Is drug use inevitable among teens and young adults? Listen to Dr. Robert DuPont’s discussion on High Truths on Drugs and Addiction, Episode # 13. Dr. DuPont gets right to the data in challenging the myth that “everyone uses.”
Dr. Roneet Lev of High Truths Podcast
A new article co-authored by IBH President Robert L. DuPont, MD and Wilson M. Compton, MD, MPE and Rita J. Valentino of the National Institute on Drug Abuse (NIDA) urges new research on the prevalence and reasons for polysubstance use to inform and improve both the prevention and treatment of opioid use disorders. The current approach to substance use disorders (i.e., addiction) is substance-specific which neglects to address the common issue of polysubstance use.
Published in Molecular Psychiatry, authors highlight the overlap of substances used by American adults across the lifetime, noting, “as a general principal, the more widely a drug is used, the higher the percentage of users who do not use other drugs; and, the less widely used, the more likely a drug is to be used with other drugs.”
Fig. 1: Overlap of substances used across the lifetime. Weighted lifetime prevalence of substance use and mean number of other substances ever used by adults age 18 and older in the United States (n = 51,000; Source: 2018 U.S. National Survey on Drug Use and Health [adapted from Eric Wish, University of Maryland, Center for Substance Abuse Research]).
Abstract: Interventions to address the U.S. opioid crisis primarily target opioid use, misuse, and addiction, but because the opioid crisis includes multiple substances, the opioid specificity of interventions may limit their ability to address the broader problem of polysubstance use. Overlap of opioids with other substances ranges from shifts among the substances used across the lifespan to simultaneous co-use of substances that span similar and disparate pharmacological categories. Evidence suggests that nonmedical opioid users quite commonly use other drugs, and this polysubstance use contributes to increasing morbidity and mortality. Reasons for adding other substances to opioids include enhancement of the high (additive or synergistic reward), compensation for undesired effects of one drug by taking another, compensation for negative internal states, or a common predisposition that is related to all substance consumption. But consumption of multiple substances may itself have unique effects. To achieve the maximum benefit, addressing the overlap of opioids with multiple other substances is needed across the spectrum of prevention and treatment interventions, overdose reversal, public health surveillance, and research. By addressing the multiple patterns of consumption and the reasons that people mix opioids with other substances, interventions and research may be enhanced.
Compton, W.M., Valentino, R.J. & DuPont, R.L. (2021). Polysubstance use in the U.S. opioid crisis. Molecular Psychiatry, 26, 41–50. https://doi.org/10.1038/s41380-020-00949-3
