University students' self-reported reasons for abstinence from prescription and non-prescription stimulants and depressants

Background: No previous publication has evaluated whether the importance of university students' reasons for abstinence differs across prescription stimulants, prescription opioids, and two illicit forms of those medications (cocaine and heroin). Methods: In response to a recruitment email sent to all enrolled undergraduates at a large public university, 768 students who reported no prior recreational use of these four substances rated the importance of 17 reasons for lifelong abstention from each of the four drugs. Results: Based on factor analyses, 16 of the 17 reasons comprised four subscales (Negative Consequences, Difficult to Acquire, Not Enjoyable, Social Disapproval). With few exceptions, importance ratings for each of the four subscales and the single non-loading reason (Against My Beliefs) were highest for heroin, followed in descending order by cocaine and the two prescription medications. Female students rated three types of reasons as more important than did males, but previous use of other illicit drugs and past medical use of prescription stimulants or prescription opioids were not typically associated with importance of reasons for abstaining. Conclusion: Each type of reason was rated a more important influence on abstention from street drugs than from comparable prescription drugs. Reasons reflecting harmful consequences were rated most important and reasons reflecting acquisition difficulties were rated least important for each drug. To the degree that importance ratings are associated with continued abstinence, education and prevention messages could emphasize negative consequences as one means to reinforce continued abstinence from these drugs.