Diversion of Prescription Stimulants by 10 to 18 year olds from N-MAPSS

Background: Recent studies on adolescent stimulant abuse discuss reasons for nonmedical use (NMU). Common sources include diversion of medications from friends and relatives with a strong association with the use of illicit substances. Aim: This analysis examines diversion of prescription stimulants (RxStim) among 10-18 year olds from the National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS). Methods: Youth were recruited for an anonymous survey from entertainment venues in 10 US metropolitan areas. Outgoing diversion (OD) included selling, trading or giving RxStim away. Incoming diversion (ID) included past 30-day use of another's RxStim or ever stealing, borrowing or being given RxStim. Predictive logistic regression models were used. Results: The sample (N=10,889) is 48% male, 43% Caucasian, and 48% urban. Over half (56%) lived with both parents; 13% reported ADD/ADHD. RxStim users (15%) vs. non-users were more likely to be male, older, Caucasian, ADD/ADHD, not live with both parents, fear being overweight, have smoked, drank alcohol, used marijuana, been suspended from school and/or report friend(s) used RxStim (63% vs. 21%). Substance use, school suspension and friend(s) who used RxStim consistently predicted diversion. Older age and fear of overweight predicted ID in both RxStim and non-users. Among RxStim users, not ADD/ADHD also predicted ID but not OD. Among non-users, male gender predicted OD but not ID. Having friend(s) who used RxStim was a stronger predictor in RxStim users than non-users (OR: 3.1-3.7 vs. 1.8-2.0). Conclusions: N-MAPSS findings suggest peer influences play a role in the relationship between RxStim diversion and other drug use.