Title

Substance use among professionals and professional students: Transforming occupational performance and experience

1

Location

Portland Room

Start Time

1-10-2016 1:30 PM

End Time

1-10-2016 2:30 PM

Session Type

Research Paper

Abstract

Purpose This project synthesizes knowledge about psychoactive substance use by professionals (e.g. dentists, accountant) and students in professional programs and the impact on occupational performance and quality of experience during engagement. Psychoactive substances alter consciousness, mood, and perception. They encompass licit substances (e.g., alcohol, over-the-counter medication), prescribed medication, illicit substances (e.g., marijuana), and healing plants (e.g., peyote). Research shows a relatively high prevalence of substance use among professionals and students. A systematic study reported use of methylphenidate (Ritalin) by medical students was 16 percent (Finger, Silva, & Falavigna, 2013). Physicians and pharmacists reported higher illicit use of opiates, anxiolytics, and sedative-hypnotics than the general population (Kenna & Wood, 2004) and cocaine use among a sample of lawyers was higher than the general population (Benjamin, Darling, & Sales, 1990).

Methods This study involved a systematic review of English, peer-reviewed articles. Databases included EMBASE, PsychInfo, CINAHL, Medline, and Sociological Abstracts. Search terms included a combination of profession-specific terms (e.g. physician/doctor; lawyer/attorney; medical student) and substance-related terms (e.g. performance enhancing; addiction; Adderall; caffeine). Included were articles that reported empirical findings by the authors. Discussions articles, commentaries, poster abstracts, theses, literature reviews, single case studies, and treatment outcome studies were excluded. Articles were reviewed for information regarding prevalence of use, types of substances used, impact of substances on performance, and contextual factors that influence use.

Results 122 articles met the search criteria regarding use of substances by professionals and students, published between 1984 to May 2016. The most common methodology was self-administered survey (n=98). Only 11 articles reported actual findings about the effects of substances on experience and performance. Desired effects include improved sleep, stress management, alleviation of boredom, and improved productivity (Merlo, Cummings, & Cottler, 2014). Students used substances to improve concentration, productivity, or grades, to enhance energy, to facilitate weight loss, and to aid in socialization (Volger, McLendon, Fuller, & Herring, 2014).

Implications A little understood phenomenon, within and outside the field of occupational science, is the deliberate use of substances to alter or enhance performance and to alter the experience of daily occupations. An examination of controlled use, perceived benefits, and naturally occurring strategies to minimise negative consequences can contribute to more comprehensive understandings about substance use in the context of daily occupation.

Keywords Substance use; occupational performance; professionals

Discussion Questions

1) Research about substance use typically investigates negative and undesired effects on occupational engagement and occupational performance. How might evaluation of the beneficial and desired effects contribute to more nuanced understandings about motivations for use?

2) What contextual factors might influence types of substances used and patterns of use by professionals and students?

3) What social ideals about optimal occupational performance influence individual decisions about use of substances as cognitive and performance enhancers?

References

Benjamin, G. A., Darling, E. J., & Sales, B. (1990). The prevalence of depression, alcohol abuse, and cocaine abuse among United States lawyers. International Journal of Law and Psychiatry, 13(3), 233-246. doi:10.1016/0160-2527(90)90019-y

Finger, G., Silva, E. R. d., & Falavigna, A. (2013). Use of methylphenidate among medical students: A systematic review. Revista da Associacao Medica Brasileira (1992), 59(3), 285-289. doi:10.1016/j.ramb.2012.10.007

Kenna, G. A., & Wood, M. D. (2004). Prevalence of substance use by pharmacists and other health professionals. Journal of the American Pharmacists Association, 44(6), 684-693.

Merlo, L. J., Cummings, S. M., & Cottler, L. B. (2014). Prescription drug diversion among substance-impaired pharmacists. American Journal on Addictions, 23(2), 123-128.

Volger, E. J., McLendon, A. N., Fuller, S. H., & Herring, C. T. (2014). Prevalence of self-reported nonmedical use of prescription stimulants in North Carolina Doctor of Pharmacy students. Journal of Pharmacy Practice, 27(2), 158-168. doi:10.1177/0897190013508139

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Oct 1st, 1:30 PM Oct 1st, 2:30 PM

Substance use among professionals and professional students: Transforming occupational performance and experience

Portland Room

Purpose This project synthesizes knowledge about psychoactive substance use by professionals (e.g. dentists, accountant) and students in professional programs and the impact on occupational performance and quality of experience during engagement. Psychoactive substances alter consciousness, mood, and perception. They encompass licit substances (e.g., alcohol, over-the-counter medication), prescribed medication, illicit substances (e.g., marijuana), and healing plants (e.g., peyote). Research shows a relatively high prevalence of substance use among professionals and students. A systematic study reported use of methylphenidate (Ritalin) by medical students was 16 percent (Finger, Silva, & Falavigna, 2013). Physicians and pharmacists reported higher illicit use of opiates, anxiolytics, and sedative-hypnotics than the general population (Kenna & Wood, 2004) and cocaine use among a sample of lawyers was higher than the general population (Benjamin, Darling, & Sales, 1990).

Methods This study involved a systematic review of English, peer-reviewed articles. Databases included EMBASE, PsychInfo, CINAHL, Medline, and Sociological Abstracts. Search terms included a combination of profession-specific terms (e.g. physician/doctor; lawyer/attorney; medical student) and substance-related terms (e.g. performance enhancing; addiction; Adderall; caffeine). Included were articles that reported empirical findings by the authors. Discussions articles, commentaries, poster abstracts, theses, literature reviews, single case studies, and treatment outcome studies were excluded. Articles were reviewed for information regarding prevalence of use, types of substances used, impact of substances on performance, and contextual factors that influence use.

Results 122 articles met the search criteria regarding use of substances by professionals and students, published between 1984 to May 2016. The most common methodology was self-administered survey (n=98). Only 11 articles reported actual findings about the effects of substances on experience and performance. Desired effects include improved sleep, stress management, alleviation of boredom, and improved productivity (Merlo, Cummings, & Cottler, 2014). Students used substances to improve concentration, productivity, or grades, to enhance energy, to facilitate weight loss, and to aid in socialization (Volger, McLendon, Fuller, & Herring, 2014).

Implications A little understood phenomenon, within and outside the field of occupational science, is the deliberate use of substances to alter or enhance performance and to alter the experience of daily occupations. An examination of controlled use, perceived benefits, and naturally occurring strategies to minimise negative consequences can contribute to more comprehensive understandings about substance use in the context of daily occupation.

Keywords Substance use; occupational performance; professionals

Discussion Questions

1) Research about substance use typically investigates negative and undesired effects on occupational engagement and occupational performance. How might evaluation of the beneficial and desired effects contribute to more nuanced understandings about motivations for use?

2) What contextual factors might influence types of substances used and patterns of use by professionals and students?

3) What social ideals about optimal occupational performance influence individual decisions about use of substances as cognitive and performance enhancers?