Adolescents Treated for Attention-Deficit/Hyperactivity Disorder in Pediatric Primary Care: Characterizing Risk for Stimulant Diversion.
Brooke S G Molina, Heather M Joseph, Heidi L Kipp and 5 others
PMID 33908377WHAT IT FOUND
Most adolescents on ADHD stimulants reported low diversion risk, but older teens were approached to divert at nearly four times the rate of younger ones.
Factors like perceived peer misuse, low fear of consequences, and medication storage issues were linked to higher intent to divert.
Key findings
01Older adolescents were approached to divert their medication at nearly four times the rate of younger adolescents (11% vs. 3%).
02One-third of adolescents reported storing their medication in potentially unprotected or unmonitored locations.
03Intent to divert was associated with greater likelihood of diversion in social scenarios, lower perceived negative consequences, previous medication cessation, and problems from alcohol or drug use.
STILL TO COME
How it was doneWhat they found
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What it does not show
The sample was drawn from pediatric primary care practices near a major medical center, limiting generalizability to patients treated by psychiatrists or in other regions. Participants were predominantly from well-educated families, with only 20% from racial or ethnic minority groups. Self-reported diversion rates may be underestimated due to fear of disclosure to providers, despite confidentiality measures. The study is cross-sectional, so it identifies associations rather than causal predictors of future diversion.
Declared interests
The study was supported by the National Institute on Drug Abuse (NIDA). No other conflicts of interest are reported in the text.
The easy way to misread this
Do not interpret the low reported diversion rate (1%) as evidence that diversion is not a risk for your patients. The study found that older adolescents were approached to divert at significantly higher rates, and intent to divert was associated with modifiable factors like medication storage and perceived consequences.