ArticleBMC public health2026
Polysubstance use in Canada: prevalence, patterns, and self-reported harms from the 2023 Canadian Substance Use Survey.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- The opioid flexion phenotype: postural flexion and nodding in the fentanyl era.Frontiers in neuroscience · 2026Article
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2 authors.
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Abstract
backgroundPolysubstance use contributes substantially to substance-related morbidity and mortality in Canada, yet contemporary population-level estimates of alcohol-involved polysubstance use are limited. We estimated national prevalence patterns and examined associations with self-reported harms using 2023 Canadian Substance Use Survey (CSUS) data.
methodsWe conducted a cross-sectional analysis of the 2023 CSUS public-use microdata file, including Canadians aged ≥ 15 years residing in the provinces. Past-year substance-use patterns were categorized as single-substance use, drug-only polysubstance use (≥ 2 drug classes without alcohol), and drug-plus-alcohol polysubstance use (alcohol plus ≥ 1 drug class). Weighted prevalence estimates were calculated using survey weights and 1,000 bootstrap replicate weights. Survey-weighted logistic regression examined associations with any self-reported harm. A primary model adjusted for sociodemographic confounders; a sensitivity model additionally adjusted for self-rated physical and mental health.
resultsPast-year polysubstance use was reported by 27.2% (95% CI 26.0-28.5) of respondents and was predominantly alcohol-involved (27.0%, 95% CI 25.7-28.3). Drug-only polysubstance use was uncommon (0.3%, 95% CI 0.2-0.4). Common patterns included alcohol plus cannabis (14.4%) and alcohol plus stimulants (11.6%). Compared with single-substance use, drug-plus-alcohol polysubstance use was associated with reporting any harm (adjusted odds ratio [aOR] 4.80; 95% CI 1.02-22.69). Results were robust in sensitivity analyses adjusting for self-rated health (aOR 4.41) and using a stricter concurrent-use definition (aOR 5.72).
conclusionsPast-year polysubstance use is common in Canada and is largely driven by alcohol co-use. Integration of alcohol into polysubstance prevention, screening, and surveillance frameworks may strengthen public health responses to substance-related harms.
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