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Prescription Drug Misuse

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Prescription drug misuse is a largely unaddressed and fast growing issue among college students.

Some students try to manage their lives by misusing prescription drugs, either with their own prescription or with medications they do not have prescriptions for. There are many serious health and legal dangers of misusing controlled substances without a prescription. It is especially important to educate college students on the many dangers of misusing prescription drugs about half of all college students will have the opportunity to misuse a prescription drug by their sophomore year. Students may turn to prescription drugs to improve academic performance, relieve stress, or even self-medicate.


Quick Links

National Data  |  Missouri Data  |  The Problem  |  Risks  |  Alternatives  |  Bystander Informatiaon 

National Data

In 2023,  14.4%  of young adults aged 18–25 reported misuse of prescription drugs in the past month, and 13.7 percent reported misuse in the past year

Stimulants were the most frequently misused prescription drug of any type among college students in 2022, reported by 15% of college students

Almost two-thirds of college seniors will be offered prescription stimulants for nonmedical use during their college career and 46% will use them at least once

Missouri Data

According to the 2018 Missouri Assessment of College Health Behaviors (MACHB):

95% of Missouri college students do not use prescription drugs without a prescription

 97%  do not use stimulants without a prescription

 98%  do not use pain medications without a prescription

 99%  do not use sleeping medications without a prescription

 99%  do not use benzodiazepines without a prescription

Unfortunately, of students who use medications without a prescription, the majority indicate that they either were given them (31%) or purchase them from other people (20%)

When asked from whom they obtained medications the two most common answers were friends (56%) and family (32%)

It is not safe to mix alcohol and prescription drugs, but unfortunately 28% of Missouri college students indicate mixing prescription drugs and alcohol in a manner other than prescribed

It is not always safe to drive after consuming prescription medications, even with a prescription, as some medications can impair driving. However, 11% of Missouri college students indicate driving after using prescription drugs

63% of Missouri college students report that it is very easy or fairly easy to obtain prescription drugs without a prescription in 2019.

The Problem

There are many serious health and legal dangers of use and misuse of a controlled substances without a prescription. It is especially important to educate college students on the many dangers of misusing prescription drugs as Generation Rx has found that about half of all college students will have the opportunity to misuse a prescription drug by their sophomore year.

Students may turn to prescription drugs to improve academic performance, relieve stress, or even self-medicate but these tendencies are not the norm!

This is a growing issue on college campuses and the pressure to take these drugs can be prominent. Prescription drugs can help us live longer and healthier lives - but only if they are used properly under medical direction.


The health risks of misusing prescription drugs are very serious yet widely misunderstood. Many believe prescription drugs are a safe alternative to illicit street drugs, when in fact more emergency department visits occur due to prescription drug misuse than due to illicit “street” drugs (SAMHSA). Additionally, with the emergence of fentanyl, and other contaminants, the use of prescription drugs have become even more dangerous.


These beliefs regarding prescription medication misuse among college students stem from the misconception that prescription medications are not addictive. Some students also believe that there are no legal ramifications regarding prescription medications because they are legally prescribed by a doctor. Also, since prescription medications are seen as safer, many have the misconception that there is nothing wrong with using someone else’s prescription and that these medications cannot lead to overdose.

Mixing prescription medications with alcoholic beverages significantly increases the risk and severity of possible physical and mental harm and may lead to overdose or death.

Though there are many types of prescription drugs, the most misused fall into four categories: stimulants, painkillers, sleep medications and sedatives. Each of these categories’ present dangerous health risks, but education on the dangers of misusing these drugs can help keep students safe.

The chart below provides examples of these drugs, their effects, and other associated risks/dangers. The possession of any of these medications without a prescription could result in legal consequences and can negatively affect your academic and professional career.

Health Risks Other Consequences
Adderall, Ritalin, Vyvanse, Concerta
High fever, convulsions, anxiety, hostility, nervousness, seizures, increased heart rate, respiration rate and blood pressure Stimulants put excessive strain on the heart which can lead to heart failure and death
Pain Relievers
Vicodin, Percocet, Oxycotin
Liver damage, intoxication, decreased mental alertness and concentration, nausea, vomiting, confusion, decreased concentration and decreased pain threshold Regular or long term misuse can lead to physical dependence and in some cases addiction
Sleep Medications
Ambien, Sonata, Lunesta, Rozerem
Lowered blood pressure, increased risk of respiratory distress and death when combined with alcohol Combining sleep medications with alcohol is especially dangerous and can lead to death
Valium, Xanax, Ambien
Loss of coordination, slowed reflexes, respiratory depression, aggressive behavior, hallucinations, inability to form memories while taking Sudden withdrawal can cause convulsions and delirium

Legal Risks

There are many prevailing misconceptions about the safety and legality of misusing prescription drugs. Not only do many believe these drugs are safer than street drugs, but many do not know the serious legal ramifications of using these drugs without a prescription.

  1. In Missouri, illegal possession of prescription drugs is a class D felony and punishable by up to 7 years in prison and a fine of up to $10,000.
  2. All prescription drugs must be kept in the original prescription container. If you do not keep them in the original container, the burden is on you to prove you have a legal prescription.
  3. Fraudulently attempting to obtain a controlled substance is a class E felony and punishable by up to 4 years in prison, and a fine of up to $10,000. This includes providing false information to obtain a prescription, claiming to be a physician or authorized person, and forging prescriptions or drug labels.
  4. It is illegal to distribute prescription drugs to anyone. This includes giving drugs to a friend. In addition, it is a class A felony to distribute a controlled substance within 2,000 feet of any school. A class A felony is punishable by 10-30 years in prison. Missouri colleges and universities are included in the law.
  5. Driving under the influence of prescription drugs could lead to a DWI arrest if the drug impairs your ability to drive safely.


This is a major concern on college campuses as the nonmedical use of prescription drugs among college students is more than twice as high as that among non-students who are 18-22 years of age (NSDUH). This can be a result of the pressure for academic success, erratic sleep schedules, and recreational drug culture typically associated with college life. Instead of turning to prescription drugs to handle the difficulties of being a college student, try these healthy alternatives!


Sometimes it can seem like stress and college life go hand-in-hand. The constant pressure of something always being due can be a huge stress, especially when managing finances, living with roommates, juggling work, and relationships! Turning to prescription drugs when stressed may seem like a quick and easy way to get through it all, but it has serious negative effects. Instead, try these tips to help relieve your stress!

 53%  of Missouri college students who reported misusing benzodiazepine/sedative prescription drugs ranked stress reduction as the contributing factor for their prescription drug misuse. Followed by helping with feelings/emotions at 44%.

Take care of your mind

  1. Avoid unnecessary stress! This may be learning how to say “no” to added responsibilities, avoiding people who stress you out or identifying and avoiding situations that add stress to your life. Recognize when you’re getting stressed! Have you found yourself feeling irritable or snapping at others? Do you cry or feel like crying more than usual? Having trouble concentrating? These are signs that you might need a break!
  2. Don’t be afraid to take breaks! If you’re feeling burnt out, take some time just for you- do something you enjoy! Not only is this a nice getaway from the stresses of life but it can also put things in perspective, which can help prevent stress. Taking care of your mental health will help you do better on exams, papers, and assignments!

Take care of your body

  1. Take deep breaths! Deliberately copying a relaxed breathing pattern tells the brain that things are okay, reducing the impact of stress. Visualize breathing in blue air and breathing out red air!
  2. Get physical! Exercise releases endorphins and endorphins make you happy! Aim for 30 minutes of physical activity (going to the gym, playing a sport, or even just taking a walk!) a day to ease stress.
  3. Refuel! Getting enough sleep and eating right go a long way towards reducing stress! Avoid consuming too much sugar or caffeine after dinner to avoid sleep trouble.

Take care of your time

  1. Make lists! Keeping shopping lists, to-do lists and goals lists will save you time and make planning much easier! Keep your favorite notebook with you or download a cool app to manage these lists no matter where you are!
  2. Manage your time! Maintain a calendar and dedicate time to planning ahead by prioritizing and organizing your tasks and goals. Make sure to check it every day so you don’t miss any important entries!
  3. Meet with someone! If you’re struggling to manage all of your responsibilities, check out your school’s Student/Academic Success Center! They will have resources to help you better manage your time and stress!


College life is not always conducive to a healthy amount of sleep, with papers to write, exams to study for and so many fun things to do! But getting enough sleep is vital to keeping our bodies and minds healthy! Try these tips for a better night’s sleep!

99% of Missouri college students do not misuse prescription sleeping medication.
  1. Maintain a regular sleep schedule. Going to bed and waking up at the same time every day will train your brain to get sleepy and wake up at the right times!
  2. Exercise regularly. Getting 30 minutes of exercise a day can help regulate your sleep patterns. Late afternoon exercise is the perfect way to help you fall asleep!
  3. Avoid caffeine close to bedtime. Caffeine can stay in the body up to 5 hours. A good rule of thumb is no caffeine after dinner time!
  4. Avoid alcohol close to bedtime. Although commonly thought of as a sedative, alcohol actually disrupts sleep, causing nighttime awakenings and less restful sleep.
  5. Use your bedroom for only sleep and sex. Living in the dorms can make it hard to separate your spaces between living, working and sleeping. Making a mental connection between your bed and sleep will make it easier to fall asleep every night!


Self-medicating or coping with pain by misusing prescription drugs is not only dangerous to your health but also can be addictive. These drugs merely mask the pain; they do not cure the cause.

 50%  of Missouri college students who reported misusing pain medication/opiates ranked pain as the contributing factor for their prescription drug misuse. Followed by to relax or relieve tension at 33%.

If you are experiencing pain:

  1. Visit your health care provider!
  2. Make an appointment with your student health center! Even if they can’t treat your pain, they will be able to refer you to someone who can!
  3. Look for a Public Health center in your area!
  4. Be sure to dispose of your pain medications after you have healed. What works for one ailment does not necessarily work for another!
For more tips/tricks to help with stress, sleep, pain, and prescription drug misuse, visit the Missouri Partners in Prevention RX page here!

Bystander Information

What can you do as a bystander?
While not all students are abusing prescription medications, those who are report getting these drugs from someone they are close to.

 85%  of Missouri college students that report using prescription drugs illegally access them from people they know.

What can you do if someone you care about is abusing prescription medications?

  1. Have a conversation with this person and ask them why they are using these prescription medications. Ask what you can do to help, and suggest healthy alternatives. Offer to assist them in seeking help from a counselor, doctor, or support group.
  2. If you believe someone you know is addicted to prescription medications, contact your local service provider through the information on our resource tab.

Best Practices

Prevention of Prescription Drug Misuse

  1. Prescription drug monitoring programs (PDMPs): more information at Prescription Drug Monitoring Program Training and Technical Assistance Center
  2. Doctor shopping and medical provider education laws: the Centers for Disease Control provides a good fact sheet on “doctor shopping laws”
  3. Safe storage and responsible disposal
    1. Prescriptions kept in lock boxes
    2. Prescription drug take-back events
  4. Public Awareness and Education
    1. Promote partnerships of schools, law enforcement, publish health agencies, and more to educate about the issue
    2. Create community coalitions to address the problem

Interventions to Increase Access and Support for Substance Misuse Services

  1. Adoption of Good Samaritan laws
  2. Laws that support access to rescue drugs and overdose harm reduction programs (opioid overdose education and Naloxone distribution)
  3. Counseling programs for prescription drug addiction
    1. Emphasis on behavioral treatments such as contingency management and cognitive-behavioral therapy
  4. Availability of medication assisted treatment (MAT)

SAMHSA has a good guide on Preventing Prescription Drug Misuse: Programs and Strategies and a good list of national and regional resources

The Community Anti-Drug Coalitions of America (CADCA) has a wonderful toolkit to Prevent RX Misuse

The Johns Hopkins Bloomberg School of Public Health has released a great evidence-based guide on the prescription opioid epidemic and strategies for prevention

Collegiate Prescription Drug Misuse Prevention

  1. Be MedWise College Resource Kit
  2. Generation Rx University

National Resources

  1. National Drug Abuse Hotline: 1 (800) 943-0566
  2. Prescription Drug Abuse Hotline: 1 (888) 939-3612
  3. National Institute on Drug Abuse (NIDA)
  4. SAMHSA Behavioral Health Treatment Services Locator
  5. National Coalition Against Prescription Drug Abuse

PIP Resources

Brochures & Posters

use as directed medication safety medication safety
There are three strategies available to address the misuse of prescription drugs on Missouri college campuses. Strategies focus on reducing access to prescription drugs and increasing education on the issues associated with prescription drug misuse. Each of the strategies is flexible to adapt to campus specific culture and funding will be in addition to existing PIP funds. The available strategies are listed below:
  1. Prescription Drug Take Back Event: Take back events will aim to reduce access to prescription drugs by removing surplus drugs from the campus community. Take back days will be accompanied by educational materials. Partners in Prevention will provide the following: funds to compensate on scene law enforcement officers, advertising materials, supplementary educational materials, event incentives, planning assistance, and evaluation data.

  2. Social Norming Media Campaign: Media campaigns will aim to increase education on the misuse of prescription drugs. Campuses will use campus data based messages on a variety of materials to make students aware of prescription drugs norms on their campus. Partners in Prevention will provide the following: media materials, promotional items, campus specific data, assistance in message development, and evaluation data.

  3. Peer Education Rx Program: Peer education programs will aim to increase education on the issues associated with the misuse of prescription drugs. Campuses will use existing peer groups to present workshops, skits, and lessons to various populations. Partners in Prevention will provide the following: access to Ohio State University’s GenerationRx program materials, training opportunities for peer educators, subpopulation identification assistance, and evaluation data.

Apply for one or more of the above listed strategies!

Click here to visit rx.missouri.edu!

Generation Rx materials are available for order through the Peer Education Rx Program. Materials were created by Ohio State University and The Cardinal Health Foundation.

  1. 15 Minutes Facilitator Notes
  2. 15 Minutes Student Workbook
  3. Adderall Facilitator Notes
  4. Adderall Handout
  5. Adderall Script with Discussion
  6. Adderall Script
  7. Drug Misuse Faciltator Notes
  8. Drug Misuse Handout
  9. Drug Misuse Script
  10. Freshman 15 Facilitator Notes
  11. Freshman 15 Handout 1 page
  12. Freshman 15 Handout 2 pages
  13. Freshman 15 PowerPoint (PPT)
  14. Rx for Disaster Facilitator Notes
  15. Rx for Disaster Handbook