Introduction: Misuse of prescription medications (MPM) is a significant health concern, particularly among college students who demonstrate particularly high rates of misuse. Research has noted many variables related to college student substance use behaviors, and one of note is normative perceptions of misuse (i.e., perceptions of misuse among peers). The current study aims to examine the relationship between college student normative beliefs regarding MPM in relation to four different prescription medications (opioids, stimulants, tranquilizers, and sedatives) and actual rates of misuse.

Methods: 397 college students (M age = 20.7, 70% female, 74.1% White) participated in the study.

Results: The sample significantly overestimated rates of misuse of all four categories of medication among peers. Significant differences were found such that descriptive and injunctive normative beliefs differed between misusers and nonusers of prescription stimulants, and descriptive normative beliefs differed between misusers and nonusers of prescription tranquilizers. There were no differences found in descriptive or injunctive norms between misusers and nonusers of either prescription opioids or sedatives. Contrary to the hypothesized results, there were gender differences among descriptive norms of all categories of prescription medications. There were no gender differences in injunctive norms for any substance. Finally, there were no gender differences in rates of misusing any prescription medication.

Discussion: The current study shows changes in normative beliefs across college students relative to past research, specifically that misusers and nonusers of opioids do not significantly differ in their normative beliefs about prescription opioid misuse and that male and female college students have different normative beliefs about substance use behaviors. Implications for intervention are discussed.