Polysubstance addiction patterns among 7,989 individuals with cocaine use disorder

Area of Science:

• Psychiatry
• Addiction Medicine
• Clinical Psychology

Background:

• Cocaine use disorder (CoUD) frequently co-occurs with other substance use disorders, a condition known as polysubstance addiction (PSA).
• Understanding the patterns of PSA among individuals with CoUD is crucial for effective treatment and research.
• Previous research has not fully characterized the distinct subgroups within CoUD based on PSA severity.

Purpose of the Study:

• To identify and characterize distinct polysubstance addiction (PSA) patterns within a large cohort of individuals diagnosed with cocaine use disorder (CoUD).
• To examine the demographic and clinical correlates, particularly comorbidities, associated with different PSA subgroups in CoUD.

Main Methods:

• Latent class analysis (LCA) was employed on a dataset of 7,989 participants with a lifetime DSM-5 diagnosis of CoUD.
• Participants were categorized into three PSA subgroups: low (17%), intermediate (38%), and high (45%).
• Demographic variables (age, sex, race-ethnicity, education, income) and clinical comorbidities were analyzed across these subgroups.

Main Results:

• Three distinct PSA subgroups (low, intermediate, high) were identified among individuals with CoUD.
• While demographic distributions varied significantly by PSA level (p < 0.001), education and income did not differ (p > 0.05).
• The high PSA subgroup exhibited significantly higher odds of antisocial personality disorder, agoraphobia, mixed bipolar episodes, PTSD, antidepressant use, and STDs compared to the low PSA subgroup, even after controlling for demographic factors.

Conclusions:

• The findings highlight the heterogeneity of polysubstance addiction within cocaine use disorder.
• Severity of PSA is a critical factor associated with a wide range of psychiatric comorbidities and health issues in CoUD.
• Clinical and research approaches to CoUD should incorporate the assessment of PSA severity and associated comorbidities for a comprehensive understanding and tailored interventions.