ABSTRACTThe escalation of deviant behavior remains a central issue for criminologists, although mechanisms of intensification remain understudied. Using a sample of prescription drug misusers recruited via time–space sampling, we test five theoretically informed hypotheses on social and psychological factors—sensation seeking; coping; stigma; peer drug associations; use for pleasant times with peers—that may impact the escalation of deviance via non-normative consumption. Social factors—peer drug associations and use for pleasant time with peers—as well as stigma were associated with escalation. Sensation seeking was mediated by social factors. Social contexts are crucial for the intensification of deviant behavior.