To our knowledge, this is the only large-scale investigation that examined the sources of prescription medication for illicit use among college students. Illicit users of prescription medication in the present study were most likely to obtain prescription medications from peer
sources and such individuals were at particularly high risk for alcohol and other drug misuse. The results provide no evidence that undergraduate students were obtaining prescription medication via the Internet. In our sample, abusable prescription medications appeared to be readily available for illicit use and this could partially explain the apparent lack of purchase via the Internet. While there is evidence that prescription drugs are widely available via the Internet (Califano, 2004
), there needs to be more research to determine the prevalence of purchasing these drugs online.
Illicit users who obtained prescription medication from peer or other (non-family) sources reported significantly higher rates of alcohol and other drug use than non-illicit users or students who obtained prescription medication from family members. In contrast, alcohol and other drug use did not differ in most instances between illicit users who obtained prescription medication from family members and non-illicit users. Thus, illicit users who obtained prescription medication from peer or other (non-family) sources should be considered a high-risk population based on their substance use behaviors.
The findings of the present study have several important implications for future practice and research. Despite the increase in illicit use, prescription medications (e.g., stimulants, benzodiazepines and opioid analgesics) remain highly effective and safe for the majority of individuals who use these drugs as prescribed (Augustin, 2001
; Greenhill et al., 2002
; Savage, 2003
; Zacny et al., 2003
). However, clinicians prescribing abusable medications should exercise caution and not overprescribe these medications to college students. Clinicians can limit both the quantity (e.g., number of tablets or capsules) of medication prescribed as well as the number of refills, thereby limiting the supply. In this study, family members were common sources of opioid analgesic, sedative/anxiolytic, and sleeping medications. Indeed, parents made up the majority of family sources for supplying these medications, a finding that is consistent with Pedersen and Lavik’s (1991)
study in which the parents were a significant source of benzodiazepines. Although the present study provides evidence that students who obtained prescription medication from family
members were not at the same increased risk for other drug use as students who obtained these drugs from peer
or other sources
, there are still risks associated with obtaining prescription medication from family
members. Individuals who receive abusable prescription medication from family
members are unlikely to receive the appropriate information about its actions and possible negative interactions with other substances. In addition, family members may not be aware of possible contraindications or adverse consequences. Taken together, these findings suggest there is a need to educate family members and parents about the potential dangers associated with providing abusable prescription medications to their children. The present study identified 18 possible sources of prescription drugs among undergraduate students and these sources can be used in future research. Based on the increasing rates of illicit prescription drug use among adolescents and young adults, it is imperative that future research carefully examine how these individuals are obtaining prescription medication for illicit use (Johnston et al., 2003
; Mohler-Kuo et al., 2003
The current study included some limitations that must be taken into account. First, the sample in the present study was from a single university so similar studies should be conducted on other college campuses. Second, we did not collect information regarding DSM-IV substance abuse or dependence criteria and future work should examine whether the sources for obtaining prescription drugs differ between those with and without DSM-IV substance abuse or dependence. Third, we found almost 3 out of 10 illicit users did not specify a source. Finally, non-response may have introduced potential bias in the present study.
Despite these limitations, the findings of the present study provide compelling evidence that peers represent the leading source of prescription medication among undergraduate students who report illicit use in the past year. Illicit users who obtained prescription medication from peer sources or other non-family sources also reported higher rates of alcohol and other drug use. Based on the findings of the present study, students who obtain prescription drugs from peer sources should be considered a high-risk population for polydrug use.