Associations between eating disorders and illicit drug use among college students

Objective To estimate the associations between a positive eating disorder screen and any lifetime eating disorder diagnosis and illicit drug use among a large, diverse sample of college students. Method We analyzed data from the national (United States), cross‐sectional 2018–2019 Healthy Minds Study (HMS; n = 42,618; response rate: 16%). HMS collects information on the physical, mental, and social health of college students. Multiple logistic regression analyses were used to estimate the association between a positive eating disorder screen (measured using the SCOFF) and any self‐reported lifetime eating disorder diagnosis and self‐reported illicit drug use in the past 30 days (any illicit drug use and use of marijuana, cocaine, heroin, methamphetamines, stimulants, ecstasy, opioids, benzodiazepines), while adjusting for potential confounders. Results Among the sample, 54.34% (n = 28,608) were female and the mean age of participants was 23.30 (SE ± 0.05) years. Logistic regression analyses revealed unique associations between a positive eating disorder screen and any lifetime eating disorder diagnosis and illicit drug use among the sample of college student participants. A positive eating disorder screen was most strongly associated with methamphetamine use (adjusted odds ratio [AOR] 3.93, 95% confidence interval [CI] 1.43–10.78), and any lifetime eating disorder diagnosis was most strongly associated with benzodiazepine use (AOR 3.42, 95% CI 2.28–5.13). Discussion Illicit drug use is common among college students who screen positive for an eating disorder and report any lifetime eating disorder diagnosis. The co‐occurring nature of eating disorders and illicit drug use may complicate treatment and lead to compounded adverse health outcomes.