Polysubstance use-the use of substances at the same time or close in time-is a common practice among people who use drugs. Results highlight affective motivations for substance use and maltreatment history as potential treatment targets and underscore the importance of studying polysubstance use in the context of the opioid epidemic. Results provide compelling initial evidence that lifetime patterns of use can be used to identify groups of substance users with distinct risk and maintenance factors. Cognitive functioning did not differentiate the heavy substance use profiles. using to seek a thrill), age of use onset, drug-related functional impairment, and experiences of childhood maltreatment. The profiles differed on affective motivations for substance use (e.g., using to cope vs.

polysubstance use (Recreational Marijuana Use, Heavy Multidrug Intoxication, Heavy Marijuana Use, and Heavy Opioid and Polysubstance Use). Four profiles of lifetime substance use emerged that diverged on severity of use and degree of mono vs. Latent profile analysis was used to identify distinct profiles of substance use that were then compared on potential risk and maintenance factors for substance use. Participants reported on the frequency of lifetime substance use across multiple drug categories (sedatives, stimulants, marijuana, heroin, hallucinogens, misuse of prescription drugs) and alcohol use. To survey a spectrum of drug use severity, 1106 adults (43.4% women) were recruited from forensic and community samples. This study took a person-centered approach to identify profiles of lifetime substance use and discern the psychosocial differences among them. To develop personalized interventions and improve outcomes in substance-using populations, research is needed on the heterogeneity in substance use patterns and motivations that exists among adult substance users. Future interventions could be tailored to polysubstance patterns during the period of justice-involvement. More diverse polysubstance patterns may serve as a proxy to identifying individuals with competing physical and mental health needs.

Conclusion: Findings indicate the heterogeneity of opioid use among a justice-involved population. Profiles differed by rural/urban geography, injection drug use, physical, and mental health symptoms. Findings: Six unique profiles of polysubstance use involving opioids and other substances were found Primarily Alcohol (9.4%), Primarily Heroin (19.0%), Less Polysubstance Use (34.3%), Tranquilizer Polysubstance Use (16.3%), Primarily Buprenorphine (7.8%), and Stimulant-Opioid (13.2%). Multinomial logistic regression predicted latent profile membership. Measurements: To determine the different typologies of polysubstance use involving opioids, latent profile analysis of the pre-incarceration thirty-day drug use of eight substances was conducted. Participants: A cohort of 6,569 individuals who reported both pre-incarceration use of opioids and reported the use of more than one substance per day. Design: Setting: Data from prison and jail substance use programing in the state of Kentucky from 2015–2017 was examined. The current study explores pre-incarceration polysubstance use patterns among a justice-involved population who use opioids.

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