Pursued for Their Prescription: Exposure to Compliance-Gaining Strategies Predicts Stimulant Diversion in Emerging Adults

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Researchers have begun to identify predictors of who will divert their stimulant prescriptions, as most emerging adults (EAs) who use prescription stimulants nonmedically procure these drugs from a friend or acquaintance with a prescription. Far less research has examined how EAs with attention-deficit/hyperactivity disorder (ADHD) are approached for these medications, and their affective and behavioral responses to these requests. We hypothesized that EAs with a stimulant prescription who reported greater exposure to compliance-gaining attempts from peers, particularly rational appeals for academic work, would be more likely to divert, as would EAs who reported lower resistance to peer influence. We recruited EAs diagnosed with ADHD (N = 149) through flyers, in-class presentations, campus-wide e-mails, and psychology subject pools at 2 demographically dissimilar college campuses. As predicted, a logistic regression showed that greater exposure to compliance-gaining strategies, Greek involvement, Northeast college attendance, and less guilt and worry about diversion predicted diversion (n = 53, 36%). Diverters were no less resistant to peer influence; however, a continuous measure assessing willingness to divert was inversely correlated with resistance to peer influence. An analysis of variance showed that rational appeals for academic work and guilt-inducing strategies for not complying with diversion requests were associated with the greatest likelihood of diversion. Further, negative affective responses (e.g., feeling manipulated, used) among students with a prescription following diversion were relatively common. Interventions to reduce diversion should inoculate EAs with ADHD against a range of compliance-gaining strategies and should help EAs who are experiencing dissonance about diversion to resist their peers’ requests more effectively.

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