Profiles of polysubstance use among people reporting past 12-month sleep-motivated nonmedical use of prescription tranquilizers/sedatives.

Background and objectives: Nonmedical use of prescription tranquilizers/sedatives (NMUPTS) is associated with a 15-times increased likelihood of polysubstance use (PSU). This is correlated with an increased risk for use disorders and death, therefore, to inform prevention efforts, we identified PSU profiles among adults reporting sleep-related NMUPTS.

Methods: National Survey on Drug Use and Health 2015-2019 participants with past 12-month sleep-related NMUPTS and use of an additional drug(s) (n = 2603) were studied. Latent class analyses identified unique latent profiles, and multivariable logistic regressions identified covariates associated with each profile.

Results: Alcohol (90.4%), tobacco (61.5%), and marijuana (55.5%) were most commonly reported, with an average of 3.6 additional substances. Two latent PSU profiles were identified: marijuana/alcohol/tobacco (MAT) (68.3%) and MAT + cocaine/hallucinogens/prescription drugs (MAT + CHPR) (31.7%). In comparison to those likely in the MAT profile, those likely in the MAT + CHPR profile had lower odds of being older than 18-25 years (26-34: adjusted odds ratio [AOR]: 0.5, 95% confidence interval [CI]: 0.3, 0.6; 35-49: AOR: 0.2, 95% CI: 0.1, 0.2; 50+: AOR: 0.1, 95% CI: 0.0, 0.1), female (AOR: 0.4, 95% CI: 0.3, 0.6), non-Hispanic Black (AOR: 0.5, 95% CI: 0.4, 0.8) or Hispanic in comparison to non-Hispanic White (AOR: 0.5, 95% CI: 0.4, 0.8), and to not have past 12-month insurance coverage (AOR: 1.7, 95% CI: 1.3, 2.3).

Conclusions and scientific significance: Two PSU profiles were identified among people with NMUPTS, with noted variations in sociodemographic characteristics. In comparison to previous studies, sleep-related NMUPTS was associated with higher rates of stimulant use, suggesting stimulant use and sleep-related NMUPTS may be related.