Examining Polydrug Use Among Adults Reporting Illicitly Manufactured Fentanyl Use, Heroin Use, or Prescription Opioid Misuse

Provisional data from the Centers for Disease Control and Prevention (CDC) indicate that an estimated 69,769 opioid-involved overdose deaths occurred in 2020, 83% involving synthetic opioids other than methadone. This session will examine demographic characteristics, history of overdose, and polydrug use patterns among adults reporting illicitly manufactured fentanyl (IMF) use, heroin use, or prescription opioid misuse who were assessed for substance use disorder (SUD) treatment. Data are from the 2017 to 2019 National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO) Addiction Severity Index-Multimedia Version (ASI-MV) tool, a convenience sample of individuals being assessed for SUD treatment. In 2019, 1.6% of ASI-MV assessments indicated IMF as their lifetime primary substance, 12.6% indicated heroin, and 4.8% indicated prescription opioid misuse. Younger adults (18-24 years), non-Hispanic Black adults, those assessed in the Northeast, and those with at least one lifetime overdose were more likely to report IMF as lifetime primary substance they used. Among those with IMF as the primary substance used, the percentage of past 30-day use was 24.7% for cannabis and 22.9% for sedatives/tranquilizers; for heroin it was 28% for cannabis and 16.7% for sedatives/tranquilizers; and for prescription opioid misuse it was 36.6% for cannabis and 22.8% for sedatives/tranquilizers. In 2019, lifetime use of sedatives/tranquilizers was associated with an increased odds of IMF use in the past 30 days, while lifetime cannabis use was associated with decreased odds. These findings provide new insights into populations who use IMF or other opioids and may help identify strategies to inform overdose prevention, treatment, and response strategies.