Exploring the Patterns of Recreational Polysubstance Use and Executive Functions in Indian Young Adults: A Cross-Sectional Study.

Background: Substance use is a serious public health concern and young adults in India often use multiple substances, often together. There is a dearth of research examining this and its neuropsychological consequences. Polysubstance use (PSU) usually indicates higher chances of dependence and negative outcomes. This study aims to describe the patterns of PSU and associated executive function profiles in a sample of young adults in India. Methods: Fifty-four participants aged 18-25 years filled out a self-report questionnaire on PSU, for lifetime and current use of seven classes of substances. Thirty-four participants also performed four executive functions (Flexibility, Inhibition, Working Memory, and Planning). A descriptive analysis was used to identify patterns of PSU and one-way analysis of variance (ANOVA) was conducted to compare the executive functions between three groups of substance users with nonusers. Results: Three patterns of PSU were identified in our sample: simultaneous (16.3%), concurrent (37.2%), and mixed (46.5%) patterns of use. Simultaneous and concurrent users reported the most commonly used substance combinations (alcohol/nicotine/cannabis). Performance on executive function tasks was compared among the different groups of substance users and nonusers. Executive function assessments revealed deficits in simultaneous users for inhibition (most errors) and planning (most number of moves) compared to other groups. Concurrent users had the lowest accuracy for the two-back visual working memory. Conclusions: The findings of this small sample study suggest executive function deficits are more common in simultaneous users and underscore the need for more research to examine the synergistic effects of substances on cognition and executive functions.