Seeking order in patterns of polysubstance use : Current Opinion in Psychiatry

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ADDICTIVE DISORDERS: Edited by John Saunders and Linda Cottler

Seeking order in patterns of polysubstance use

Connor, Jason P.a,b; Leung, Jannia; Chan, Gary C.K.a; Stjepanović, Daniela

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Current Opinion in Psychiatry 36(4):p 263-268, July 2023. | DOI: 10.1097/YCO.0000000000000881


Purpose of review 

This review provides an overview of recent developments in understanding polysubstance use patterns across the lifespan, and advances made in the prevention and treatment of harm arising from polysubstance use.

Recent findings 

A comprehensive understanding of the patterns of polysubstance use is hampered by heterogeneity across study methods and types of drugs measured. Use of statistical techniques such as latent class analysis has aided in overcoming this limitation, identifying common patterns or classes of polysubstance use. These typically include, with decreasing prevalence, (1) Alcohol use only; (2) Alcohol and Tobacco; (3) Alcohol, Tobacco, and Cannabis; and finally (4) a low prevalence, Extended Range cluster that includes other illicit drugs, New Psychoactive Substances (NPS), and nonmedical prescription medications.


Across studies, there are commonalities present in clusters of substances used. Future work that integrates novel measures of polysubstance use and leverages advances in drug monitoring, statistical analysis and neuroimaging will improve our understanding of how and why drugs are combined, and more rapidly identify emerging trends in multiple substance use. Polysubstance use is prevalent but there is a paucity of research exploring effective treatments and interventions.

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