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Substance use has been strongly liked to psychosis, though less is known about illicit/prescription drug use and its relation to psychotic experiences among college students. We analyzed data from the 2020-2021 Cohort of the Healthy Minds Study (September 2020 – June 2021), which was an online survey administered across 140 college campuses in the United States. Multivariable logistic regression models showed the associations between each illicit/prescription drug and 12-month psychotic experiences, adjusting for socio-demographic characteristics, as well as alcohol, tobacco, and marijuana use. Nearly one-in-six of the sample reported psychotic experiences over the past year, and approximately 4% reported misusing any illicit or prescription drug over the past month. Separate multivariable logistic regression models showed that each drug was associated with greater odds of having psychotic experiences. The associations between drug use and psychotic experiences persisted even after adjustment for alcohol, tobacco, and marijuana use, though the relationships with heroin and methamphetamine use were statistically insignificant. The count of substances was associated with increased odds of psychotic experiences in a dose-response relation. Use of several illicit and prescription drugs was associated with psychotic experiences, even when accounting for alcohol, tobacco, and marijuana use.

Illicit and prescription drug use and psychotic experiences among university students in the United States