Self-reported use of methylphenidate by hostel students at a South African tertiary academic institution

Abstract

The study set out to determine the extent and nature of methylphenidate use by hostel students from a South African tertiary academic institution. The study was executed in two phases: the literature phase and empirical phase. The literature phase involved a comprehensive literature review that served the purpose of contextualising the study. The empirical phase entailed a quantitative cross-sectional study that used a structured questionnaire to obtain data. The study population consisted of 328 voluntary participants from ten randomly selected hostels at a South African tertiary academic institution. Data were captured using Excel® and analysed using IBS SPSS Statistics 22. Descriptive statistics included frequencies, means, standard deviations and percentages. Categorical data were analysed with the Chi-square (χ2) test and tested for significance using Pearson’s correlation coefficient. Effect sizes were determined with Cramer’s V where ~0.1 was indicative of a small effect, ~0.3 of a medium effect and 0.5 or larger of a large effect. Numerical data were analysed using a student t-test. A result was considered to be statistically significant when p≤0.05. The results revealed that one in four hostel students have used methylphenidate at least once in their lives. Half of the students who have had prescribed methylphenidate prescribed to them have never been diagnosed with ADHD. The majority of all users have used methylphenidate during their time at university (79.8%) and most of the methylphenidate users started using the drug in high school or university (89.6%). Medical users were more likely to use methylphenidate every day (45.8% vs. 11.3%; p=0.001) while nonmedical users tended to rely on methylphenidate before examinations (73.6%) and semester tests (43.4%). The most common reasons for methylphenidate use were for academic purposes. Recreational reasons for use were uncommon. No correlation could be found between methylphenidate use and demographic characteristics. Approximately 86% of all users have experienced adverse effects due to methylphenidate use, the most common of which were sleep difficulties and reduced appetite. Students more often reported they have used extended release methylphenidate (85.7%) than immediate release (14.3%). Unfortunately, due to low reported rates, no analysis could be conducted for the route of administration used. Both medical and nonmedical users have used illicit sources to acquire methylphenidate, for instance 58.8% of all users have acquired it from friends. Finally, users were found to be more knowledgeable about methylphenidate than non-users (p=0.002). The study shows that hostel students from a South African tertiary academic institution divert methylphenidate and use it in nonmedical ways. It also provides evidence to suggest that a large proportion of methylphenidate prescriptions are not for the two registered uses.