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TÜRKİYE’DE AKDENİZ BÖLGESİNDE EĞİTİM GÖREN TIP ÖĞRENCİLERİNDE METİLFENİDATIN TIBBİ OLMAYAN KULLANIMI: NİTEL BİR ARAŞTIRMA

Year 2023, Volume: 30 Issue: 2, 245 - 252, 22.06.2023
https://doi.org/10.17343/sdutfd.1301782

Abstract

Amaç
Metilfenidatın reçetesiz kullanımı son yıllarda uluslararası
yazında ilgi duyulan bir konu haline gelmiştir.
Özellikle lise ve üniversite öğrencilerinin başarı için
bu ilaçları kötüye kullanımları önemli bir araştırma
konusu olmuştur. Gençler, hem derslerinde, girdikleri
sınavlarda başarılı olmak hem de sosyal yaşamdan
kopmamak için bu ilaçları bir kurtarıcı olarak görmektedir.
Dünyada tıp eğitimi, öğrenciler açısından zor ve
streslidir. Öğrenciler başarılı olmak için üzerlerinde
çok fazla baskı hissetmektedir. Bu koşullar öğrencileri,
üzerlerindeki baskıyı azaltacak, uyanık kalmalarını
ve uzun süre odaklanmalarını sağlayacak alternatiflere
yöneltmektedir. Bu çalışma, tıp eğitimi alan öğrencileri
metilfenidat içeren ilaçlara yönelten süreci ve
kullanım alışkanlıklarını anlamayı amaçlamaktadır.
Gereç ve Yöntem
Çalışma, antropolojik bakış açısı ile tasarlanmış nitel
bir araştırmadır. Tıp eğitimi alan öğrencilerle derinlemesine
görüşmeler yapılarak, metilfenidatın reçete
dışı kullanımı üzerine deneyimleri, düşünceleri ve
gözlemleri derlenmiştir. Çalışmaya 2019 yılı sonlarında
yüz yüze görüşmelerle başlanmıştır. Koronavirüs
pandemisi nedeniyle verilen uzun bir aranın ardından
görüşmeler Şubat 2022’de tamamlanmıştır. Çalışmaya
katılan 17 gönüllü öğrencinin görüşleri, betimleyici
bir yaklaşımla değerlendirilmiştir.
Bulgular
Araştırma bulgularımıza göre tıp öğrencileri yan etkilerine
rağmen geçici ve hızlı bir çözüm olarak metilfenidatın
reçete dışı kullanımına olumlu bakmaktadır.
İlacın kullanımı özellikle sınav zamanlarında artmaktadır.
Öyle gölünüyor ki ilaç öğrenciler için kolay bir
alternatiftir. İlaçlar büyük oranda yine kullanan diğer
arkadaşlardan temin edilmektedir. Ayrıca ilacın zayıflamak
için de kullanıldığı görüldü. Metilfenidatın olası
etkilerinin yine reçete dışı kullanan öğrenciler tarafından
övüldüğü ve diğer öğrencilere tanıtıldığı söylenebilir.
Çalışmanın bulguları çeşitli ülkelerde yapılmış
araştırma bulguları ile büyük oranda paralellik göstermektedir.
Sonuç
Ülkemizde psikomotor stimülanların reçetesiz kullanımları
üzerine yapılmış çok az sayıda araştırma bulunmaktadır.
Bulgular, tıp öğrencilerinin üzerlerindeki
stres ve baskı ile baş edebilmeleri yolunda sağlıklı
ve sürdürülebilir alternatiflere ihtiyaç duyduklarını ka-
nıtlar niteliktedir. İlaçların reçetesiz, kötüye kullanımlarının
uzun vadede yaratacağı olumsuz etkilerinin
belirlenebilmesi ve önlem alınabilmesi açısından, bu
çalışmanın bir temel oluşturacağı düşünülmektedir.
Araştırma, mevcut durumu keşfetme amaçlı bir ön
değerlendirme niteliğindedir. Alanda daha çok bilgiye,
nicel ve nitel veriye ihtiyaç olduğu açıktır.

Supporting Institution

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Project Number

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Thanks

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References

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  • 2. FDA. Questions and Answers Regarding Methylphenidate Hydrochloride Extended Release Tablets (generic Concerta) made by Mallinckrodt and UCB/Kremers Urban (formerly Kudco) [Internet]. FDA. 2022 [cited 01 March 2021]. Available from: https://www.fda.gov/drugs/drug-safety-and-availability/ questions-and-answers-regarding-methylphenidate-hydrochloride- extended-release-tablets-generic)
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  • 4. McNiel AD, Muzzin KB, DeWald JP, McCann AL, Schneiderman ED, Scofield J, Campbell PR. The nonmedical use of prescription stimulants among dental and dental hygiene students. Journal of Dental Education. 2011;75(3):365–376.
  • 5. Tuttle JP, Scheurich, NE, Ranseen J. Prevalence of ADHD Diagnosis and Nonmedical Prescription Stimulant Use in Medical Students. Academic Psychiatry. 2010;34(3):220-223. https:// doi.org/10.1176/appi.ap.34.3.220
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  • 9. Finger G, Silva ER, Falavigna A. Use of methylphenidate among medical students: a systematic review. Revista da Associação Médica Brasileira. 2013;59(3):285–289. https://doi. org/10.1016/j.ramb.2012.10.007
  • 10. Caferoğlu Z, Özel HG, Hamidi F, Ertürk G. Dikkat Eksikliği Hiperaktivite Bozukluğu Tanısı Olan Çocuklarda İlaç Tedavisinin Beslenme Durumu Üzerine Etkileri. Beslenme ve Diyet Dergisi. 2015; 42(2):99-107.
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  • 12. Şahin S, Bozkurt H. Epileptic Seizure Following A Switch From Short-acting Methylphenidate to Long-acting Methylphenidate Treatment: A Case Report. Turkish Journal of Child and Adolescent Mental Health. 2016; 26(3):136–139. https://doi. org/10.4274/tjcamh.galenos.2016.2015.09.022
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  • 14. Babcock Q, Byrne T. Student Perceptions of Methylphenidate Abuse at a Public Liberal Arts College. Journal of American College Health. 2000; 49:143-145.
  • 15. Low KG, Gendaszek AE. Illicit Use of Psychostimulants among College Students: A Preliminary Study. Psychology, Health and Medicine. 2002; 7:283-287. https://doi.org/10.1080/13548500220139386
  • 16. Teter CJ, McCabe SE, Cranford JA, Boyd CJ, Guthrie SK. Prevalence and motives for illicit use of prescription stimulants in an undergraduate student sample. J Am Coll Health. May-Jun; 2005; 53(6):253-62. https://doi.org/10.3200/JACH.53.6.253-262
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  • 18. McCabe SE, West BT, Teter CJ, Boyd CJ. Trends in medical use, diversion, and nonmedical use of prescription medications among college students from 2003 to 2013: Connecting the dots. Addictive Behaviors. 2014; 39(7):1176–1182. https://doi. org/10.1016/j.addbeh.2014.03.008
  • 19. Gahr M, Freudenmann RW, Hiemke C, Kölle MA, Schönfeldt- Lecuona C. Abuse of methylphenidate in Germany: Data from spontaneous reports of adverse drug reactions. Psychiatry Research. 2014; 215(1): 252-254. https://doi.org/10.1016/j. psychres.2013.11.008
  • 20. Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE. Monitoring the Future National Survey Results on Drug Use, 1975–2009. Vol. II. College Students and Adults Ages 19–50. NIH publication No. 10–7585. Washington, DC: US Department of Health and Human Services, 2010.
  • 21. McCabe SE, Knight JR, Teter CJ, Wechsler H. Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey. Addiction. 2005; 100(1):96–106. https://doi.org/10.1111/j.1360- 0443.2005.00944.x
  • 22. Steyn F. Methylphenidate use and poly-substance use among undergraduate students attending a South African university: original research. South African Journal of Psychiatry. 2016;22(1):a760.
  • 23. Merier LJ, Liechti ME, Herzig F, Schaub MP. To Dope or Not to Dope: Neuroenhancement with Prescription Drugs and Drugs of Abuse among Swiss University Students. PLoS ONE. 2013; 8(11):e77967. https://doi.org/10.1371/journal.pone.0077967
  • 24. Liakoni E, Schaub MP, Maier LJ, Glauser G-V, Liechti ME. The Use of Prescription Drugs, Recreational Drugs, and “Soft Enhancers” for Cognitive Enhancement among Swiss Secondary School Students. PLoS ONE. 2015; 10(10):e0141289. https:// doi.org/10.1371/journal.pone.0141289
  • 25. Singh I, Bard I, Jackson J. Robust Resilience and Substantial Interest: A Survey of Pharmacological Cognitive Enhancement among University Students in the UK and Ireland. PLoS ONE. 2014; 9(10):e105969. https://doi.org/10.1371/journal. pone.0105969
  • 26. Lengvenyte A, Strumila R, Grikiniene J. Use of cognitive enhancers among medical students in Lithuania. Nordic Studies on Alcohol and Drugs. 2017; 33(2):173-187. https://doi. org/10.1515/nsad-2016-0014
  • 27. Micoulaud-Franchi JA, MacGregor A, Fond G. A preliminary study on cognitive enhancer consumption behaviors and motives of French Medicine and Pharmacology students. Eur. Rev. Med Pharmacol. Sci. 2014; 18(3):1875-8.
  • 28. Abiodun AO, Adelekan ML, Ogunremi OO et al. Psychosocial correlates of alcohol, tobacco and cannabis use amongst secondary school students in Ilorin, Nigeria. West Afr J Med. 1994; 13:213-7.
  • 29. Liu Z, Zhou W, Lian Z, Mu Y, Cai Z, Cao J: The use of psychoactive substances among adolescents in an area in the south west of China. Addiction. 2001; 96(2):247-50. https://doi. org/10.1080/09652140020020973. PMID: 11182869.
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  • 31. Fallah CF, Moudi S, Hamidia A, Bijani A. Stimulant use in medical students and residents requires more careful attention. Caspian J. Intern. Med. 2018; 9(1):87-91. https://doi.org/10.22088/cjim.9.1.87
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NON-MEDICAL USE OF METHYLPHENIDATE IN MEDICAL STUDENTS IN THE MEDITERRANEAN REGION OF TÜRKİYE: A QUALITATIVE RESEARCH

Year 2023, Volume: 30 Issue: 2, 245 - 252, 22.06.2023
https://doi.org/10.17343/sdutfd.1301782

Abstract

Objective
he misuse of methylphenidate is an important issue
in the relevant literature. The abuse of these drugs
for success, especially by high school and university
students, is quite common at the international level.
Young people consider these drugs as a savior in
order to be successful in the exams and to sustain
with their social life. It is possible that medical
education is very hard and stressful for students in
the world. The students feel too much pressure to
succeed. So, this situation directs students towards
alternatives that will reduce the pressure, stay awake
and focus more. This study aims to understand the
process and usage habits that direct medical students
to methylphenidate.
Material and Method
The study was designed as a qualitative research
method with an anthropological perspective. Medical
students' experiences, thoughts, and observations
on the illicit use of methylphenidate were collected
by researcher, using the in-depth interviews. The
study started with face-to-face interviews at the
end of 2019. Due to the coronavirus pandemic, the
negotiations were completed in February 2022, after
a long break. The opinions of 17 volunteer students
who participated in the study were evaluated with a
descriptive approach.
Results
According to our research findings, medical
students are positive about the non-medical use of
methylphenidate to save the day, despite its side
effects. The use of the drug increases especially
during exam periods. It is seen that drugs are as
an easy alternative for students. The medicines are
mostly provided from other friends who still use them.
In addition, the drug is also used for weight loss. It is
a fact that its effects are exaggerated and advertised
among non-prescription users. The results of our
research are similar with international ones.
Conclusion
There are very few studies on the illicit use of
psychomotor stimulants in our country. The findings
prove that medical students need healthy and
sustainable alternatives to cope with the stress and
pressure on them. It is thought that this study will be
a basis for determining the long-term negative effects
of misuse of the drugs and taking precautions. The
research is a preliminary assessment to explore the
current situation. It is clear that there is a need for
more information, quantitative and qualitative data in
the field.

Project Number

yok

References

  • 1. FDA. Methylphenidate hydrochloride [Internet]. FDA. 2022 [cited 01 March 2021]. Available from: https://www.fda.gov/drugs/ drug-safety-and-availability/methylphenidate-hydrochloride-extended- release-tablets-generic-concerta-made-mallinckrodt- and-kudco
  • 2. FDA. Questions and Answers Regarding Methylphenidate Hydrochloride Extended Release Tablets (generic Concerta) made by Mallinckrodt and UCB/Kremers Urban (formerly Kudco) [Internet]. FDA. 2022 [cited 01 March 2021]. Available from: https://www.fda.gov/drugs/drug-safety-and-availability/ questions-and-answers-regarding-methylphenidate-hydrochloride- extended-release-tablets-generic)
  • 3. Kudlow PA, Naylor KT, Xie B, McIntyre RS. Cognitive enhancement in Canadian medical students. Journal of Psychoactive Drugs. 2013;45(4):360–365. https://doi.org/10.1080/02791072 .2013.825033
  • 4. McNiel AD, Muzzin KB, DeWald JP, McCann AL, Schneiderman ED, Scofield J, Campbell PR. The nonmedical use of prescription stimulants among dental and dental hygiene students. Journal of Dental Education. 2011;75(3):365–376.
  • 5. Tuttle JP, Scheurich, NE, Ranseen J. Prevalence of ADHD Diagnosis and Nonmedical Prescription Stimulant Use in Medical Students. Academic Psychiatry. 2010;34(3):220-223. https:// doi.org/10.1176/appi.ap.34.3.220
  • 6. Webb JR, Thomas MW, Valasek MA. Contemplating Cognitive Enhancement in Medical Students and Residents. Perspectives in Biology and Medicine. 2010;53(2):200-214. https://doi. org/10.1353/pbm.0.0154
  • 7. Webb JR, Valasek MA, North CS. Prevalence of stimulant use in a sample of US medical students. Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists. 2013; 25(1):27–32.
  • 8. Cohen YG, Segev RW, Shlafman N, Novack V, Ifergane G. Methylphenidate use among medical students at Ben-Gurion University of the Negev. Journal of Neurosciences in Rural Practice. 2015; 6(3) 320–325. https://doi.org/10.4103/0976-3147.158749
  • 9. Finger G, Silva ER, Falavigna A. Use of methylphenidate among medical students: a systematic review. Revista da Associação Médica Brasileira. 2013;59(3):285–289. https://doi. org/10.1016/j.ramb.2012.10.007
  • 10. Caferoğlu Z, Özel HG, Hamidi F, Ertürk G. Dikkat Eksikliği Hiperaktivite Bozukluğu Tanısı Olan Çocuklarda İlaç Tedavisinin Beslenme Durumu Üzerine Etkileri. Beslenme ve Diyet Dergisi. 2015; 42(2):99-107.
  • 11. Durukan I, Erdem M, Kara K, Karaman D. Effects of Psychostimulant Drugs on Developing Brain. Psikiyatride Güncel Yaklaşımlar (Current Approaches in Psychiatry). 2013; 5(4):538-539. https://doi.org/10.5455/cap.20130532
  • 12. Şahin S, Bozkurt H. Epileptic Seizure Following A Switch From Short-acting Methylphenidate to Long-acting Methylphenidate Treatment: A Case Report. Turkish Journal of Child and Adolescent Mental Health. 2016; 26(3):136–139. https://doi. org/10.4274/tjcamh.galenos.2016.2015.09.022
  • 13. Yarıcı U, Görgülü Y, Çınar RK, Sönmez MB. Metilfenidat ile Tetiklenen Afektif ve Psikotik Süreç, Vaka Sunumu. Bağımlılık Dergisi. 2017;1: 25–30.
  • 14. Babcock Q, Byrne T. Student Perceptions of Methylphenidate Abuse at a Public Liberal Arts College. Journal of American College Health. 2000; 49:143-145.
  • 15. Low KG, Gendaszek AE. Illicit Use of Psychostimulants among College Students: A Preliminary Study. Psychology, Health and Medicine. 2002; 7:283-287. https://doi.org/10.1080/13548500220139386
  • 16. Teter CJ, McCabe SE, Cranford JA, Boyd CJ, Guthrie SK. Prevalence and motives for illicit use of prescription stimulants in an undergraduate student sample. J Am Coll Health. May-Jun; 2005; 53(6):253-62. https://doi.org/10.3200/JACH.53.6.253-262
  • 17. Quintero G, Peterson J, Young B. An Exploratory Study of Socio- Cultural Factors Contributing to Prescription Drug Misuse among College Students. Journal of Drug Issues. 2006; 6:903-931.
  • 18. McCabe SE, West BT, Teter CJ, Boyd CJ. Trends in medical use, diversion, and nonmedical use of prescription medications among college students from 2003 to 2013: Connecting the dots. Addictive Behaviors. 2014; 39(7):1176–1182. https://doi. org/10.1016/j.addbeh.2014.03.008
  • 19. Gahr M, Freudenmann RW, Hiemke C, Kölle MA, Schönfeldt- Lecuona C. Abuse of methylphenidate in Germany: Data from spontaneous reports of adverse drug reactions. Psychiatry Research. 2014; 215(1): 252-254. https://doi.org/10.1016/j. psychres.2013.11.008
  • 20. Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE. Monitoring the Future National Survey Results on Drug Use, 1975–2009. Vol. II. College Students and Adults Ages 19–50. NIH publication No. 10–7585. Washington, DC: US Department of Health and Human Services, 2010.
  • 21. McCabe SE, Knight JR, Teter CJ, Wechsler H. Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey. Addiction. 2005; 100(1):96–106. https://doi.org/10.1111/j.1360- 0443.2005.00944.x
  • 22. Steyn F. Methylphenidate use and poly-substance use among undergraduate students attending a South African university: original research. South African Journal of Psychiatry. 2016;22(1):a760.
  • 23. Merier LJ, Liechti ME, Herzig F, Schaub MP. To Dope or Not to Dope: Neuroenhancement with Prescription Drugs and Drugs of Abuse among Swiss University Students. PLoS ONE. 2013; 8(11):e77967. https://doi.org/10.1371/journal.pone.0077967
  • 24. Liakoni E, Schaub MP, Maier LJ, Glauser G-V, Liechti ME. The Use of Prescription Drugs, Recreational Drugs, and “Soft Enhancers” for Cognitive Enhancement among Swiss Secondary School Students. PLoS ONE. 2015; 10(10):e0141289. https:// doi.org/10.1371/journal.pone.0141289
  • 25. Singh I, Bard I, Jackson J. Robust Resilience and Substantial Interest: A Survey of Pharmacological Cognitive Enhancement among University Students in the UK and Ireland. PLoS ONE. 2014; 9(10):e105969. https://doi.org/10.1371/journal. pone.0105969
  • 26. Lengvenyte A, Strumila R, Grikiniene J. Use of cognitive enhancers among medical students in Lithuania. Nordic Studies on Alcohol and Drugs. 2017; 33(2):173-187. https://doi. org/10.1515/nsad-2016-0014
  • 27. Micoulaud-Franchi JA, MacGregor A, Fond G. A preliminary study on cognitive enhancer consumption behaviors and motives of French Medicine and Pharmacology students. Eur. Rev. Med Pharmacol. Sci. 2014; 18(3):1875-8.
  • 28. Abiodun AO, Adelekan ML, Ogunremi OO et al. Psychosocial correlates of alcohol, tobacco and cannabis use amongst secondary school students in Ilorin, Nigeria. West Afr J Med. 1994; 13:213-7.
  • 29. Liu Z, Zhou W, Lian Z, Mu Y, Cai Z, Cao J: The use of psychoactive substances among adolescents in an area in the south west of China. Addiction. 2001; 96(2):247-50. https://doi. org/10.1080/09652140020020973. PMID: 11182869.
  • 30. Cadwalladr C. Students used to take drugs to get high [Internet]. Now they take them to get higher grades. The Guardian. 2015. [Accessed 03 March 2021]. Available from: https://www. theguardian.com/society/2015/feb/15/students-smart-drugs-higher- grades-adderall-modafinil
  • 31. Fallah CF, Moudi S, Hamidia A, Bijani A. Stimulant use in medical students and residents requires more careful attention. Caspian J. Intern. Med. 2018; 9(1):87-91. https://doi.org/10.22088/cjim.9.1.87
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There are 48 citations in total.

Details

Primary Language English
Subjects Nursing, Medical Education
Journal Section Research Articles
Authors

Hilal Yakut İpekoğlu 0000-0002-2273-1379

Giray Kolcu 0000-0001-8406-5941

Project Number yok
Publication Date June 22, 2023
Submission Date May 24, 2023
Acceptance Date June 16, 2023
Published in Issue Year 2023 Volume: 30 Issue: 2

Cite

Vancouver Yakut İpekoğlu H, Kolcu G. NON-MEDICAL USE OF METHYLPHENIDATE IN MEDICAL STUDENTS IN THE MEDITERRANEAN REGION OF TÜRKİYE: A QUALITATIVE RESEARCH. Med J SDU. 2023;30(2):245-52.

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