Trends and psychosocial correlates of same day polysubstance use among people who inject drugs in Australia, 2012-2022.

Int J Drug Policy

National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia; School of Psychological Sciences, University of Tasmania, Hobart, Australia.

Published: August 2023

AI Article Synopsis

  • * The study analyzed 10 years of survey data (2012-2022) to identify five polysubstance use profiles and found a significant decline in opioid-depressant use, correlating with reduced pharmaceutical opioid usage and treatment, while single drug class use increased.
  • * Various polysubstance use profiles showed associations with psychosocial issues like unstable housing and high psychological distress, along with risky behaviors such as needle sharing and non-fatal overdoses, highlighting the complex nature of

Article Abstract

Background: Polysubstance use is associated with negative health and social outcomes among people who inject drugs. We aimed to describe trends in polysubstance use and identify psychosocial correlates and associated drug use risk behaviours. We defined polysubstance use as intentional same day use of more than one of three drug classes: opioids, other non-opioid depressants (hereafter 'depressants'), and stimulants.

Methods: We used 10 years (2012-2022, excluding 2020) of data from annual surveys in Australian capital cities with people who inject drugs (N=5657) to construct five mutually exclusive polysubstance use profiles: opioid-depressant, opioid-stimulant, stimulant-depressant, opioid-stimulant-depressant, and single drug class use. We examined time trends using the Mann Kendall test and identified correlates using multinomial logistic regression.

Results: Same day polysubstance use was relatively common among this sample (43.6%). Opioid-depressant use was the most frequent polysubstance use profile, but this decreased over the study period (32.6% to 13.3%, p<0.001). This aligned with observed decreases in use of pharmaceutical opioids (p<0.001), opioid agonist treatment (p=0.007), and benzodiazepines (p=0.001). There was no evidence for any trend in the other polysubstance use profiles, although single drug class use increased (51.9% to 64.7%, p=0.031). The different polysubstance use profiles were variously associated with psychosocial factors, including unstable housing and very high psychological distress, and other drug use risk behaviours, including non-fatal overdose, receptive and/or distributive needle sharing, and reusing one's own needles.

Conclusion: Same day polysubstance use has remained relatively common among this sample over time, although the typology has changed. Collectively, our findings point to diverse drug use patterns among people who inject drugs and reiterate the need for a range of harm reduction, treatment, and support options.

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Source
http://dx.doi.org/10.1016/j.drugpo.2023.104150DOI Listing

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