Understanding the role of race, ethnicity, and culture in the development of polysubstance use

Polysubstance use—use of more than one drug—is the norm rather than the exception among people who use drugs. Despite this, most of what we know about substance use is based on investigations of individual drugs. As researchers have increasingly attended to developmental patterns of polysubstance use, they have excluded minoritized racial groups from these investigations at worst. At best, they have assumed substance patterns are consistent across racial/ethnic groups despite myriad evidence pointing to the impact of cultural factors on single substance use development. Thus, guided by theories of race, health ecology, and polysubstance use, we present a program of work aimed at first, disentangling common configurations of polysubstance use among minoritized racial/ethnic groups and second, examining the impact of cultural factors on the development of those configurations. We revisit long-held myths about the low risk of polysubstance use among minoritized racial/ethnic groups, illuminating specific polysubstance patterns among these groups that have been overlooked. We also point to emerging evidence that factors culturally relevant to minoritized groups in the U.S. (e.g., racial/ethnic discrimination, acculturation, and racial identity) may help disentangle polysubstance use patterns among these groups. Overall, this work underscores the importance of including and considering race, ethnicity, and culture in the investigation of polysubstance use as this nascent field rapidly expands.