Detecting the diverted use of psychoactive drugs by adolescents and young adults: A pilot study

Pharmacoepidemiol Drug Saf. 2018 Nov;27(11):1286-1292. doi: 10.1002/pds.4624. Epub 2018 Sep 25.


Purpose: The increasing trend of diversion of nonprescription drugs (NPDs) by adolescents or young adults is worrying. We implemented this pilot study before a national investigation to identify requests for suspected recreational use of psychoactive drugs made by young subjects to community pharmacies.

Methods: Thirty-eight French community pharmacies were asked to complete questionnaire (with age, gender of subjects; name, form, quantity of drugs) for each suspect request formulated by subjects under 26. Besides, pharmacists were asked about the regulatory measures they thought useful to decrease this diverted use by young people. Nineteen pharmacies participated. The study covered from December 12, 2016 to January 23, 2017.

Results: Forty-one requests mentioning 51 drugs were reported. They concerned males (85%) aged 20 years old on average, including 6 minors. The most frequent age class was that comprised between 18 and 20 years old. Codeine-containing drugs (29 reports) and promethazine (17 reports), the main components of the popular cocktail "Purple drank," were the most requested, followed by dextromethorphan (3 reports). Fifteen drugs were requested in syrup form. One request concerned the prescription drug ketamine. Pharmacists suggested to schedule the concerned NPDs to prescription-only drugs and to increase the education of students as well as the public.

Conclusions: Codeine and promethazine, the main components of the popular cocktail Purple drank, were the most requested. Suspect requests of psychoactive drugs made by adolescents or young adults in community pharmacies should be carefully surveyed and combined to the monitoring of falsified prescriptions.

Keywords: addictovigilance; adolescent; community pharmacy; diversion; drug abuse; pharmacoepidemiology; purple drank; young.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Antitussive Agents / adverse effects
  • Antitussive Agents / chemistry*
  • Codeine / adverse effects
  • Female
  • France
  • Humans
  • Ketamine / adverse effects
  • Male
  • Nonprescription Drugs / adverse effects*
  • Pharmacies / statistics & numerical data
  • Pharmacovigilance
  • Pilot Projects
  • Prescription Drug Diversion / prevention & control*
  • Prescription Drugs / adverse effects*
  • Promethazine / adverse effects
  • Psychotropic Drugs / adverse effects*
  • Sex Factors
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / etiology
  • Substance-Related Disorders / prevention & control
  • Surveys and Questionnaires / statistics & numerical data
  • Young Adult


  • Antitussive Agents
  • Nonprescription Drugs
  • Prescription Drugs
  • Psychotropic Drugs
  • Ketamine
  • Promethazine
  • Codeine