Under pressure: non-medical use of prescription drugs among undergraduate students

Demenech, Lauro Miranda; Dumith, Samuel C.; Dytz, Alessandro S.; Fontes, Fernanda; Neiva-Silva, Lucas

doi:10.1590/0047-2085000000260

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ORIGINAL ARTICLE • J. bras. psiquiatr. 69 (1) • Jan-Mar 2020 • https://doi.org/10.1590/0047-2085000000260 linkcopy

Under pressure: non-medical use of prescription drugs among undergraduate students

Sob pressão: uso não médico de medicamento prescrito entre estudantes de graduação

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective To measure lifetime, last-year and last-month prevalence of Non-Medical Use of Prescription Drugs (NMUPD) as well as the characteristics associated to last-month NMUPD among undergraduate students of a university in southern Brazil.

Methods This was a cross-sectional study, with a sample that was selected through a clustered systematic sampling strategy. Multivariate analysis was conducted with Poisson regression according to a four-level hierarchical model of analysis. Fieldwork was conducted in 2015, and 1,423 students participated.

Results Lifetime, last-year and last-month prevalence of NMUPD were 25.2%, 13.1% and 8.5%, respectively. Anxiolytics and barbiturates were the most prevalent. Variables independently associated were being female, having a family income lower than one or higher than six Brazilian minimum wages, being enrolled in a health sciences-related undergraduate course, and having reported lifetime NMUPD by a friend.

Conclusions Based on these results, we suggest the development of prevention and promotion activities on this theme for students and professors, especially among those from health sciences-related courses. These interventions should focus on harmful effects of NMUPD, psychosocial coping strategies and socially established gender roles.

Non-medical use of prescription drugs; universities; students

Variable	n	%
Sex (N = 1,401)
Female	711	50.7
Male	690	49.3
Age (N = 1,307)
18 to 21 years	520	39.8
22 to 25 years	362	27.7
26 to 29 years	153	11.7
30 years or more	272	20.8
Skin color (N = 1,410)
White	1,109	78.6
Black, brown or yellow	301	21.4
Family income (Brazilian minimum wages) (N = 1,312)
Lower than one	136	10.4
Between one and six	839	63.9
Higher than six	337	25.7
Living situation (N = 1,390)
Live with relatives	915	65.8
Live alone	177	12.8
Live with peers	298	21.4
Field of study (N = 1,414)
Exact sciences	725	51.3
Humanity sciences	476	33.7
Health sciences	89	6.3
Biological sciences	124	8.7
Religious practice (N = 1,414)
Never	563	39.8
Annually	343	24.3
Monthly	265	18.7
Weekly or daily	243	17.2
Last-month use of tobacco (N = 1,415)
No	1,187	83.9
Yes	228	16.1
Last-month use of alcohol (N = 1,388)
No	408	29.4
Yes	980	70.6
Last-month use of illicit drugs (N = 1,396)
No	1,149	82.3
Yes	247	17.7
Lifetime NMUPD by friend (N = 1,408)
No	1,261	89.6
Yes	147	10.4
Lifetime NMUPD by relative (N = 1,397)
No	1,373	98.3
Yes	24	1.7

	Lifetime % (95% CI)	Last-year % (95% CI)	Last-month % (95% CI)
NMUPD	25.2 (22.9-27.5)	13.1 (11.3-14.9)	8.5 (7.1-9.9)
Types
Anxiolytics	13.1 (11.3-14.9)	7.1 (5.8-8.4)	4.7 (3.6-5.8)
Barbiturates	13.6 (11.8-15.4)	7.3 (5.9-8.6)	4.8 (3.7-5.9)
Amphetamines	10.0 (8.4-11.4)	3.6 (2.6-4.6)	1.9 (1.2-2.6)

Level	Variable	%	Crude PR (95% CI)	Adjusted PR (95% CI)
1 ^st	Sex		p = 0.002	p < 0.001
	Female	10.7	1.71 (1.23-2.37)	1.88 (1.33-2.66)
	Male	6.3	1	1
	Age		p = 0.732	p = 0.595
	18 to 21 years	8.6	1	1
	22 to 25 years	7.6	0.90 (0.60-1.34)	0.98 (0.64-1.50)
	26 to 29 years	7.9	0.94 (0.52-1.73)	1.00 (0.50-1.99)
	30 years or more	10,0	1,19 (0,77-1,85)	1,33 (0,85-2,09)
	Skin color		p = 0.266	p = 0.350
	White	9.0	1	1
	Black, brown or yellow	7.1	0.80 (0.54-1.19)	0.81 (0.52-1.26)
	Family income (BMW)		p = 0.001	p < 0.001
	Lower than one	13.2	2.17 (1.33-3.52)	2.25 (1.39-3.66)
	Between one and six	6.2	1	1
	Higher than six	11.6	1.89 (1.26-2.82)	2.04 (1.36-3.05)
2 ^nd	Living situation		p = 0.120	p = 0.064
	Live with relatives	7.9	1	1
	Live alone	12.5	1.59 (0.99-2.53)	1.40 (0.84-2.33)
	Live with peers	8.8	1.10 (0.70-1.73)	0.79 (0.45-1.38)
	Field of study		p < 0.001	p = 0.003
	Exact sciences	7.5	1	1
	Humanity sciences	8.6	1.12 (0.75-1.69)	1.07 (0.68-1.68)
	Health sciences	18.0	2.35 (1.67-3.31)	2.04 (1.30-3.22)
	Biological sciences	8.1	1.06 (0.68-1.66)	0.97 (0.58-1.61)
	Religious practice		p = 0.753	p = 0.884
	Never	8.4	1	1
	Annually	8.5	1.01 (0.66-1.55)	0.86 (0.55-1.35)
	Monthly	10.1	1.20 (0.76-1.88)	0.87 (0.54-1.43)
	Weekly or daily	7.5	0.89 (0.52-1.53)	0.87 (0.52-1.56)
3 ^rd	Last-month use of tobacco		p < 0.001	p = 0.062
	No	7.3	1	1
	Yes	15.0	2.03 (1.40-2.95)	1.53 (0.98-2.41)
	Last-month use of alcohol		p = 0.067	p = 0.161
	No	6.2	1	1
	Yes	9.4	1.51 (0.97-2.34)	1.44 (0.86-2.38)
	Last-month use of illicit drugs		p = 0.025	p = 0.057
	No	7.6	1	1
	Yes	12.2	1.60 (1.06-2.41)	1.52 (0.98-2.35)
4 ^th	Lifetime NMUPD by friend		p < 0.001	p < 0.001
	No	7.3	1	1
	Yes	20.3	2.78 (1.90-4.07)	2.63 (1.77-3.91)
	Lifetime NMUPD by relative		p = 0.029	p = 0.545
	No	8.3	1	1
	Yes	20.8	2.47 (1.09-5.54)	1.38 (0.49-3.88)

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Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro Av. Venceslau Brás, 71 Fundos, 22295-140 Rio de Janeiro - RJ Brasil, Tel./Fax: (55 21) 3873-5510 - Rio de Janeiro - RJ - Brazil
E-mail: editora@ipub.ufrj.br

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[TFN1] Notes. N = Total of respondents by category; n = Absolute frequency by category; % = Prevalence; NMUPD = Non-medical use of prescription drugs; FURG = Federal University of Rio Grande.