Preventing prescription stimulant diversion and misuse through brief intervention: Moderators and secondary outcomes from a randomized controlled trial.

Abstract

Prescription stimulant diversion (PSD) and misuse (PSM) are prevalent among young adults with stimulant prescriptions and have been associated with conduct problems and poorer attention-deficit/hyperactivity disorder symptom management, functional impairment, and other substance use and misuse. Few evidence-based interventions address PSD and PSM; to date, no research has examined for whom these interventions are most/least effective and potential downstream benefits on psychosocial functioning. In the present study, we examined whether conduct problems in childhood moderated response to an interactive web-based intervention focused on preventing PSD and PSM and whether immediate release prescriptions were associated with more PSD and PSM. We also evaluated the impact of the intervention on functional impairment, binge drinking, other substance use, and accidental injuries. We randomized students from three U.S. universities with current stimulant prescriptions (M_age = 20.42 years, 74% female, 86% White) to the intervention (n = 128) or attention-matched placebo (n = 121) in a single-blind design, with 3- and 6-month follow-ups. Conduct problems and being prescribed an immediate release medication were associated with a greater likelihood of PSD, but not PSM; however, conduct problems were not associated with a differential response to the intervention (any PSD/PSM). Compared to the placebo, the intervention group reported lower attention-deficit/hyperactivity disorder impairment and substance use at the 6-month follow-up; rates of accidental injuries did not differ between the two groups. Findings suggest the intervention had significant but modest effects on psychosocial outcomes. Future targeted interventions for PSD may focus on students with conduct problem histories and/or immediate release prescriptions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).