College students are more likely to have problems with alcohol abuse or with alcoholism rather than with drug abuse or dependence; however, drug abuse is also a problem for many students. Some students are illicit abusers of prescription drugs, while others use illegal drugs: marijuana, cocaine, methamphetamine, and other drugs. Peer pressure and/or loneliness or other factors may lead college students to substance abuse, although some students had previously abused alcohol and/or drugs in high school.
In general, college students have a lower risk of using illicit substances than their peers who do not attend college; for example, college students were much less likely to abuse cocaine than their same-age peers, and only 9. 5 percent of college students have ever abused cocaine, compared to 16. 5 percent of their same-age peers. Among college students, the next most frequently abused drug after alcohol was marijuana, which was abused by 49. 1 percent of college students and 57. percent of their same-age peers not in college. However, research from the annual Monitoring the Future study, released in 2005, reveals that college students have higher rates of abuse than their age peers for some specific drugs, such as flunitrazepam, gamma hydroxybutyric acid (GHB), and ketamine. These drugs are all considered date rape drugs, or drugs that are administered to others without their knowledge or permission for nefarious purposes; however, these drugs are sometimes used voluntarily and knowingly by students.
In addition, college students are more likely to abuse methylphenidate (Ritalin) than their noncollege peers; about 5 percent of college students abuse methylphenidate compared to less than 2 percent of their peers not attending college. In most cases, males, whether in college or not, were more likely to abuse drugs than females. However, females were slightly more likely to abuse alcohol than males, whether the women were in college or not. In general, male college students consume larger amounts of both alcohol and illicit drugs than female students; for example, in 2004, 6. percent of male college students abused marijuana on a daily basis, compared to 3. 1 percent of females, according to the Monitoring the Future study. In addition, nearly half (49 percent) of college males reported having five or more drinks in a row over the previous two weeks, versus 38 percent of college females who reported this type of binge drinking behavior. There were also some other gender differences in consumption of marijuana; for example, male college students were more likely to use marijuana than were their noncollege male peers, while female college students were less likely to abuse marijuana than their female peers.
In considering the 30-day prevalence of the abuse of illicit drugs, prescribed drugs, and alcohol in 2004 male college students were slightly more likely to abuse illicit drugs (26. 1 percent) than their noncollege male peers of the same age (25. 3 percent). In contrast, female college students were less likely to abuse illicit substances than noncollege females. Male college students were also more likely than their same-age male peers to abuse marijuana over 30 days, although again, this finding was not true for female college students, who had a lower abuse rate than their noncollege female peers.
Surprisingly, when considering the 30-day prevalence, male college students were more likely than the noncollege male peers to abuse both cocaine and crack cocaine. Some college students abuse prescription drugs. Studies have shown that college students were also less likely to use other drugs than their age peers, such as methylenedioxymethamphetamine (MDMA/ecstasy), as well as prescription drugs such as Vicodin, a form of hydrocodone. In addition, college students were much less likely to use crystal methamphetamine (“ice”); or 2. 2 percent of the college students abused this drug compared to 8. percent of their noncollege same-age peers. In one random sample of more than 9,000 undergraduate students, reported in Drug and Alcohol Dependence in 2005, the researchers found that the illicit use of prescription painkiller drugs in the past year was a greater problem among undergraduate students with a prior prescription for pain medication.
For example, only 4. 4 percent of women who had had no painkillers prescribed used pain medications illicitly in the past year, compared to 9. 4 percent who had been previously prescribed painkillers in college. With regard to prescription drug abuse, the abuse rates were higher for men; 6. percent of the male college students who had not previously used prescription painkillers had abused these drugs in the past year, compared to 15. 4 percent of the male college students who had been prescribed a painkiller in college. The researchers also found that college students who had been prescribed a prescription painkiller while in elementary school were more likely than others to abuse painkillers in college; for example, about 14 percent of the men and 16 percent of the women who reported past year illicit use of pain medications had been prescribed painkillers in elementary school.
The researchers state: Of greatest significance is our finding regarding early exposure to pain medication. Interestingly, those exposed earlier to prescription pain medications reported higher rates of illicit use of prescription pain medications and this positive relationship was apparent across every age of exposure and was particularly evident among women. In other words, the earlier the initiation of prescribed pain medication, the higher the reported use of illicit pain medication both lifetime and in the past year and this indicated that this was not merely a cumulative effect of illicit use.
Furthermore, this positive relationship remained across every age of exposure after controlling for other important variables such as race, class year, among others. For both male and female college students, prescription painkiller drug abuse in the past year was more common among those who lived outside the city in which the university was located or lived in a house or an apartment, compared to those students who lived in a residence hall (dormitory).
College students who had lower grade point averages (GPAs), such as below a 2. 5 GPA, were more likely to have used painkillers illicitly in the past year. The researchers also found that most of the students had obtained the prescription pain medication illicitly from their peers, and the next most common source were family members (and most often their mothers). In some cases, the family members were medical professionals, such as nurses, who gave the drug to their child to alleviate pain rather than to induce intoxication.
Often when they had obtained the drug from a friend, abusers combined the prescription painkiller with alcohol. Those users who obtained the drugs from their peers had significantly higher rates of other forms of substance abuse than those who obtained the drugs from their family members. In a more recently reported study on college students and prescription drug abuse, reported in 2005 in Addiction, the researchers sampled nearly 11,000 college students in 2001 on their abuse of prescribed stimulants, such as Adderall, Dexedrine, and Ritalin.
They found higher rates of prescription drug abuse among students in northeastern colleges with competitive admission standards. Members of fraternities and sororities were more likely to abuse stimulants than other students. Abusers were more likely to report that they also abused alcohol, cocaine, marijuana, and Ecstasy in addition to the prescription drugs. As drug abuse was a historical problem, in the early 20th century, many individuals believed that drug addiction was treatable or at least tolerable.
However, since most addicts were middle- and upper-class women, often addiction was simply ignored. For those who sought treatment in the early part of the century (mostly men), facilities for individuals afflicted with drug abuse dotted the nation and primarily served those who could afford to pay their fees. The treatments of that time (hot baths, purgatives, and so forth) did not work, but the point is that attitudes toward the addict were not negative. This situation changed.
By about 1920, physicians were deeply split between those who felt it acceptable and humane to treat drug addicts with maintenance doses of the drug to which individuals were addicted and those doctors who considered it immoral to sell “dope” to so-called dope fiends. Many physicians believed that there was no organic basis for addiction, and consequently, anyone addicted to drugs should be compelled to stop taking drugs altogether. Some key figures, such as Dr. Lawrence Kolb, Sr. of the United States Public Health Service, believed normal people could not become addicted to drugs and only psychopathic individuals would develop an addiction. He believed a normal person would experience no euphoria from a morphine injection, whereas a psychopath would experience such a high. Many modern studies have shown that some individuals have a genetic predisposition toward substance abuse; however, their physiological reaction to an initial injection of opiates is, as far as is known, the same as or similar to the experience of those who have no familial predispositions toward addiction.
Reformers became distressed by opium-laced remedies in the early part of the 20th century, and in 1905, Samuel Hopkins Adams ran his “Great American Fraud” series in Collier’s magazine, attacking suppliers of these nostrums. This series was influential in affecting public attitudes. In addition, after the passage in 1906 of the federal Pure Food and Drug Act, which required labeling of narcotics and alcohol on the bottle, the narcotic content of most patent medications diminished. According to Musto, the morphine content of Mrs. Winslow’s Soothing Syrup declined from 0. grain per ounce in 1908 to 0. 16 grain in 1911, and morphine was totally removed from the product by 1915. According to Spillane in Federal Drug Control, prior to World War I, many physicians believed in the antibody theory of addiction: that drug use somehow created antibodies in the blood of addicts, who, as a result, were helpless to end their drug addiction. Says Spillane, “These physiological changes were [believed to be] beyond the control of the addict, and many doctors accepted that these changes required maintenance doses to be given indefinitely.
Many of the leading supporters of the narcotic clinics had been schooled in versions of the antibody theory. ” Researchers now know that chronic drug use can result in brain changes, although these are not caused by antibodies or reactions to viruses, as far as is known. By 1919, the theory that antibodies caused addiction was no longer in favor, and instead, addicts were believed to be mentally defective or psychopathic, with no willpower to resist addictive drugs. Law enforcement was seen as the answer to keep addicts away from the drugs they craved.
Because of this punitive attitude and change in policy, most narcotic maintenance clinics were closed by 1921. Researchers for the National Survey on Drug Use and Health found distinct patterns among those youths who were more likely to abuse alcohol and drugs, including differences in gender, age, race, and ethnicity; perceived parental attitudes toward illegal drugs; attitudes toward school; the belief that religious beliefs were important; and fighting and delinquent behavior.
Gender Among youths ages 12-17 years in 2004 in the United States, the rate of overall substance abuse was nearly identical for girls and boys: 9. 0 percent for females and 8. 7 percent for males. However, with regard to the abuse of marijuana, significantly more girls abused the drug. In fact, since 2002, more girls than boys started using marijuana for each year, and in 2004, 675,000 girls started using marijuana, compared to 577,000 boys who had an onset of marijuana use. It is also true that teenage girls are more likely than adolescent boys to engage in prescription drug abuse.
In 2004, 14. 4 percent of adolescent girls had misused prescription drugs in their lives, compared to 12. 5 percent of teenage boys. In considering prescription drug abuse in the past month, 4. 1 percent of teenage girls had abused prescription drugs, compared to 3. 2 percent of teenage boys. These abuses may be at least in part due to a rate of depression among adolescent girls that is more than double that among teenage boys; for example, 2. 40 million teenage girls had ever suffered a major depressive episode in 2004, compared to 1. 07 million of adolescent males.
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