Public Health Agency of Canada, Montréal, Quebec, Canada.
Public Health Agency of Canada, Ottawa, Ontario, Canada.
Health Promot Chronic Dis Prev Can. 2022 Feb;42(2):47-59. doi: 10.24095/hpcdp.42.2.01.
Polysubstance use-the use of substances at the same time or close in time-is a common practice among people who use drugs. The recent rise in mortality and overdose associated with polysubstance use makes understanding current motivations underlying this pattern critical. The objective of this review was to synthesize current knowledge of the reasons for combining substances in a single defined episode of drug use.
We conducted a rapid review of the literature to identify empirical studies describing patterns and/or motivations for polysubstance use. Included studies were published between 2010 and 2021 and identified using MEDLINE, Embase, PsycINFO and Google Scholar.
We included 13 qualitative or mixed-method studies in our analysis. Substances were combined sequentially to alleviate withdrawal symptoms or prolong a state of euphoria ("high"). Simultaneous use was motivated by an intention to counteract or balance the effect(s) of a substance with those of another, enhance a high or reduce overall use, and to mimic the effect of another unavailable or more expensive substance. Self-medication for a pre-existing condition was also the intention behind sequential or simultaneous use.
Polysubstance use is often motivated by a desire to improve the experience based on expected effects of combinations. A better understanding of the reasons underlying substance combination are needed to mitigate the impact of the current overdose crisis.
同时或接近使用多种物质（即药物滥用）是吸毒者的常见行为。最近与药物滥用相关的死亡率和过量用药的上升，使得了解这种模式背后的当前动机变得至关重要。本综述的目的是综合当前关于在单次药物使用中合并使用物质的原因的知识。
我们对文献进行了快速综述，以确定描述药物滥用中同时使用多种物质的模式和/或动机的实证研究。纳入的研究发表于 2010 年至 2021 年之间，使用 MEDLINE、Embase、PsycINFO 和 Google Scholar 进行了识别。
我们的分析纳入了 13 项定性或混合方法研究。物质的合并使用是为了缓解戒断症状或延长欣快感（“快感”）的持续时间；同时使用是为了抵消或平衡一种物质与另一种物质的作用，增强快感或减少总用量，并模仿另一种不可用或更昂贵的物质的效果；为了治疗先前存在的疾病而进行的自我药物治疗也是同时或顺序使用的原因。
药物滥用通常是基于对组合效果的预期，为了改善体验而进行的。需要更好地了解物质组合背后的原因，以减轻当前过量用药危机的影响。
