Drug misuse and diversion in adults prescribed anxiolytics and sedatives

Study Objective. To identify patterns of misuse and diversion of anxiolytic and sedative drugs among a sample of adults prescribed these drugs. Design. Cross-sectional study. Setting. University research center in Canada. Participants. Sixty-seven adults (aged 19-61 yrs) who had current prescriptions for anxiolytic or sedative drugs. Intervention. Face-to-face interviews and questionnaires were used to gather information on demographics as well as variables relating to drug misuse and diversion such as personality dimensions, psychiatric symptoms, and other substance use. Measurements and Main Results. Of the 67 participants, 36 (54%) reported misusing their drugs on at least one occasion, and 35 (52%) reported diverting their drugs at least once. A variety of forms of anxiolytic or sedative misuse were reported, including exceeding the recommended dosage (28 participants [42%]), deliberately using the drug with alcohol or another drug (27 [40%]), or taking it by an alternate route of administration (5 [7%]). Misuse and diversion were associated with a history of substance use and substance-related problems, as well as personality characteristics relating to impulsivity and hopelessness. Diversion was also associated with an increased likelihood of having taken any psychoactive prescription drug without having a valid prescription for it. Conclusion. A variety of forms of drug misuse and diversion occurred among this population of adults who were prescribed anxiolytics or sedatives. Likelihood of engaging in misuse or diversion was associated with other substance use, substance use disorders, and personality characteristics. Despite the modest sample size and cross-sectional design, this study identified substantial heterogeneity in prescription anxiolytic and sedative misuse, suggesting that the use of clearly defined operational criteria will be essential in future efforts to further characterize this phenomenon.