One in five U.S. adults used more than one drug over the past year. A new study reveals this information from researchers at the University of Colorado Anschutz Medical Campus. This highlights that substance use is not only common but often far more complex than previously assumed.
The research was published in the American Journal of Public Health. It suggests that multiple drug use patterns vary widely. This calls for more nuanced prevention and treatment strategies.
FOUR DISTINCT DRUG USE PROFILES IDENTIFIED
Drawing from a survey of 30,000 adults, the research categorized people who use prescription medications, recreational drugs like cannabis, and illegal substances like cocaine into four major patterns:
• Medically Guided Use (11.5%)
Individuals who primarily use prescribed medications with occasional cannabis use.
• Cannabis-Focused Use (4.0%)
Users who mainly consume cannabis alongside other drugs, often simultaneously.
• Self-Guided Use (3.4%)
Individuals taking prescription drugs without medical supervision.
• Indiscriminate Use (2.1%)
People using multiple drugs—including both prescription and recreational—without a clear pattern or guidance.
Lead author Dr. Karilynn Rockhill, a researcher at the Colorado School of Public Health, noted that these findings offer a “more nuanced picture” of substance use across the country.
“It’s essential we shift toward tailored approaches in healthcare and public health. These diverse drug use patterns demand targeted prevention and treatment options,” Rockhill explained.
PUBLIC HEALTH IMPLICATIONS: ONE SIZE DOESN’T FIT ALL
Notably, individuals in the “cannabis-focused” and “indiscriminate use” groups showed higher rates of substance use disorders. However, these individuals are often not connected to regular medical care.
This disconnect signals a major gap in outreach and treatment, especially when it comes to early screening and intervention. Current strategies often assume a singular drug-use model, overlooking the complex behaviors many adults actually exhibit.
“Improving how doctors screen for substance use, and expanding public health outreach, could identify at-risk individuals sooner,” said Rockhill. “Many are slipping through the cracks.”
WHY PERSONALIZED STRATEGIES ARE ESSENTIAL
The research underscores a pressing need for personalized public health frameworks. Instead of treating all drug users the same, experts now advocate for customized interventions based on use patterns.
For instance:
• Medically guided users may benefit from discussions around safe cannabis use alongside prescribed medications.
• Self-guided users may need better access to healthcare and prescription oversight.
• Cannabis-focused and indiscriminate users might require more intensive support and community outreach to prevent substance misuse from escalating.
Moreover, some individuals may not recognize their behaviors as risky. This is especially true if they’re using substances seen as socially acceptable or medically legal. Examples include cannabis or prescription drugs.
A CALL FOR SMARTER, MORE COMPASSIONATE POLICIES
With nearly 21% of U.S. adults falling into these multi-drug categories, experts argue that healthcare systems must reconsider their approach to substance use. Policymakers must also change their strategies towards this issue.
This includes:
• Updating clinical guidelines to reflect real-world use patterns.
• Enhancing medical training for primary care doctors to recognize less obvious signs of misuse.
• Designing outreach programs that speak to people’s lived experiences, especially in underrepresented communities.
As the U.S. faces a growing mental health and addiction crisis, these tailored strategies could prove crucial in reducing harm and saving lives.
