Although recent increases in collegiate prescription drug misuse have generated a great deal of concern, there are few analyses available that examine the socio-cultural factors influencing these trends. This article attempts to address this gap in knowledge by providing an analysis of several socio-cultural factors influencing pharmaceutical misuse by college students. Prescription drugs are put to a number of different purposes in the collegiate setting, including self-medication, socio-recreation, and academic functioning. Such misuse is acceptable in a social context where individuals deliberately attempt to experiment with drugs. Widespread knowledge regarding effects, dosages, and compatibilities with other drugs, coupled with the extensive availability of pharmaceuticals in collegiate social circles, makes this class of drugs an attractive alternative to other psychoactive substances. These factors underscore several implications for substance abuse prevention efforts on college campuses and suggest a number of important issues for further research.