Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, 800 East Leigh Street, Box 980126, Richmond, VA 23298, USA.
Department of Psychiatry, Virginia Commonwealth University, P.O. Box 980308, Richmond, VA 23298, USA.
Alcohol Alcohol. 2022 Sep 10;57(5):622-629. doi: 10.1093/alcalc/agac012.
The present study examined patterns and correlates of polysubstance use among individuals with severe alcohol use disorder (AUD).
Participants were 2785 individuals (63% female; mean age = 43 years, range = 18-78 years) from the Genes, Addiction and Personality Study. All participants met lifetime criteria for severe AUD (6+ symptoms). We used latent class analysis to identify patterns of frequency of lifetime use for cigarettes, marijuana, cocaine, stimulants, sedatives, opioids and hallucinogens. A variety of demographic and behavioral correlates of latent class membership were tested in univariable and multivariable models.
A five-class solution was selected: extended range polysubstance use (24.5%); cigarette and marijuana use (18.8%); 'testers,' characterized by high probabilities of smoking 100 or more cigarettes, using marijuana 6+ times, and trying the remaining substances 1-5 times (12.3%); moderate range polysubstance use (17.1%) and minimal use (reference class; 27.3%). In univariable analyses, all potential correlates were related to latent class membership. In the multivariable model, associations with gender, race/ethnicity, age of onset for alcohol problems, dimensions of impulsivity, depressive symptoms, antisocial behavior and family history density of alcohol problems remained significant, though the pattern and strength of associations differed across classes. For instance, sensation-seeking, lack of premeditation and family history were uniquely associated with membership in the extended range polysubstance use class.
Patterns of polysubstance use are differentially related to demographic and behavioral factors among individuals with severe AUD. Assessing use across multiple substances may inform the selection of targets for treatment and prevention.
本研究考察了患有严重酒精使用障碍（AUD）个体的多种物质使用模式及其相关因素。
参与者为来自基因、成瘾和人格研究的 2785 名个体（63%为女性；平均年龄为 43 岁，年龄范围为 18-78 岁）。所有参与者均符合终生严重 AUD（6+症状）标准。我们使用潜在类别分析来确定终生使用香烟、大麻、可卡因、兴奋剂、镇静剂、阿片类药物和致幻剂的频率模式。在单变量和多变量模型中，测试了多种人口统计学和行为相关因素与潜在类别成员的关系。
选择了一个五类别解决方案：广泛范围的多种物质使用（24.5%）；香烟和大麻使用（18.8%）；“测试者”，其特点是吸烟 100 支或以上、大麻使用 6 次或以上以及尝试其余物质 1-5 次的概率较高（12.3%）；中度范围的多种物质使用（17.1%）和最小使用（参考类别；27.3%）。在单变量分析中，所有潜在的相关因素都与潜在类别成员有关。在多变量模型中，与性别、种族/民族、酒精问题发病年龄、冲动性维度、抑郁症状、反社会行为以及酒精问题家族史密度相关的因素仍然具有显著意义，但关联的模式和强度因类别而异。例如，寻求刺激、缺乏预谋以及家族史与广泛范围的多种物质使用类别成员身份具有独特的相关性。
在患有严重 AUD 的个体中，多种物质使用模式与人口统计学和行为因素存在差异。评估多种物质的使用情况可能有助于确定治疗和预防的目标。
