Methylphenidate Consumption Behaviors among Students of Ardabil University of Medical Sciences, 2017

Introduction

Methylphenidate or Methylphenidate is derivatives of the amphetamines group. It is used to treat narcolepsy, brain damage, depression and to reduce behavioral disorders such as hyperactivity disorder and attention deficit in children^1,2. This drug exert its stimulating effect by increasing the release of dopamine from the granular reservoirs of the neural terminals and also by inhibiting the open absorption of dopamine and depending on its fast performance, its symptoms due to use appear quickly³. Despite the methylphenidate treatment effects, there are many reports of its abuse. Methylphenidate arbitrary use at high dose is associated with an increasing risk of drug addiction and physical complications such as cardiovascular disease, headache, hypertension and psychological complications such as aggression, fear and anxiety and in worse cases associated with suicidal tendencies or kill other people⁴. Studies show that the popularity of Methylphenidate has increased among students over the recent years and most students use this drug to improve their academic performance, improve concentration and own learning. In a study in California at 2006, results showed that 11.2% of students used Methylphenidate in the past year and 4% in past 30 day⁵.Risky behavior is a particular form of behavior that is associated with increased sensitivity to a particular disease or a hazard for health⁶. According to the organization for the monitoring of youth behavior reports in America, Tobacco, opium and high-risk sexual behaviors that lead to sexually transmitted infections cause to hazard for health that may be associated with illness or death^7,8.Use of opium, alcohol and high-risk sexual behaviors is responsible for 13% disability in 13-15 year old people⁹.Identifying high risk subgroups provide an opportunity for health service providers and policy makers to identify people who have the same characteristics based on risky behavior patterns. Although researchers are investigating the risk factors and Methylphenidate abuse among students, but there are many questions about the factors affecting use of Methylphenidate, ways of reducing consumption, changing the behavior of the consumer and increasing the protective ways. In research about the prevention of drug abuse, it is important to know the cognitive factors such as knowledge, attitude, tendencies and behavioral intention of individuals¹⁰. The aim of this study was to investigate Methylphenidate consumption among students of Ardabil University of Medical Sciences.

Methods

This study was a descriptive cross-sectional study that has been done on different fields of Ardabil University of Medical Sciences in 2017. By estimation the necessary parameters in 95% CI and power 80%, the estimated sample size was 150 students which selected randomly from all university students and then answered our questionnaire. We used a research-based questionnaire included questions about attitude, behavioral tendencies, behavioral intent and motivation of the respondents as well as demographic information including field, gender, educational level, age, residence place, marital status and history of smoking, alcohol, drugs and psychotropic drugs use which designed by Ataei and et al based Prototype/ Willingness Model (PWM)¹¹. All students complete the consent form and then participated in the study. The collected data were analyzed by statistical methods in SPSS version 16. P-value less than 5% was considered as significant.

Results

Among the 150 students, 52.6% were women and the rest of them were men. The mean age of students was 22.2±6 years (range: 18-40) and 83.3% of them were in age group 18-24 years. 84.6% of students were married that of them 22.1% had history of Methylphenidate use. 55.3% were non-dormitory of which 26.5% had a history of Methylphenidate use and of the 70% of PhD students, 28.6% had history of taking Methylphenidate. The history of smoking, alcohol, opium and psychotropic drugs were 26.6%, 16%, 4.6% and 2.6% among students that 75% of psychiatric drug users had a history of Methylphenidate use. There was a significant relationship between the level of education, gender, age, marital status and history of smoking, alcohol, opium and psychotropic drugs with a history of Methylphenidate abuse (Table 1). 81.6% of students referred to thinking and memory disorder as the least motivation in using Methylphenidate and 63.2% increased self esteem as the most important motivation for Methylphenidate abuse and the relationship between motivation and Methylphenidate abuse was significant (p = 0.001) (Table 2). 22.2% of Students were willing to offer Methylphenidate to their friends but there was no relationship between students’ behavioral intent and Methylphenidate abuse (Table 3). 65.8% of students pointed to Methylphenidate consumers as self-confident people and 39.5% known them as inexperienced people (Figure 1). The most commonly used Methylphenidate users were dentistry students with 72.7% and the least consumed in the field of health with 5% which was statistically significant (p = 0.001) (Figure 2). 63.2% of the students responded negatively to Methylphenidate’s suggestion that the relationship between the field of study and Methylphenidate consumption was statistically significant (p = 0.001). Also, the relationship between behavioral tendencies and behavioral intention of students with the field of study was statistically significant (P = 0.001) 60% of students say no for using Methylphenidate (Figure 3).

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Figure 1.

Attitude of students about the Methylphenidate consumers.

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Figure 2.

History of Methylphenidate use among students by fields.

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Figure 3.

Tendencies of students in exposure with Methylphenidate use.

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Discussion

The mean age of students in the study was 22.2±6 years which was lower than the internal studies done by Fallah and Jalilian et al., with an average age of 22.68 years^12,13.

In the recent study by increasing age, the percentage of consumers also increased and the age range of 30-40 years old has the highest number of consumers which may be due to not denying the use of Methylphenidate by age. The present study showed that male students had twice as much Methylphenidate use as female students while more than half of the students were women. 25.3% of students had Methylphenidate abuse and the prevalence of consumption among PhD students was higher than Bachelor students. Dentistry and hygiene students had highest and lowest rate of Methylphenidate abuse. In Low et al., this value was 35.5%, in White et al study was 16%. In the study of Habibzadeh et al., in Tabriz, the prevalence of Methylphenidate consumption was 8.7% and in the study by Jalilian et al., it was 5.4% which was lower than the present study.^4,13–15. Different studies have shown that partnership in a high-risk behavior is associated with participation in other high risk behaviors¹⁶. For example, use of smoking is seen with hookah, alcohol or other opium use^17–19. More than half of the students in the recent study had a history of smoking, alcohol, psychotropic drugs and Methylphenidate abuse which was higher than other internal studies^13,20. Similar to our study, other studies have shown that the use of AOD (Alcohol and Other Drugs) among drug users was more than people who do not use these drugs for example the use of cigarettes , alcohol, cocaine and amphetamines in these individuals is more than the general population. In this study, Methylphenidate users also had a high percentage of smoking, alcohol and other substances for example 75% of drug users had history of Methylphenidate use^1,21. In the recent study, 63.2% of students pointed to increasing self-confidence and 55.3% pointed to more focus on the lessons as the highest motivation and pointed to the disorder of thinking and memory with 81.6% and addiction and creating dependency with 55.3% were the lowest motivation for taking Methylphenidate. Studies have shown that the more motivation of students to use stimulant drugs has been to increase their concentration and increase the level of consciousness and performance. For example, in the study of Teter et al., raising focus and consciousness with 53% and 48% are the motivation for taking Methylphenidate.^14,21–25. The lack of attractiveness was the highest students’ attitude toward Methylphenidate consumers and lack of confidence is another characteristic of Methylphenidate users which in line with our study results^26–29. The desire to engage in high risk behaviors is called behavioral tendencies that its importance has been shown in many studies. In the present study, say no to the use of Methylphenidate was one of the main characteristics of students^29–31. Behavioral intention is one of the motivational factors influencing behavior. The recommendation to use Methylphenidate to the friends was the behavioral intention of students. Studies have shown that the role and influence of friends in the abuse of Methylphenidate is effective and students by increasing their living skills especially against the insistence of others, learn to say no and do not feel emotional with the suggestion of consuming substances^32,33.

Conclusion

The results indicated that increasing self-confident and improving focus during the study are the main reasons for the student’s tendency to Methylphenidate abuse that can be prevented by teaching life skills to students and providing educational programs on appropriate study methods especially during the academic term and promoting a negative tendency toward Methylphenidate abuse.