescription drug misuse in daily life: an exploratory study

Abstract

Background

Limited prior research to examine co-occurrence of prescription drug misuse with other substances among young adults has documented outcomes that are more problematic for those with higher rates of co-ingesting alcohol. There is a need to understand how college students in this period of heightened risk use other salient substances in moments of their prescription misuse in daily life.

Method

Young-adult college students who engaged in recent prescription misuse (N = 297) completed ecological momentary assessment (EMA) over a 28-day period, resulting in 23,578 reports. Multilevel modeling examined within-person associations between other momentary substance use (including alcohol, nicotine, energy drinks, and marijuana) and prescription misuse in daily life. Analyses accounted for between-person characteristics, having a current focal prescription, and effects of reporting over time. Participant sex was also explored as a moderator.

Results

In adjusted multilevel models, college students’ momentary nicotine use and energy drink use each were associated with their greater likelihood of prescription misuse in daily life. In contrast, momentary marijuana use was linked with lower likelihood of misuse. Moderation results indicated that males (but not females) were less likely to engage in prescription misuse in moments of their alcohol use.

Conclusions

Drawing from data obtained using EMA, findings provide novel insights about the real-world associations between prescription drug misuse and other salient substance behaviors during a developmental period that is important for establishing later substance use and health.

Keywords:

• College
• prescription drug misuse
• alcohol use
• nicotine use
• marijuana use

Authors’ contribution

Lauren M. Papp, Department of Human Development and Family Studies, University of Wisconsin-Madison. Chrystyna D. Kouros, Department of Psychology, Southern Methodist University.

Ethical statement

We have followed ethical guidelines for conducting research with human participants. Participants completed informed consent procedures prior to data collection. Prior to the study, we obtained a Certificate of Confidentiality from the NIH and University IRB approval.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets generated during the current study are not publicly available due to the funded grant’s data-sharing process but are available from the corresponding author upon reasonable request.

Notes

1 The generalized multilevel model was estimated again using only the Level 1 EMA reports and associated follow-ups that were completed within 15 min of being sent. Results of the focal substance use predictors of misuse in daily life were consistent (in terms of directionality of associations and meeting statistical significance levels) across the full and reduced EMA datasets. Results based on the full EMA dataset were reported to maximize statistical power.

Additional information

Funding

Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number R01DA042093. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.