Annals of epidemiology · 2026
Polysubstance use and risk of infectious diseases: Evidence from a national cohort, 2018-2023.
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Khan Saadiah I, Wen Sijin, Fisher Melanie, Rudisill Toni M, Bhandari Ruchi
Аннотация
PURPOSE: National surveillance data indicate increasing complexity in substance use patterns, with rising polysubstance use among United States (U.S.) adults. This study quantifies and compares subsequent infectious disease diagnoses, hospitalizations, and emergency department (ED) visits measured using International Classification of Diseases, 10th Revision codes (ICD-10 codes) among U.S. adults with prior single substance versus polysubstance use.
METHODS: A retrospective cohort study of 42,576 demographically and geographically diverse participants was conducted using 2018-2023 data from the All of Us Research Program (AoURP). This study evaluated the risk of infectious disease outcomes, (using ICD-10 codes) associated with single substance and polysubstance use among U.S. adults. Descriptive statistics and log-binomial regression models were used to estimate relative risks (RR), adjusting for demographic and socioeconomic confounders.
RESULTS: We analyzed 7480 individuals who reported infectious disease outcomes in their electronic health records (EHR). Individuals with polysubstance use had significantly higher risk of infectious disease compared to those who use single substance (Adjusted Relative Risk [ARR] = 4.48; 95% CI: 4.29-4.68, p < 0.001).
CONCLUSIONS: This study offers evidence that the growing polysubstance use crises poses a serious public health threat of increased infectious disease risk, especially to the populations historically underrepresented in biomedical research.
METHODS: A retrospective cohort study of 42,576 demographically and geographically diverse participants was conducted using 2018-2023 data from the All of Us Research Program (AoURP). This study evaluated the risk of infectious disease outcomes, (using ICD-10 codes) associated with single substance and polysubstance use among U.S. adults. Descriptive statistics and log-binomial regression models were used to estimate relative risks (RR), adjusting for demographic and socioeconomic confounders.
RESULTS: We analyzed 7480 individuals who reported infectious disease outcomes in their electronic health records (EHR). Individuals with polysubstance use had significantly higher risk of infectious disease compared to those who use single substance (Adjusted Relative Risk [ARR] = 4.48; 95% CI: 4.29-4.68, p < 0.001).
CONCLUSIONS: This study offers evidence that the growing polysubstance use crises poses a serious public health threat of increased infectious disease risk, especially to the populations historically underrepresented in biomedical research.