Senior students at 23 regionally distributed medical schools received an anonymous questionnaire designed to examine current and prior use of tobacco, alcohol, and nine other drugs. The overall response rate was 67% (N = 2046). Substance use prevalence rates during the 30 days preceding the survey included alcohol, 87.5%; marijuana, 10.0%; cigarettes, 10.0%; cocaine, 2.8%; tranquilizers, 2.3%; opiates other than heroin, 1.1%; psychedelics other than LSD (lysergic acid diethylamide), 0.6%; amphetamines, 0.3%; barbiturates, 0.2%; LSD, 0.1%; and heroin, 0.0%. Compared with national, age-related comparison groups, senior medical students reported less use of all substances during the past 30 days and the past 12 months, except for alcohol, tranquilizers, and psychedelics other than LSD. Substantial new drug use after entry into medical school was reported only for tranquilizers. Seven students (0.2%) admitted to current dependence on a substance other than tobacco, four of these implicating marijuana. Thirty-three students (1.6%) believed that they currently needed help for substance abuse. Only 25.7% were aware of any policy on substance abuse at their own school.
Until recently, relatively few reliable or generalizable data have been available on medical student substance use and abuse. In their review and critique of the literature, Borkman and Rosenberg1 found that previous studies generally involved single schools or classes of students, or the use of a single or a limited number of substances. In addition, they found that survey methods varied, making comparisons between reported prevalence rates difficult. Finally, there has been little consideration of regional and demographic variables such as gender, age, marital status, social class, and religion, which are known to affect substance use.2 After attempting to compare rates of medical student substance use reported by a number of different investigators, at different times, at different schools, and for different drugs, Borkman and Rosenberg1 concluded that larger samples and better methods are needed.
With these criticisms in mind, we conducted a pilot study in 1986 on the use of cigarettes, alcohol, and nine other drugs among 589 senior students at 13 medical schools.3 We now report the results of an expanded 1987 survey of substance use and abuse among 2046 senior students at 23 nationally distributed medical schools.