Prescription Stimulant Diversion on a College Campus: Intrapersonal, Interpersonal, and Environmental Correlates

Abstract

Prescription stimulant diversion is a behavior that increases the availability and accessibility of prescription stimulants for purposes such as misuse. As such, we aimed to develop a theory-guided understanding of diversion correlates. Data are from a probability sample of 499 undergraduate college students attending one California university. Participants completed a 100-item survey related to prescription stimulant misuse and diversion. We first calculated prevalence of diversion and associations with demographic variables. Next, to examine intrapersonal, interpersonal, and environmental correlates of diversion, we estimated three separate nested logistic regression models. Prescription stimulant diversion during college was reported by approximately 10% of the sample. In the nested logistic analyses, diversion was found to be associated with intrapersonal, interpersonal, and environmental variables. These findings highlight the importance of examining a comprehensive set of correlates to identify subgroups of students at risk for engaging in sharing and/or selling of prescription stimulants.

Intranasal Use of Prescription Stimulants Among Adults Aged 18 to 30: Results From A Crowdsourcing Platform

“…The primary source of diverted medication was family and friends, while most of the medication that was diverted was given or shared rather than purchased. Diversion is a public health concern because it is invisible (Garcia et al, 2022; Lam et al, 2020; Lasopa et al, 2015), and yet must be balanced with the recognized need and medical benefit of prescription stimulants. Most IN users reported performance enhancement as their primary reason for NMU (Compton et al, 2018; Faraone et al, 2020; Wilens et al, 2008), however, a sizeable proportion of IN users reported IN use to get high or to “party longer.” An interaction between route of administration and motivation for use has been recently reported in other literature and bears further examination to better characterize this relationship (Vosburg, Robbins et al, 2021).…”

Using Narrative Vignettes to Understand the Misuse and Diversion of Stimulants Among College Students With and Without a Prescription

“…With respect to diversion, another study that surveyed college students with a prescription found that 43.8% had diverted their prescription stimulant medication (Schultz et al, 2017). In a more recent study, Lam and colleagues (2020) reported that diversion is not limited solely to students with a prescription, indicating that the sub-population of students engaging in these behaviors is greater than previously considered. As prescription stimulant misuse and diversion represent interrelated substance use behaviors, and emerging adulthood has been noted as a period when the prevalence of substance use is highest (Arnett, 2005), then it is understandable that a systematic review of 111 studies found misuse and diversion to disproportionately affect college-attending emerging adults (Faraone et al, 2020).…”

“…From a developmental perspective, if emerging adulthood is viewed as a period of identity explorations (Arnett, 2005), students with high levels of exploration should engage in more misuse and diversion as compared to students with lower levels of exploration. Indeed, prior research has shown that students who view college as a time to experiment with drugs, and students who endorse the characteristics of a sensation-seeking personality, engage in more frequent prescription stimulant misuse and diversion (e.g., Bavarian et al, 2013; Lam et al, 2020).…”

“…Ecological health behavior theories such as the Theory of Triadic Influence (TTI; Flay & Petraitis, 1994) have previously been used to quantitatively examine prescription stimulant misuse (e.g., Bavarian et al, 2013) and diversion (Lam et al, 2020). The TTI posits habitual behavior is influenced by experiences with trial behavior, the immediate precursor to trial behavior is intentions, and intentions are influenced by risk and protective factors that fall within one of three streams of influences (i.e., Intrapersonal, Interpersonal, and Environmental).…”

Upstream Approaches to Addressing Prescription Stimulant Misuse and Diversion: Exploring Perspectives of College Students Who Misuse and Divert

“…For example, in one study with college students who have a prescription for stimulant medications, the prevalence of past-year misuse and diversion was 33% and 18%, respectively (Ramachandran et al, 2020). In a separate study including students with and without a prescription, the prevalence of having ever misused or diverted during college was approximately 21% (Bavarian et al, 2018) and 10% (Lam et al, 2020), respectively. These levels of diversion are particularly problematic because when friends and/or acquaintances serve as the primary source of prescription stimulants (Garnier-Dykstra, Caldeira, Vincent, O'Grady, & Arria, 2012), the oversight provided by health care providers is lacking, thereby increasing the chance for adverse effects (Goldsworthy, et al, 2008).…”