Baumgarten, Elsa <br/><br/>
Motivations for psychoactive substance use among medical students at three universities in Île-de-France: A pre-COVID study. 

 -  2025.<br/>							 
<br/><br/> 99 
<br/><br/> Introduction: The consumption of psychoactive substances among students is a public health issue worldwide, particularly affecting medical and health sciences students in the broad sense [1-5]. This has important implications for their health, training, and clinical and practical skills. Despite this, there is a clear lack of recent and methodologically robust studies on this subject [6,7]. To respond appropriately to these students’ needs, it is essential to understand their patterns of consumption, as well as the causes and motivations behind these behaviors. One well-documented issue in the United States is the consumption of substances to improve academic performance or cope with study-related pressure [7], which remains insufficiently evaluated in France. Methods: The objective of our study was to explore the motivations of medical students (Diploma of Advanced Training in Medical Sciences: DFASM 1-DFASM3), from the universities of Créteil, Paris Descartes, and Versailles regarding their substance use. Data were collected through self-administered questionnaires. The chosen method of analysis was thematic content analysis (TCA), a method consisting of “identifying recurring general themes in verbal or textual expressions that appear within various more concrete contents” [8], and systematically identifying, grouping and, subsequently, conducting a discursive examination of the themes addressed” [9]. The results were then quantified by theme. Results: A total of 276 students responded to the survey (F: 181, 65.82% – M: 93, 33.82%). One student did not indicate their gender. The majority of students (73%) reported consuming alcohol for recreational purposes and caffeine (71.5%) to maintain alertness. Stress was found to be an important motivation for the use of alcohol, caffeine, cannabis, antidepressants, and benzodiazepines. The term “decompress” was recurrent in verbatim responses. Similarly, students reported seeking to improve their cognitive performance through the use of caffeine, methylphenidate, and thyroid hormones. Notably, 46 out of the 276 students (14.5%) reported consuming nitrous oxide despite its major health risks. Discussion: The findings suggest that students primarily use caffeine to maintain wakefulness and increase their cognitive performance, and secondarily for recreational and hedonic purposes. Alcohol consumption is widely seen as recreational; however, a significant proportion of students reported feelings of overuse and consumption for anxiolytic purposes. The overall perception of psychostimulant use was largely negative. Yet, while many students opposed such behaviour and considered it dangerous, it was often regarded as understandable within the context of academic pressures and could be seen as a solution to meet university challenges—though also perceived as unfair competition. In addition, sedatives and anxiolytics were generally viewed more positively than psychostimulants, with their use seen as useful, even necessary, or beneficial, and viewed as less dangerous.