Polysubstance use latent class membership in New Jersey: Association with prior overdoses, prior emergency department peer recovery engagement, and mental health diagnosis among participants in an opioid overdose recovery program

Abstract

Background: Epidemiological research has indicated higher polysubstance use among individuals who misuse opioids in the United States. Polysubstance use is also associated with multiple emergency department (ED) engagements in intervention services. Less is known about polysubstance use among individuals who use opioids or were engaged in an ED setting as part of an opioid recovery intervention program. Examining emerging patterns of polysubstance use among individuals who use opioids may help shape policy and practice around developing drug markets and social norms. The objective of this study was to understand subpopulations who demonstrated distinct patterns of polysubstance use among participants in an ED Opioid Overdose Recovery Program (OORP) in New Jersey. Method: This study investigated patterns of polysubstance use among participants in a New Jersey OORP using latent class analysis (LCA; N = 1690; 70.2% male; 84.7% White non-Hispanic; mean_age = 35.72 ± 11.95). Multinomial logistic regression analyses examined latent class (LC) membership based on clinically relevant indicators. Results: Five latent classes were identified (Model fit: L² = 33.76, BIC = 4482.69, AIC = 4245.01, and the bootstrap L² p-value =0.27; standard R² value of 0.85). Multinomial logistic regression analyses showed that subgroups with the greatest odds of prior OORP engagement related to those participants in subgroups with heroin and polysubstance use. Conclusion: It is critical to examine the heterogeneity among people engaging in prescription opioid use and polysubstance use in the United States. This study represents an important contribution in identifying polysubstance use LC membership groups and associations with clinically relevant indicators among those engaged in an opioid recovery program. Results can be valuable in understanding the nature of the larger epidemic and how it can be addressed.

Keywords:

• Polysubstance use
• overdose
• opioid use
• peer recovery

Acknowledgments

The views expressed are those of the authors and do not necessarily represent the views of the funding agency. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported in part by a contract from the state of New Jersey Division of Mental Health and Addiction Services to Rutgers University, School of Social Work.