A Longitudinal Behavioral Economic Analysis of Non-medical Prescription Opioid Use Among College Students


Despite the growing opioid epidemic in the US, few studies have identified theoretically based risk factors for non-medical prescription opioid (NMPO) use among young adults. The goal of the current study was to evaluate the behavioral economic hypotheses that NMPO use would be associated with lower levels of reinforcement from substance-free activities and future time orientation. Participants were 71 undergraduate students (62% women, 52.1% Caucasian, 35.2% African American) who either reported past-year NMPO use or demographically similar control participants with no past-year drug use. Participants provided information on alcohol and drug use, completed three measures of substance-free reinforcement (time allocation to exercise and academic activities, hedonic response to substance-free pleasant images, and self-report anhedonia), and a measure of future orientation, at baseline, 6-month, and 12-month follow-up. Consistent with nationwide trends, most NMPO users also reported use of marijuana (94%) and alcohol (80%). Compared to no drug use, NMPO use was associated with lower time allocation to academic activities, lower hedonic response to pleasant images, greater self-reported anhedonia, and lower future orientation across the 12-month study period. Among NMPO users, greater positive hedonic response to substance-free pleasant images predicted less alcohol use at 12-month follow-up, and greater baseline future orientation predicted less marijuana and NMPO use at 12-month follow-up. These findings provide partial support for behavioral economic models that link substance misuse to diminished levels of substance-free reinforcement and lower consideration of the future.

Publication Title

Psychological Record