Polysubstance Use Profiles Among the General Adult Population, United States, 2022
American Journal of Public Health – March 20, 2025
Source: OpenAlex
Summary
A 15,800-person survey found nearly 21% of the adult population engages in polysubstance use. A latent class model identified four patterns. While 11.5% showed medically guided use from a medical prescription, 4.0% exhibited a principal cannabis use variety, informing Cannabis and Cannabinoid Research, with 31.9% having substance abuse. Another 3.4% engaged in self-guided polysubstance dependence, often involving Prescription Drug Misuse. 2.1% displayed indiscriminate coexposures, relevant to Psychedelics and Drug Studies, with 58.9% substance abuse. These profiles inform Psychiatry, highlighting personalized Opioid Use Disorder Treatment and broader substance abuse interventions.
Abstract
Objectives. To characterize present-day polysubstance use patterns in the general adult population. Methods. From a 2022 nationally representative survey in the United States, we defined polysubstance use as last 12-month use of 2 or more drugs (n = 15 800). Latent class analyses included medical (as indicated) and nonmedical (not as directed) use of prescription opioids, stimulants, benzodiazepines, and antidepressants; recreational use of cannabis, psilocybin or mushrooms, other psychedelics, cocaine, methamphetamine, and illicit opioids; and concomitant use with alcohol, cannabis, prescriptions, or recreational drugs. Results. The national prevalence of polysubstance use was 20.9% (95% confidence interval = 20.5%, 21.3%), broken down into the following 4 latent classes: (1) medically guided polysubstance use (11.5% prevalence, 6.1% substance use disorder [SUD]): prescribed drug use, some cannabis, and no concomitant use; (2) principal cannabis use variety (4.0% prevalence, 31.9% SUD): high probability of cannabis use with various drugs concomitantly used; (3) self-guided polysubstance use (3.4% prevalence, 14.5% SUD): nonmedical use of prescriptions and concomitant use; and (4) indiscriminate coexposures (2.1% prevalence, 58.9% SUD): concomitant drug use with indiscriminate drug preference. Conclusions. Different polysubstance profiles show adults with untreated SUDs, and there are 2 previously unrecognized classes. Prevention and treatment strategies addressing polysubstance use should take a personalized perspective and tailor to individuals’ use profile. ( Am J Public Health. 2025;115(5):747–757. https://doi.org/10.2105/AJPH.2024.307979 )