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

Abstract

Objective

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
• other drugs
• prescription stimulants
• resistance strategies
• diversion
• college students

Additional information

Funding

This work was supported by National Institute on Drug Abuse (NIDA) grant R03 DA041584. NIDA had no role in the study design, analysis and interpretation of data, the writing of the report, or in the decision to submit the article for publication.