How to say "no" most effectively: Evaluating resistance strategies for prescription stimulant diversion to inform preventive interventions

J Am Coll Health. 2020 Nov-Dec;68(8):872-882. doi: 10.1080/07448481.2019.1626861. Epub 2019 Jun 26.

Abstract

We evaluated the perceived effectiveness of resistance strategies students could employ if approached to give away, trade, or sell their prescription stimulant medication, a growing concern on college campuses. Participants: We sampled undergraduates (N = 1,521) at three demographically dissimilar institutions between Fall 2017 and Spring 2018. Methods: We administered an anonymous, online survey and used linear mixed models to examine the effects of strategy type, face support (ie, adding politeness), and substance use history on perceived strategy effectiveness. Results: Internal (eg, "I am not comfortable sharing my medication") and external (eg, "My doctor won't prescribe me if I share") explanations were perceived to be most effective. Excuses, direct refusals, and suggesting an alternative (eg, energy drink) were less preferred. Adding face support improved perceived effectiveness for direct refusals and internal explanations. Conclusion: Preventive interventions for stimulant diversion could encourage the use of internal or external explanations or direct refusals with face support.

Keywords: Health education; college students; diversion; other drugs; prescription stimulants; resistance strategies.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Central Nervous System Stimulants / therapeutic use*
  • Female
  • Humans
  • Male
  • Prescription Drug Diversion / psychology*
  • Prescription Drug Diversion / statistics & numerical data
  • Prescription Drug Misuse / prevention & control*
  • Prescription Drug Misuse / psychology*
  • Prescription Drug Misuse / statistics & numerical data
  • Prescription Drugs / therapeutic use*
  • Students / psychology*
  • Students / statistics & numerical data
  • Surveys and Questionnaires
  • United States
  • Universities / statistics & numerical data
  • Young Adult

Substances

  • Central Nervous System Stimulants
  • Prescription Drugs