In 2019, 902 overdose deaths among young adults were related to prescription stimulants. This may be due to the growing issue of prescription drug diversion which is the sharing, selling, and/or trading of prescription medications to others for non-medical purposes. The diversion of prescription drugs increases the availability of these drugs to populations seeking to misuse. Therefore, it is important to identify protective factors against diversion initiation and prescription stimulant misuse. This study examines the motivations for prescription stimulant misuse and diversion cessation among college students who have a history of initiating and discontinuing these behaviors.
The study’s sample consisted of 13 college students who completed an interview focused on prescription stimulant misuse and diversion. The interviews addressed overall experiences and contexts within which misuse and diversion occurred, deterrents to continuing those behaviors, and recommendations for addressing the behaviors. Students who reported not engaging in misuse and diversion behaviors during the past year were asked to elaborate on why. Data was analyzed using a three step inductive coding process: open coding, axial coding, and selective coding. A discussion-based approach was then used to identify common themes.
The data analysis revealed four themes surrounding short-term and long-term cessation of diversion and misuse behaviors: engaging in related behavior change, seasonality of the behaviors, changes in personal needs, and negative experiences with behaviors. Two themes surrounding diversion only were also identified: moral and legal concerns and not wanting to be perceived as a drug dealer. In regards to the first theme, some related behaviors that were identified were end of personal use, no longer partying, and no longer using cannabis. For seasonality of behaviors misuse was often associated with academics or recreation. Changes in personal needs that were identified included medical, academic, and/or financial. Negative experiences associated with misuse and diversion was also a common theme identified. Some of the negative experiences reported were adverse health events and experiencing no effect at all. The moral and legal concerns that were addressed were not wanting someone else to have a reaction and/or overdose and fear of legal prosecution.
Takeaway: When college student who had a history of prescription stimulant misuse and/or diversion initiation and cessation were interviewed six themes emerged: engaging in related behavior change, seasonality of the behaviors, changes in personal needs, negative experiences, moral and legal concerns, and not wanting to be perceived as a drug dealer.