Among adults with any substance use disorder (SUD), having more than one such disorder is highly prevalent depending on the type of substance they misuse, and more common among those who initiated substance use before age 18, according to a study published this week in Molecular Psychiatry.Why It’s Relevant
Though previous research has established that many adults misuse multiple substances, there is still limited understanding of the prevalence, severity, and correlates of polysubstance use disorders (having two or more SUDs).
By the Numbers
- The researchers used 2022-2023 national survey data from 92,233 adult respondents to assess various polysubstance use combinations and examine the impact that age of substance initiation has on later use.
- Overall, 50% of respondents reported using two or more substances in the past year.
- Although 66% of adults with alcohol use disorder and 62% of adults with nicotine dependence did not have other SUDs, most adults with other specific drug use disorders had polysubstance use disorders.
- The prevalence of having three or more SUDs ranged significantly—from 16% among those with cannabis use disorder to 48%, 62%, and 72% among those with methamphetamine, cocaine, and hallucinogen use disorders, respectively.
- Nearly half of U.S. drug overdose deaths involved multiple substances in 2022.
What’s More
Seventeen percent of respondents who initiated substances before age 18 reported past-year use of four or more substances, compared with 2% of those who initiated from ages 21 to 29. Further, 2.6% of those who initiated any substance before age 18 reported three or more SUDs, compared with just 0.2% among those who initiated from ages 21 to 29.
The Other Side
The researchers cautioned against drawing causal relationships from their findings, as the use of specific substances may be bidirectionally related to the use of other substances. The data they used also did not include information on lifetime prevalence of SUDs.
Takeaway Message
Though overdose deaths decreased in 2023, polysubstance overdose mortality has continued to climb, highlighting the complexity of the overdose crisis and the urgent need to address polysubstance use disorders. Additionally, the researchers’ finding as to the importance of age of first substance initiation underscores the crucial nature of prevention strategies that target youth.
Related Information
Source
Beth Han, et al. Polysubstance use disorders among US adults. Molecular Psychiatry. Published April 29, 2026. doi: 10.1038/s41380-026-03618-z
(Image: Getty Images/iStock/ccsccs7)
|
HHS Seeks to Curb Psychiatric Overprescribing Today, the U.S. Department of Health and Human Services (HHS) announced steps aimed at promoting appropriate psychiatric prescribing—including deprescribing when clinically indicated. Among the actions was a Dear Colleague Letter encouraging providers to prioritize informed consent and regularly review the risks and benefits of psychiatric medications with patients. Read more about HHS’ action plan as well as APA’s response. |
