Diversion is particularly a problem among adolescents, who are easily influenced by peer pressure. In some cases, adolescents steal drugs from their parents and give or sell them to their friends. Older individuals may also receive diverted drugs or engage in stealing, prescription tampering, and illegal purchases of drugs over the Internet. Many abusers use two or more substances; for example, diverted Ritalin is often used in combination with alcohol and/or other drugs.

According to Zacny and colleagues in their article on opioid abusers of prescription drugs, there are four major types of abusers: (1) those who abuse or depend on only prescription drugs and not other drugs, (2) those who normally abuse illegal opioids such as heroin and will use prescribed opioids when they cannot obtain heroin, (3) those who primarily use other drugs but who sometimes use prescription opioids to gain an enhanced or different type of euphoria, and (4) those who have legitimate medical problems and sometimes develop a dependence on opioids. (Note that most experts agree that patients who experience severe pain and have no past history of abuse or dependence usually do not develop an addiction to a prescribed scheduled drug.)

In a study reported in 2005 in Addiction, the researchers sampled nearly 11,000 college students in 2001 on their abuse of prescribed stimulants, including Adderall, Dexedrine, and Ritalin. The researchers found that higher rates of abuse were found in students in northeastern colleges with competitive admission standards. They also discovered that abuse was more common among students who were white males. Members of fraternities and sororities were more likely to abuse stimulants than other students. In addition, abusers were more likely to report that they also abused alcohol, cocaine, marijuana and Ecstasy.

Experts report that there are several major ways to decrease prescription drug diversion, including the implementation of state prescription drug monitoring programs; further education of health care professionals, such as doctors and nurses; and plans to prevent theft and fraud, such as preventing theft from pharmacies and also prosecution of illegal Internet pharmacies.

OxyContin, a timed-release form of oxycodone, was partly developed to reduce its abuse potential because the medication is gradually delivered over time. Unfortunately, abusers subsequently discovered that the drug could be crushed and swallowed or injected, so that the entire drug would be absorbed at once.

References:

Kraman, Pilar. Prescription Drug Diversion. Lexington, Ky.: The Council of State Governments, April 2004.

McCabe, Sean Esteban, et al. "Non-Medical Use of Prescription Stimulants among US College Students: Prevalence and Correlates from a National Study." Addiction 100, no. 1 (January 2005): 96-106.

McCabe, S. E., C. J. Teter, and C. J. Boyd. "The Use, Misuse and Diversion of Prescription Stimulants among Middle and High School Students." Substance Use and Misuse 39, no. 7 (2004): 1,095-1,116.

National Center on Addiction and Substance Abuse (CASA) at Columbia University. Under the Counter: The Diversion and Abuse of Controlled Prescription Drugs in the U.S. New York: National Center on Addiction and Substance Abuse at Columbia University, July 2005.

Office of Applied Studies, Substance Abuse and Mental Health Services Administration. Overview of Findings from the 2004 National Survey on Drug Use and Health. Rockville, Md.: Department of Health and Human Services Publication Number SMA 05-4061, September 2005.

Poulin, Christiane. "Medical and Nonmedical Stimulant Use Among Adolescents: From Sanctioned to Unsanctioned Use." Canadian Medical Association Journal 165, no. 8 (2001): 1,039-1,044.

Zacny, James, et al. "College on Problems of Drug Dependence Taskforce on Prescription Opioid Non-Medical Use and Abuse: Position Statement." Drug and Alcohol Dependence 69 (2003): 215-232.

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