Perceived Risk and Prescription Amphetamine Misuse Among US High School Seniors: A Cross-Sectional Analysis
Michael X Peck1, Maria A Parker1
1School of Public Health, Department of Epidemiology & Biostatistics, Indiana University, Bloomington, Indiana, USA.
Background:
Perceived risk, or an individual's perception of the risk associated with a behavior, has been identified as a protective factor against initiating prescription stimulant use. This study examined the association between perceived risk and misuse of prescription amphetamines among US high school seniors.
Methods:
We analyzed 12th grade data from the Monitoring the Future (MTF) study (2012-2023; n = 16,927). Perceived risk of occasional Adderall use was self-reported, with responses ranging from "No Risk" to "Great Risk." Weighted modified Poisson regression models with robust standard errors assessed the cross-sectional association between perceived risk of Adderall use and past 30-day prescription amphetamine misuse, adjusting for demographic covariates. We also ran sex-stratified models to examine sex differences.
Results:
Approximately a third of students perceived "Low Risk" (32.5%), 25.7% perceived "Moderate Risk," and 41.% perceived "High Risk" of occasional Adderall use. Overall, 2.9% used prescription amphetamines in the past 30 days. Higher perceived risk of occasional Adderall use was significantly associated with lower prescription amphetamine misuse for students perceiving "Low Risk" (APR = 5.65, 95% CI: 4.21, 7.59) and "Moderate Risk" (APR = 1.98, 95% CI: 1.39, 2.83) compared to "High Risk." This association held for both males and females, with no significant sex differences across risk groups.
Conclusion:
Perceiving higher risk of occasional Adderall use was associated with lower prescription amphetamine misuse among US high school seniors. Findings support the role of perceived risk as protective and underscore its relevance for early intervention strategies. Future longitudinal studies are needed to clarify the directionality and temporality of this association.
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