Polysubstance addiction patterns among 7,989 individuals with cocaine use disorder

To characterize polysubstance addiction (PSA) patterns of cocaine use disorder (CoUD), we performed a latent class analysis (LCA) in 7,989 participants with a lifetime DSM-5 diagnosis of CoUD. This analysis identified three PSA subgroups among CoUD participants (i.e., low, 17%; intermediate, 38%; high, 45%). While these subgroups varied by age, sex, and racial-ethnic distribution (p < 0.001), there was no difference with respect to education or income (p > 0.05). After accounting for sex, age, and race-ethnicity, the CoUD subgroup with high PSA had higher odds of antisocial personality disorder (OR = 21.96 vs. 6.39, difference p = 8.08x10-6), agoraphobia (OR = 4.58 vs. 2.05, difference-p= 7.04x10(-4)), mixed bipolar episode (OR =10.36 vs. 2.61, difference-p= 7.04x10(-4)), posttraumatic stress disorder (OR =11.54 vs. 5.86, difference-p= 2.67x10-4), antidepressant medication use (OR =13.49 vs. 8.02, difference-p= 1.42x10(-4)), and sexually transmitted diseases (OR = 5.92 vs. 3.38, difference-p= 1.81x10-5) than the lowPSA CoUD subgroup. These findings underscore the importance of modeling PSA severity and comorbidities when examining the clinical, molecular, and neuroimaging correlates of CoUD.

Automated summary

A latent class analysis identified three polysubstance addiction (PSA) subgroups among individuals with cocaine use disorder (CoUD), demonstrating differences in age, sex, and racial-ethnic distribution. The high PSA subgroup of CoUD was associated with increased risk of various comorbidities including antisocial personality disorder, agoraphobia, mixed bipolar episode, posttraumatic stress disorder, antidepressant medication use, and sexually transmitted diseases.