College-based social and situational predictors of real-time prescription drug misuse in daily life.

Background: This study examined social and situational context predictors of prescription drug misuse among college-students at a large public university in the Midwest. Social and situational context predictors considered were hour of the day, weekend vs weekday, whether participants were at home or another place, and who they were with during instances of misuse. Salient social events, including home football games, city-regulated parties, and the 2019 Midwest polar vortex were also recorded.

Method: Using ecological momentary assessment methodology, 297 students completed momentary reports for 28 days. Participants indicated whether they had misused prescription medication (sedatives or sleeping pills, tranquilizers or anxiety medications, stimulants, and pain relievers) and reported on their social and situational context in the moment of misuse.

Results: Multilevel modeling indicated that participants were more likely to misuse prescription medication earlier in the day vs. the evening, on weekdays vs. weekends, when at home vs. not at home, and while alone vs. with others.

Conclusions: This study provides descriptive information on the social context in which prescription drug misuse is most likely to occur among college students. Our findings suggest that social and situational contexts of prescription drug misuse likely differ as compared to other substances (e.g., alcohol) among college students. Further research aimed at identifying momentary predictors of prescription drug misuse in this population is warranted.