Other than marijuana, most exposures to illicit substances occurred after both initial prescription stimulant NMU and initial non-oral prescription stimulant NMU. Results: Approximately 1 in 5 began their substance use trajectory with prescription stimulants (19.1%). Data reported here include substance, route of administration and class transitions, as well as qualitative data from the interviews. After completion of the survey, a second study consisting of an in-depth telephone interview was conducted with 23 participants: interviews took place between July and September 2019. Methods: Adults ( n = 225) reporting non-oral prescription stimulant NMU within the last 5 years were recruited to complete an online survey by banner ads placed on the Reddit website between February and September 2019. The purpose of the present study was to characterize the pathways and substance transitions associated with prescription stimulant NMU and non-oral prescription stimulant NMU in this unique sample of adults. To focus on this gap, a sample of adults with non-oral prescription stimulant NMU within the last 5-years was recruited. While the risks of prescription stimulant NMU have been considered, less is known about non-oral use. Objective: Prescription stimulant non-medical use (NMU) is a national predicament. 3Department of Psychiatry, State University of New York (SUNY) Upstate Medical University, Syracuse, NY, United States.2Department of Psychology, Syracuse University, Syracuse, NY, United States.

1Inflexxion, An IBH Company, Costa Mesa, CA, United States.

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