Analgesic knowledge, attitudes, and self-reported use practices among students at a Palestinian university

We assessed analgesic knowledge, attitudes, and self-reported practices in a convenience sample of students at An-Najah National University. This cross-sectional survey (March–May 2026) used a study-specific questionnaire with unvalidated general analgesic-knowledge (0–9) and adverse-effect recognition (0–6) indices. Item-level findings were reported, and exploratory multivariable models examined adjusted associations. Existing sensitivity analyses assessed knowledge-item ambiguity and uncertain dose-exceedance responses. Among 404 students, 77.0% were female and 69.8% studied health-related subjects. Mean general knowledge was 5.61/9 ( n = 399), and adverse-effect recognition was 2.53/6 ( n = 404). Broad safety principles were recognized more frequently than several specific adverse effects. Non-prescription analgesic use was reported by 82.9%, ever use of more than one analgesic by 24.3%, and dose exceedance by 11.9%; another 8.9% were unsure about dose exceedance. Female sex, health-related major, and higher self-rated knowledge were associated with higher scores on both indices. Greater agreement that repeated use without consulting a doctor is safe was associated with self-reported use of more than one analgesic (adjusted odds ratio 1.50; 95% confidence interval 1.16–1.94) and confirmed dose exceedance (1.57; 1.16–2.14). The academic-year association with general knowledge was not retained after excluding the grouped NSAID-interval item. The multinomial analysis distinguished uncertain responses from confirmed exceedance, and knowledge-index associations depended on how uncertainty was handled. These descriptive and exploratory findings apply to this convenience sample. Non-prescription use and use of more than one analgesic cannot be classified as inappropriate or unsafe from these questions. Comparing current knowledge and attitudes with lifetime practices prevents conclusions about temporal order or causality.