Academic journal article American Journal of Pharmaceutical Education

Substance Use Attitudes, Behaviors, Education and Prevention in Colleges of Pharmacy in the United States

Academic journal article American Journal of Pharmaceutical Education

Substance Use Attitudes, Behaviors, Education and Prevention in Colleges of Pharmacy in the United States

Article excerpt


Healthcare professionals are at risk for developing substance use disorders (SUDs). (1) According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), SUD is the updated term that embraces the two interrelated conditions of substance abuse and dependence. (2-4) The term addiction was completely eliminated from the updated SUD terminology in the DSM-5 because of its debatable definition and associated stigma. (3) The unidimensional disorder (SUD) is defined as a "problematic pattern of behaviors related to the use of substance" that can lead to significant impairment or distress. (2-5) Table 1 lists SUD criteria specified in the DSM-5 manual. SUD clinical and functional impairments may include health problems, disabilities, and being unable to meet significant obligations at home, school, and/ or work. (4,5) The most common substances associated with SUD in the United States include alcohol, tobacco, cannabis, stimulants, hallucinogens, and opioids. (2,5)

In 2003, the National Institute on Drug Abuse (NIDA) stated that 8% to 12% of healthcare workers had chemical dependencies. (6) Approximately 10% to 15% of healthcare professionals are estimated to misuse alcohol or drugs at some time during their career. (1) Among healthcare professionals, pharmacists play a central role in medical care and are medication experts, yet they are highly vulnerable to SUDs. (1) Research shows that approximately 40% of pharmacists have reported nonmedical use of prescribed drugs. (7-10) In addition, a higher percentage of pharmacists report lifetime use of an opioid or anxiolytic (approximately 25% and 14%, respectively) as compared to nurses (15% and 8%, respectively). (11) As a result, the healthcare process and patients' health might be threatened.

Substance use behaviors and/or disorders may develop during preprofessional years (ie, college years or even before). (12,13) In one study, 88% of pharmacy practitioners who admitted lifetime use of nonprescribed drugs began to use drugs during college. (7) In general, substance use behaviors among college students have been a concern for many years. According to the National Survey on Drug Use and Health (NSDUH), college students are more likely than their same age group (18-22 years) counterparts to report alcohol use. (14) Higher rates of current (within the past 30 days), binge (5 or more drinks at the same time or within 2 hours on one or more days in the past month), and heavy (5 or more drinks on the same occasion on 5 or more days in the past month) alcohol use were reported by college students as compared to rates reported by young adults not enrolled in college. (15) In addition to alcohol, research shows that college students commonly report use of other substances. For example, in a 2014 national survey, 22.3% of college students reported using illicit drugs in the past month. (15)

Previous research also suggests that healthcare professional students are a significant subsample of the college student population that is at higher risk for problematic substance use behaviors. (16-18) However, less research has examined substance use among student pharmacists in comparison to other healthcare professional students. (8,9,18,19) Substance use and its disorders can cause personal disruption and loss of productivity at school and professionally. The primary purposes of this literature review were: to highlight what is known about substance use behaviors among student pharmacists, and to identify factors that might influence problematic substance use behaviors among student pharmacists.


This review includes studies completed within US colleges and universities identified through multiple databases (PubMed, Web of Knowledge, Google Scholar, and PsycINFO). Searches were conducted using the key words "substance use" OR "alcohol" OR "caffeine" OR "cannabis" OR "hallucinogen" OR "inhalants" OR "opioids" OR "sedatives" OR "hypnotics" OR "anxiolytics" OR "stimulants" OR "tobacco" AND "student pharmacists" OR "pharmacy schools" in the title and/or abstract. …

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