Prescription Drug Abuse Amongst College Students

By Team RehabAid

Last Updated March 22, 2024

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It’s no secret that many college and university students engage in alcohol and drug use. After all, the college years are a time of experimentation and exploration. However, the danger with drug and alcohol consumption during this period is that it can easily get out of control. Confronted with so many academic pressures and new experiences, students can become overwhelmed, leading them to take substances to cope.

According to some studies, 35% of college students have used prescriptions non-medically at least once by the time they’re 25. In another study, it was reported that 38.9% had used prescription stimulants to enhance their academic performance.

While these rates are high, the good news is that abuse and addiction can be treated and prevented. This article provides information about prescription drug abuse among college students in the U.S., along with which medications are most widely abused, and how to seek help.

Prescription Drug Use in College

Prescription drug use among college and university students has been on the rise since the 1990s. This has coincided with a sharp increase in prescription drug use across the U.S. more generally, that has grown into a major public health concern. According to the Substance Abuse and Mental Health Services Administration, rates of prescription drug misuse among college students rose from 8.3% in 1996 to 14.6% in 2006. Most prevalent among these drugs are stimulants, painkillers, and sedatives.

Why Students Turn to Drugs

While ease of access has contributed to a rise in prescription drug use, another reason is the numerous new medications that have been introduced in the last 50 years. This includes depressant drugs, such as Valium and Xanax, anti-depressants such as Prozac, and stimulants like Adderall and Ritalin that are designed to treat attention-hyperactivity disorder (ADHD). The production of these drugs has also risen alongside increased clinical diagnoses for conditions like anxiety, depression, and ADHD.

Access and diagnoses aside, college students also have other reasons for turning to drugs:

Stress

High academic demands, part-time jobs, social pressures, and more can create large amounts of stress. Many students turn to drugs to cope, relax, and let off steam.

Academic Performance

Students are often burdened with big course loads and pressing deadlines. While some of this can be dealt with through appropriate time management, many students turn to study drugs to do marathon all-night study sessions and complete assignments.

Peer Pressure

Young adults are greatly influenced by their peers. Exposure to drug-taking behavior can cause students to engage in the same experimentation to fit in. They might also be influenced by other students who are using stimulants to boost their academic performance.

To Have Fun

Part of being a college student is to have fun and socialize with friends. While this is a natural and healthy thing to do, it can also expose students to risky behavior.

Problems With Drug Sharing

Drug sharing is a common problem among college students and is one of the main ways that individuals gain access. The practice is so commonplace that in some cases, nearly 50% of students with an ADHD stimulant prescription have reported being approached to sell or trade their medications.

The problem with drug sharing is it poses physical and mental health risks to people who haven’t been assessed by a doctor and had the medication prescribed to them. This is especially the case when it comes to dosage, as students will not know how much is safe to take.

Are Prescription Drugs Addictive?

The short answer is, yes. While each type of prescription drug affects the body differently, there are general ways that they lead to addiction. The first is that the body develops a tolerance to the drug, which means that the person needs to take higher and higher doses to achieve the desired effect. The second is that this increased tolerance also results in intense drug cravings if the medication is discontinued. This cycle of tolerance and cravings can create an addiction loop that is difficult to break without intervention.

Prescription drugs can also be addictive for emotional and psychological reasons. Many college students take them to help with pain, anxiety, depression, or as an aid to put in more study hours and increase concentration. The need for these drugs to cope with college life and perform to a high standard can cause students to form a psychological addiction to the drug

Statistical Overview of College Prescription Drug Use

• More than 6 million young adults meet the criteria for a substance use disorder.
• Over 28.1% of college students report misusing some type of prescription drug in the past year.
• More than 33% of students have sold, traded, or given away their prescription medication.
• 2/3 of those drugs that are sold or given away are ADHD medications, while the other 1/3 are pain medications.
• 5% of college-age people are estimated to misuse pain medications.
• Nearly 1.9 million young adults misuse opioids.
• Between 1993 and 2005, the number of students who abused tranquilizers like Xanax and Valium increased by 450%.

Prescription Drugs Most Abused by College Students

The most widely used prescription medications among college students are stimulants, painkillers, and anti-anxiety drugs. Below are the most abused drugs from those categories and their effects.

Stimulants

Stimulants produce energy and increase brain activity, alertness, and euphoria. This is due to the way these drugs stimulate the production of dopamine, a pleasure chemical in the brain. However, in high doses, stimulants can lead to high body temperature, irregular heartbeat, aggression, paranoia, heart failure, or seizures. The two most abused stimulants amongst college students are Adderall and Ritalin.

Adderall

Along with its popularity amongst students, Adderall is also the most commonly prescribed amphetamine stimulant in the U.S. According to some studies, almost 35% of college students have taken stimulant drugs without a prescription at least once during their enrollment.

While this drug is primarily used to treat attention-deficit hyperactivity disorder (ADHD) and sleep disorders, Adderall is used by students as a study drug and performance enhancer. Adderall’s ability to increase energy, attention, and focus during study makes it an easy drug to abuse.

Ritalin

Ritalin is another highly abused stimulant amongst college students, as it helps with energy and focus. The drug is similar to Adderall, as it is also used to treat ADHD; however, the difference between these two medications is that Ritalin is made of methylphenidate hydrochloride, whereas Adderall is composed of amphetamine salts. Ritalin is also widely available, making it an easy drug to misuse and abuse.

Stimulant Withdrawal Effects

Stimulants alter the functioning of neurotransmitters in the brain. Therefore, sudden discontinuation can create several uncomfortable symptoms that can cause students to continue taking them. These include:

• Depression
• Irritability
• Headaches
• Insomnia
• Increased appetite
• Fatigue
• Nightmares
• Difficulty concentrating
• Anxiety
• Suicidal thoughts

Painkillers/Opioids

Since the 1990s, access to opioid medications has become widespread, and alarmingly, overdose deaths are high. According to the CDC, 14,000 people died from prescription opioids in 2019. The issue with painkillers is that tolerance and dependence can easily occur, so ideally they should only be used in the short-term. However, opioids are commonly abused by college students to relieve pain or to experiment with and get high.

Opioid medications work by targeting the opioid receptors in the body’s nervous system to reduce pain. When these drugs are taken in excess, they can lead to feelings of euphoria that are similar to heroin. However, too much of the drug can result in physical effects, such as vomiting, breathing problems, coma, or even death.

Oxycodone (OxyContin/Percocet)

Oxycodone, which is highly addictive and causes euphoria and sedation, is another drug commonly abused by college students. When taken correctly, it is used to treat moderate or severe pain following cancer treatment, accidents, or operations. It is sold under the popular brand name, OxyContin, and is also sold in combination with acetaminophen, under the name, Percocet. This drug is so popular that, according to the Drug Enforcement Agency (DEA), 58.8 million prescriptions for Oxycodone were dispensed in 2013.

Hydrocodone (Vicodin)

Vicodin, another popular pain medication among students, contains a combination of hydrocodone and acetaminophen. Like OxyContin, Vicodin is intended for short-term use following injuries or medical procedures. As an opioid analgesic, Vicodin works by changing the way the brain responds to pain. When the drug is abused or used in excess, it can lead to feelings of euphoria and relaxation.

Codeine

Codeine is a common pain reliever that is often found in prescription-strength cough syrup and is also used to relieve the symptoms of cold and flu. It is also the most prescribed and misused of all opioids, especially among young people. When codeine is consumed in high quantities, it can cause sedation and an altered state of consciousness. Codeine is often combined with sugary soda to produce illicit concoctions known as “purple drank,” “sizzurp,” or “lean.”

Opioid Withdrawal Effects

Like stimulants, withdrawing from opioids can produce severe and uncomfortable symptoms. Medically assisted detox is normally recommended as the withdrawal symptoms can be difficult to deal with and lead to relapse. These include:

• Strong drug cravings
• Chills
• Difficulty sleeping
• Agitation or irritability
• Runny nose
• Excessive sweating
• Digestive problems

Central Nervous System (CNS) Depressants

CNS depressants are drugs that are typically prescribed to help with anxiety and sleep issues. These medications, which include barbiturates and benzodiazepines (benzos), work by attaching to the gamma-aminobutyric acid (GABA) receptors in the brain, effectively controlling the neurotransmitters that contribute to anxiety and stress. This generates feelings of calmness and muscle relaxation.

CNS depressants are more commonly known as “downers,” which are in contrast to stimulants, which are referred to as “uppers.” College students are known to abuse downers to cope with their high levels of anxiety and stress. At high doses, CNS depressants can slow your heartbeat or breathing to dangerous levels. They can also lead to seizures.

Xanax

Xanax is a potent benzodiazepine that is used to treat anxiety, panic attacks, and insomnia. When used in excess, Xanax drugs can produce a high that is similar to being drunk. It is commonly abused by college students to enhance the effects of alcohol and reduce the anxiety that can occur when coming down from ecstasy/MDMA.

However, mixing Xanax and other drugs is dangerous, especially when it comes to alcohol, as both are nervous system depressants. This combination can lead to respiratory failure, over-sedation, coma, and death.

Klonopin and Valium

Klonopin and Valium are brand names for clonazepam and diazepam, two other drugs in the benzodiazepine category. Like Xanax, these drugs are prescribed for their sedative effects and are another commonly abused drug among college students. While sometimes they are used as a party drug, in other cases, they’re taken to ease anxiety, which can lead to dependence. In high doses, these drugs can produce euphoric highs, relaxation, a feeling of drunkenness, and talkativeness.

CNS Withdrawal Effects

Like opioids, withdrawal from CNS depressants can be difficult and uncomfortable, so medically supervised detox is recommended. Some of the withdrawal effects include:

• Strong drug cravings
• Nausea
• Anxiety and panic
• Excessive sweating
• Headaches
• Difficulty sleeping
• Muscle pain

Other Abused Substances

College students are also known to abuse alcohol and other illicit drugs, which are sometimes mixed with prescription medications. The most abused substances include:

• Alcohol
• Ecstasy
• Cannabis
• Cocaine
• Over-the-Counter Medications (e.g., DXM)

Signs & Symptoms of Prescription Drug Abuse

The signs and symptoms of prescription drug abuse can vary between people, depending on the type of drug, how much they’ve taken, and long they’ve used it. However, below are some common signs of abuse to look out for:

Opioids

• Depression or anxiety
• Dizziness
• Poor coordination
• Slow or shallow breathing
• Upset stomach, vomiting, or constipation
• Slurred speech
• Mood swings

CNS Depressants

• Memory problems
• Slow breathing
• Mood changes
• Difficulty walking
• Trouble concentrating
• Poor judgment
• Slow reflexes
• Slurred speech

Stimulants

• Paranoia
• Headache
• Insomnia
• Weight loss and lack of appetite
• Dizziness
• Nervousness
• High blood pressure
• Uneven heart rate

Behavioral Symptoms

Addiction and abuse are also accompanied by behavioral signs and symptoms, which can be applied across most prescription drug types. These include:

• Low grades or poor school record.
• Running out of prescriptions early.
• Faking symptoms to get prescriptions.
• “Doctor shopping:” seeking out several doctors to acquire multiple prescriptions.
• Hiding or lying about prescription drug use.
• Continuing to use prescription medications despite their negative side-effects.
• Spending a great deal of time using, obtaining, or recovering from prescription drug use.
• Traffic or transport accidents.
• Finishing college early or dropping out.
• Isolation from work, family, and social life.
• Impulsive behaviors.
• Financial problems.
• Loss of interest in activities or hobbies
• Abusing other substances (poly-substance).
• Relationship problems.
• A decline in personal hygiene.

Risk Factors

Like most substances, there are risk factors that can make you more susceptible to prescription drug abuse. These include:

• Peer pressure or influence from friends or colleagues.
• A history of aggression.
• Lack of parental supervision and support.
• Poor academic performance.
• Mental health issues.
• Limited social skills.
• Past drug experimentation.
• Poor economic status.
• Genetics and biology.
• Mental health and/or co-occurring mental health conditions (e.g., anxiety or depression).

Effects of Drug Abuse on College Students

College should be an exciting time. Frequent drug abuse and addiction can lead to the opposite, causing harm to one’s physical and mental health and impacting one’s academic studies. Some of the potential effects that drug abuse can have on students include:

• Development of a mental illness.
• Development of an alcohol or drug use disorder.
• Physical health issues, such as reduced brain activity, sleep problems, poor concentration, fatigue, lack of coordination, irregular heart rate, weakened immune system, impaired memory, slow reaction times, and cardiovascular or respiratory issues.
• Poor behavior and academic performance.
• Decreased motivation.

Overdose

Another important thing to look out for is a potential drug overdose. Key signs and symptoms of a prescription drug overdose include:

• Confusion, delirium, hallucinations.
• Breathing problems, including slowed or irregular breathing.
• Cold body temperature, with dry skin.
• Violent mood swings.
• Bluish skin around the lips or under the fingernails.
• Nausea or vomiting.
• Pinpoint pupils.
• Coma or inability to come to sense.

Mental Health & College Students

Mental health issues are a big concern amongst college students, especially as many conditions can lead them to abuse prescription drugs. Some of the most common conditions are:

Anxiety

Anxiety is the most common mental health condition in the U.S., with some 40 million adults being affected each year. Symptoms of anxiety include racing thoughts, excessive worry, panic attacks, insomnia, and poor concentration. This applies particularly to college students, who often report strong feelings of anxiety in the face of immense academic pressures.

These feelings of anxiety can cause students to turn to drugs such as Xanax and Klonopin to cope, but the effects of these drugs far outweigh the benefits if they’re abused or used for long-term periods. Anxiety is uncomfortable, but it can be managed with counseling and treatments such as cognitive-behavioral therapy (CBT).

Depression

Depression is another common mental health condition in the U.S., affecting more than 17 million adults each year. Many college students also struggle with depression, with as many as 4.6 million of them reporting a major depressive episode in 2018. Like anxiety, depression can be debilitating, which is why many students turn to drugs to cope.

However, many drugs also create the symptoms of depression and anxiety when they wear off, which is why substance abuse can be a double-edged sword. Symptoms of depression include social withdrawal, persistent sadness, suicidal thoughts, insomnia, and loss of interest in people and activities. Students experiencing depression should seek help, as treatments are available.

Eating Disorders

Some research indicates that eating disorders such as anorexia, bulimia, and binge eating disorder are responsible for one death every 62 minutes in the U.S. Students with an eating disorder may use stimulants like Ritalin to suppress their appetite, which can also lead to abuse and addiction. While these conditions can be debilitating, they are highly treatable. The first step is to seek help and know that you’re not alone.

Preventing Prescription Drug Abuse in College

Prescription drug abuse is widespread, but it is also preventable. Below are some of the ways that students can avoid this dangerous path:

Know the Early Signs of Misuse

Misuse involves taking a medication in a way that exceeds or goes against its prescribed use. For example, are you taking the medication compulsively, rather than when prescribed? Are you taking it at higher doses than prescribed? Do you find that your physical and mental functions are impaired due to the medication? These questions can help you identify whether you are misusing the drug.

Stay Connected

College life can be scary and overwhelming, which can cause some students to withdraw. This can lead to secretive drug abuse and strong feelings of isolation. If you are struggling with drug use and/or feeling alone, reach out to colleagues, teachers, or college support staff for help. This can help provide structure and accountability.

Educate Yourself

Being educated about the dangers of addiction and prescription drug use can help you make informed decisions. This information will also help you say no if a substance is being offered to you that you don’t want to take.

Become Familiar With Your Resources

In the same way that it’s important to stay connected, it’s also vital that you get to know what resources there are on campus. For example, are there counselors or mentors on hand? Is there a health and wellness program? Are there drug information centers? By being familiar with these resources, you can better reach out for help if you need it.

Seeking Help for Prescription Drug Addiction

If you think your prescription drug use is out of control and causing problems in your life, it can be a good idea to seek help through the following:

• Speak with your campus health center physicians or mental health counselors at your college. This can be an excellent first step in seeking treatment for your problem.
• If you don’t have access to on-campus counselors or medical professionals, national drug abuse hotlines are also another option.
• Depending on where you live, you could also contact local support groups, such as Alcoholic Anonymous (AA) or Narcotics Anonymous (NA).

If required, you may need to visit an alcohol and drug treatment center. These facilities are well-equipped to provide tailored, individualized recovery plans. Below is a list of the most common forms of substance abuse treatment programs and what they entail.

Detox Programs

These clinics supervise a person’s drug withdrawal and provide supportive medications where necessary. They are usually staffed with a team of doctors and nurses who have experience with addiction and drug withdrawal. The advantage of going to a detox center is that medical assistance is readily available.

Inpatient (Residential)

These centers typically start with medical detox and are followed by a program of addiction treatment, such as therapy or counseling, for a period of anywhere between 30 days and 18 months. These facilities usually provide 24-hour medical support and are often led by a team of counselors, clinicians, and doctors.

Partial Hospitalization Programs (PHP)

PHP typically consists of hospital treatment 5 to 7 days a week for 4 to 8 hours per day. PHP also involves counseling and group therapy, as well as specialized services that focus on skill-building, relapse prevention, and employment assistance.

Intensive Outpatient Programs (IOP)

These are less involved than partial hospitalization programs and typically take place at a treatment center or outpatient clinic. Clients receiving intensive outpatient treatment will usually visit the center 2 to 5 days per week, for 2 to 4 hours per day. IOP programs vary, but they often involve a mixture of individual and group therapy, case management, 12-Step programs, experiential therapies, cognitive-behavioral therapies (CBT), and services that cover topics like skill-building, goal setting, and relapse prevention.

Standard Outpatient Programs

These programs are suited to individuals who have just completed an inpatient program and want to continue some form of therapy. Standard outpatient is also ideal for people who may be juggling other responsibilities, such as work or school. Individuals typically report to a treatment center or clinic 1 or 2 days per week.

Resources

If you or a loved one are struggling with prescription drug addiction, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.

You can also find a list of treatment centers near you on our website to help get you on the path to recovery.

Key Sources

ANAD. (2021). Eating Disorder Statistics. https://anad.org/get-informed/about-eating-disorders/eating-disorders-statistics.

Arria, A. (2006). Nonmedical Use of Prescription Stimulants Among Students. Pediatr Ann. 35(8), 565–571. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168781.

Bouchrika, I. (2020). 75 College Drug Abuse Statistics: 2020/2021 Data, Facts & Predictions. https://www.guide2research.com/research/college-drug-abuse-statistics.

Lesser, B. (2021). Frequently Drug Abuse by College Students. Dual Diagnosis.org. https://dualdiagnosis.org/drug-addiction/college-drug-abuse.

Substance Abuse and Mental Health Services Administration. (n.d.). Prescription Drug Misuse Among College Students. https://publichealth.hsc.wvu.edu/media/4239/college_students_no-samhsa-logo.pdf.

Substance Abuse and Mental Health Services Administration. (2018). Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf.

Medical Disclaimer

At RehabAid.com, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

We provide our readers with factual, evidence-based content concerning the causes and nature of addiction, as well as available treatment options. However, this informative content is intended for educational purposes only. It is by no means a substitute for professional medical advice, diagnosis, or treatment. With regard to any addiction-related health concerns, you should always seek the guidance of a qualified, registered physician who is licensed to practice medicine in your particular jurisdiction. You should never avoid or delay seeking professional health care advice or services based on information obtained from our website. Our authors, editors, medical reviewers, website developers, and parent company do not assume any liability, obligation, or responsibility for any loss, damage, or adverse consequences alleged to have happened directly or indirectly as a result of the material presented on RehabAid.com.