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Polysubstance use: diagnostic challenges, patterns of use and health

Connor, Jason P.a,b,c; Gullo, Matthew J.a,b; White, Angelaa; Kelly, Adrian B.a

Current Opinion in Psychiatry: July 2014 - Volume 27 - Issue 4 - p 269–275
doi: 10.1097/YCO.0000000000000069
ADDICTIVE DISORDERS: Edited by John B. Saunders and Linda B. Cottler

Purpose of review Polysubstance use is common, particularly amongst some age groups and subcultures. It is also associated with elevated risk of psychiatric and physical health problems. We review the recent research findings, comment on changes to polysubstance diagnoses, report on contemporary clinical and epidemiological polysubstance trends, and examine the efficacy of preventive and treatment approaches.

Recent findings Approaches to describing polysubstance use profiles are becoming more sophisticated. Models over the last 18 months that employ latent class analysis typically report a no use or limited-range cluster (alcohol, tobacco and marijuana), a moderate-range cluster (limited range and amphetamine derivatives), and an extended-range cluster (moderate range, and nonmedical use of prescription drugs and other illicit drugs). Prevalence rates vary as a function of the population surveyed. Wide-ranging polysubstance users carry higher risk of comorbid psychopathology, health problems, and deficits in cognitive functioning.

Summary Wide-ranging polysubstance use is more prevalent in subcultures such as ‘ravers’ (dance club attendees) and those already dependent on substances. Health risks are elevated in these groups. Research into the prevention and treatment of polysubstance use is underdeveloped. There may be benefit in targeting specific polysubstance use and risk profiles in prevention and clinical research.

aFaculty of Health and Behavioural Sciences, Centre for Youth Substance Abuse Research, The University of Queensland

bAlcohol and Drug Assessment Unit, Princess Alexandra Hospital

cDiscipline of Psychiatry, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia

Correspondence to Jason P. Connor, PhD, FAPS, Centre for Youth Substance Abuse Research, The University of Queensland, K-Floor, Mental Health Centre, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia. Tel: +61 7 3365 5150; fax: +61 7 3365 5488; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins