Social norms of college students engaging in non-medical prescription drug use to get high: What's sex got to do with it?

Relationships exist between perceived peer and own use of alcohol, cannabis, and tobacco, particularly when peers and participants are sex-matched. We investigated sex influences on social norms effects for college students' non-medical prescription drug use (NMPDU). Methods: N = 1986 college students reported on their perceptions of male and female peers' NMPDU frequency and their own past-month NMPDU. Results: Approximately 3% of students self-reported past month NMPDU, with no sex differences. In a linear mixed model, participants who engaged in NMPDU perceived significantly more frequent peer use. Female participants perceived more frequent peer NMPDU than did male participants, particularly when perceiving male peers' NMPDU. Significant positive correlations were found between perceived peer NMPDU frequency and participants' own NMPDU for all peer-participant sex combinations, with no evidence for stronger correlations with sex-matched pairs. Conclusions: While social norm interventions may be effective for college student NMPDU, sex-matching of these interventions is likely unnecessary.Emerging adults (18-25 years) show elevated rates of substance use relative to other age groups.1 Almost 80% of emerging adults have engaged in past-month alcohol use2 and approximately 7% have a substance use disorder.3 In the context of the current prescription drug crisis,4 approximately 14.4% of emerging adults report past-year5 and 4.8% report past-month non-medical prescription drug use (NMPDU).6 NMPDU rates among college students are particularly concerning. Stimulants, opioids, and sedatives/tranquilizers are the most common types of prescriptions taken non-medically among college students, and their past-year prevalence rates of NMPDU for each type of prescription drug has been reported to be 19.6% for stimulants, 17.3% for opioids, and 11.8% for sedatives/tranquilizers.7 NMPDU has been associated with numerous adverse consequences among college students such as physical reactions (eg, stomach pain or vomiting), functional or cognitive impairment (eg, academic problems, feeling detached from reality, difficulties speaking), relationship issues (eg, causing emotional harm to loved ones), financial repercussions, dependence, or overdose.8,9 The concerning rates of NMPDU and the severity and breadth of associated harms among college students highlight that this phenomenon warrants further investigation.