Polysubstance Use Disorders in Individuals with Cannabis Use Disorder: Results from a Nationally Representative Sample (National Epidemiologic Survey on Alcohol and Related Conditions)

Objective: Cannabis use disorder (CUD) is one of the most common substance use disorders (SUDs) worldwide and is frequently associated with high rates of polysubstance use; however, despite rising rates of polysubstance use disorders (PUD), the characteristics of individuals with both CUD and PUD remain unclear. This study, therefore, aims to examine social and clinical characteristics of adults diagnosed with CUD and comorbid PUD. It also aims to assess whether psychiatric disorders are linked to higher odds of PUD among individuals with CUD. Methods: Using a nationally representative U.S. dataset, we assessed 972 individuals with past-year DSM-5 CUD, grouped as CUD only, CUD individuals with one additional SUD (CUD + 1), and CUD individuals with two or more SUDs (CUD + 2). Descriptive statistics summarized social and clinical presentations; multivariate logistic regression examined factors contributing to PUD, controlling for clinical diagnoses and childhood maltreatment. Results: Among CUD individuals, 89.3% (n = 868) used at least one other substance in the past year, with 34.2% (n = 332) using two or more. Both the CUD + 1 and CUD + 2 groups experienced significantly more severe childhood maltreatment than CUD only. After adjusting for controls, personality disorders were associated with membership in the CUD + 1 group (odds ratio [OR]: 1.88, p = 0.01); mood disorders were associated with a higher likelihood of being in the CUD + 1 group (OR: 1.50, p = 0.049) and CUD + 2 group (OR: 2.58, p = 0.005). Conclusion: Mood and personality disorders were highly prevalent and linked with PUD in CUD cases. We recommend screening for these disorders in complex CUD cases.