Dataset Information

One Is Not Enough: Understanding and Modeling Polysubstance Use.

ABSTRACT: Substance use disorder (SUD) is a chronic, relapsing disease with a highly multifaceted pathology that includes (but is not limited to) sensitivity to drug-associated cues, negative affect, and motivation to maintain drug consumption. SUDs are highly prevalent, with 35 million people meeting criteria for SUD. While drug use and addiction are highly studied, most investigations of SUDs examine drug use in isolation, rather than in the more prevalent context of comorbid substance histories. Indeed, 11.3% of individuals diagnosed with a SUD have concurrent alcohol and illicit drug use disorders. Furthermore, having a SUD with one substance increases susceptibility to developing dependence on additional substances. For example, the increased risk of developing heroin dependence is twofold for alcohol misusers, threefold for cannabis users, 15-fold for cocaine users, and 40-fold for prescription misusers. Given the prevalence and risk associated with polysubstance use and current public health crises, examining these disorders through the lens of co-use is essential for translatability and improved treatment efficacy. The escalating economic and social costs and continued rise in drug use has spurred interest in developing preclinical models that effectively model this phenomenon. Here, we review the current state of the field in understanding the behavioral and neural circuitry in the context of co-use with common pairings of alcohol, nicotine, cannabis, and other addictive substances. Moreover, we outline key considerations when developing polysubstance models, including challenges to developing preclinical models to provide insights and improve treatment outcomes.

SUBMITTER: Crummy EA

PROVIDER: S-EPMC7309369 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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One Is Not Enough: Understanding and Modeling Polysubstance Use.

Crummy Elizabeth A EA O'Neal Timothy J TJ Baskin Britahny M BM Ferguson Susan M SM

Frontiers in neuroscience 20200616

Substance use disorder (SUD) is a chronic, relapsing disease with a highly multifaceted pathology that includes (but is not limited to) sensitivity to drug-associated cues, negative affect, and motivation to maintain drug consumption. SUDs are highly prevalent, with 35 million people meeting criteria for SUD. While drug use and addiction are highly studied, most investigations of SUDs examine drug use in isolation, rather than in the more prevalent context of comorbid substance histories. Indeed ...[more]

PMID: 32612502

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Project description:Background:Research on cannabis has focused on lifetime use or regular/heavy use (i.e., daily or almost daily). Regular, albeit not necessarily daily, cannabis use has received less scientific attention. Objectives:This study aims to identify demographic and personality factors associated with recurrent cannabis use (i.e., cannabis usage 5 to 50 times in the last six months) and to investigate the relationship between cannabis use and use of other substances. Methods:Public and private university students (N = 11,236) in Bergen, Norway, participated in an online survey during autumn 2015. Binary logistic regression was run to identify individual characteristics related to recurrent cannabis use. Chi-square tests were conducted to investigate differences in substance use (alcohol, nicotine, and illicit drugs) between recurrent cannabis users and cannabis abstainers/low-frequency users. Results:A total of 4.0% of the students reported recurrent cannabis use. Students born in North America, non-Christians (compared to non-religious students), and men were more likely to be recurrent users. Recurrent cannabis users scored higher on extroversion and intellect/imagination compared to abstainers/low-frequency users. Male and female recurrent cannabis users had somewhat different characteristics (e.g., agreeableness scores were negatively associated with recurrent use among females but not among males). Recurrent cannabis use was overall strongly associated with polysubstance use. Conclusions:The prevalence of recurrent cannabis use among Norwegian students is low. Recurrent cannabis use seems more prevalent among individuals marked by extroversion and intellect/imagination, which supports the notion of cannabis use as a social activity for individuals identifying themselves as outgoing and unconventional. Cannabis use among students seems strongly associated with use of other substances, suggesting that cannabis should not be considered a replacement drug.

Project description:ObjectiveTo assess trends in polysubstance use among pregnant women with opioid use disorder in the United States.MethodsWe conducted a time trend analysis of pooled, cross-sectional data from the National Inpatient Sample, an annual nationally representative sample of U.S. hospital discharge data. Among 38.0 million females aged 15-44 years with a hospitalization for delivery from 2007 to 2016, we identified 172,335 pregnant women with an International Classification of Diseases, Ninth Revision, Clinical Modification or International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis of opioid use disorder. Polysubstance use among pregnant women with opioid use disorder was defined as at least one co-occurring diagnosis of other substance use, including alcohol, amphetamine, cannabis, cocaine, sedative, or tobacco. We fit weighted multivariable logistic regression models to produce nationally representative estimates, including an interaction between year and rural compared with urban county of residence; controlled for age, race, and insurance type. Average predicted probabilities and 95% CIs were derived from regression results.ResultsPolysubstance use among women with opioid use disorder increased from 60.5% (95% CI 58.3-62.8%) to 64.1% (95% CI 62.8%-65.3%). Differential time trends in polysubstance use among women with opioid use disorder were found in rural compared with urban counties. Large increases in amphetamine use occurred among those in both rural and urban counties (255.4%; 95% CI 90.5-562.9% and 150.7%; 95% CI 78.2-52.7%, respectively), similarly to tobacco use (30.4%; 95% CI 16.9-45.4% and 23.2%; 95% CI 15.3-31.6%, respectively). Cocaine use diagnoses declined among women with opioid use disorder at delivery in rural (-70.5%; 95% CI -80.4% to -55.5%) and urban (-61.9%; 95% CI -67.6% to -55.1%) counties. Alcohol use diagnoses among those with opioid use disorder declined -57% (95% CI -70.8% to -37.7%) in urban counties but did not change among those in rural counties.ConclusionOver the past decade, polysubstance use among pregnant women with opioid use disorder has increased more rapidly in rural compared with urban counties in the United States, with amphetamines and tobacco use increasing most rapidly.

Dataset Information

One Is Not Enough: Understanding and Modeling Polysubstance Use.

Publications

One Is Not Enough: Understanding and Modeling Polysubstance Use.

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