Polysubstance use patterns and risk behaviors among people with cocaine use disorder

Both laboratory model and real-world study data suggest that cocaine use is associated with impulsivity and risk-taking. Further, many people who use cocaine report polysubstance use; however, there is a lack of research investigating associations between and among impulsivity, risk-taking, and polysubstance use. Polysubstance use involving cannabis is especially relevant given its use by over half of Americans who use cocaine. No work to date has examined the potential relations between concurrent use of cannabis and cocaine and outcomes of impulsivity and risk-taking. The present study compared participants whose urine was positive for cocaine, positive for cocaine and cannabis, and negative for cocaine and cannabis during an initial pretreatment baseline visit for 122 participants prior to enrollment in a randomized clinical trial for cocaine use disorder. Data suggest participants who co-used cocaine and cannabis were likely to use more cocaine and other substances (e.g., alcohol, other drugs) and self-report risky sexual behavior. Participants who abstained from cocaine and cannabis prior to the baseline appointment gambled at greater rates in a gambling task. Groups did not differ with respect to self-reported impulsivity. Co-use of cocaine and cannabis among those with cocaine use disorder is associated with increased drug use but may have limited association with self-reported impulsivity. (PsycInfo Database Record (c) 2025 APA, all rights reserved).