Alcohol, Drugs, or All the Above: A Person-Centered Approach to Understand Polysubstance Use Patterns and Correlates with Emotion Regulation and Sensation-Seeking.

Julia K Nicholas,Konrad Bresin,Rowan A. Hunt,Y. Mekawi

Published 2026 in Substance Use & Misuse

ABSTRACT

OBJECTIVE Substance use and misuse remain significant public health challenges in the United States. Although individuals who use one substance often use multiple substances, theories and research have largely focused on single-substance use. The present study aimed to identify patterns of substance use across multiple substances using latent class analysis (LCA) and to explore correlates of these patterns, including traits related to emotion and emotion regulation, sensation-seeking, and drinking motives. METHOD In Study 1 (N = 353) undergraduate students completed an online questionnaire battery. LCA was used to identify classes of substance use. Covariate analyses tested associations of age, urgency, emotion dysregulation, distress tolerance, and sensation seeking with class membership. Study 2 (N = 559) extended Study 1 by testing drinking motives as additional covariates in community adults with hazardous alcohol use and/or non-suicidal self-injury. RESULTS In Study 1, LCA identified three classes: nonuse, alcohol and marijuana use, and polysubstance use. Urgency, difficulties regulating emotions, and low distress tolerance predicted membership in the substance use classes versus the no-use classes. In Study 2, LCA identified three classes: alcohol use, alcohol and marijuana use, and polysubstance use. Coping and enhancement drinking motives differentiated the three classes. CONCLUSIONS In both undergraduate and community samples, substance use was characterized by three classes representing alcohol-only or no-use, alcohol and marijuana use, and polysubstance use. Urgency, difficulties regulating emotions, distress tolerance, sensation-seeking, and drinking motives significantly distinguished between different substance use profiles.

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