Prevalence and Correlates of Non-Prescribed Methylphenidate Use: A Cross-Sectional Study in Dutch University Students.

BACKGROUND: Methylphenidate, prescribed for ADHD, is also used without prescription by students to enhance cognitive performance. While correlates of non-prescribed methylphenidate (NPM) use have been identified, few studies compared recent and former use across domains. This study examined sociodemographic characteristics, academic progress, study related experiences, mental wellbeing, and substance use associated with recent and former NPM use. METHOD: Participants (N = 3,494; Mage = 22.6, SD = 2.5; 70.2% female) from the Healthy Student Life study completed an online survey (Wave 2, 2022). With multinomial regressions we examined correlates of recent and former versus never use. RESULTS: Lifetime and recent NPM use were reported by 6.6% and 2.7% of students. Both recent and former use were associated with more substance use, living with roommates (vs. parents) and higher age. Recent use was linked to poorer study experiences, lower academic performance, and reduced mental wellbeing. Former use showed limited associations (higher prevalence of past substance use, higher scores on burnout symptoms). In the final model, recent use was strongly associated with higher prevalence of nicotine, party stimulants and sedatives, higher scores on cognitive impairment, more Fear of Missing Out, and higher age, explaining 33.3% of the variance in NPM use. CONCLUSION: NPM use is embedded in substance use patterns, with students using one substance more likely to use others. Associations with academic, wellbeing, and sociodemographic factors were observed but explained less variance. Findings underline the importance of addressing NPM use in the wider context of student health and substance use prevention efforts.