The prevalence of prescription drug misuse and abuse has increased dramatically, particularly in young adults age 18-25. Recent research now indicates that young adults living in rural communities are more likely than their urban counterparts to abuse prescription drugs. The purpose of this 2-phase, exploratory study is twofold: 1) to examine the prevalence rates and correlates of nonmedical prescription drug (NMPDU) use among college students on a rural southeastern college campus, and 2) to examine how environmental factors, specifically coming from a rural environment (vs. urban) and living in a rural college environment affect students’ current collegiate NMPDU.

This study used mixed-methods study design with focus groups (Phase 1) to inform a campus-wide survey (Phase 2). For Phase 1, 40 students (32 from the general student population; 8 from the Center for Addiction Recovery) were recruited to participate in 5 focus groups of 8 students each. Focus groups were recorded and these audio files were transcribed into text files which were loaded into Atlas.ti, a qualitative data analysis software, for analysis. Classical three-pass coding was performed. Open-ended coding during the first pass-through to locate themes and assign initial codes, the second pass, combined themes to form cluster of concepts from open coding, The final coding was used to determine the types of comparisons, and select relevant themes to guide Phase 2. Higher prevalence of NMPDU in the rural environment is discussed as well as perceptions of NMPDU gleaned from these focus groups.