Data Show Social Factors Linked to Polysubstance Use, Overdose

Massachusetts data suggest that polysubstance use has become markedly more common than opioid use alone in the population of fatal opioid overdose victims, and a number of social factors appear to be linked to the adverse outcomes in this group.

The 2014-15 findings, published in the journal Drug and Alcohol Dependence, found that among 2,244 opioid-related overdose victims for whom toxicology results were available, 17% had only opioids present in their system, while 36% had opioids and stimulants (mainly cocaine) and 46% had opioids and other non-stimulant substances.

The presence of opioids and stimulants together was more likely in several subgroups, including non-Hispanic blacks, persons who recently had been homeless, and individuals with co-occurring mental illness.

“To truly make a difference in reducing opioid overdose deaths, we must tackle issues such as homelessness and access to mental health services,” said study lead author Joshua Barocas, MD, an infectious disease physician at Boston Medical Center. The study, which analyzed Massachusetts Department of Public Health data, was led by Boston Medical Center's Grayken Center for Addiction.

Prior research had examined opioid overdose deaths and social determinants of health on a broad level, but the researchers said there had not been studies examining social factors associated with polysubstance vs. non-polysubstance deaths.