Transformative Epidemiological Insights into Polysubstance Use and Health Outcomes Using EHR Data - Project Summary/Abstract Polysubstance use, the concurrent use of multiple substances within a short period, is a critical public health issue associated with increased healthcare costs, psychiatric comorbidities, overdoses, and reduced treatment efficacy. Despite its prevalence, research often overlooks the compounded effects of simultaneous substance use, focusing instead on individual substances. This gap highlights the need for comprehensive studies to inform public health policies and prevention strategies effectively. Addressing this issue is vital to reduce healthcare costs and improve treatment outcomes for affected populations. This project aims to fundamentally enhance our understanding of the mechanisms and impacts of polysubstance use, with particular attention to early adolescence and sex differences. Leveraging the extensive Oracle EHR Real-World DataTM (OERWD) database, which encompasses 1.9 billion encounters from 113 million patients across 700 U.S. hospitals and clinics, we will conduct a large-scale longitudinal study to elucidate the clinical and epidemiological patterns, long-term health outcomes, and comorbidities associated with polysubstance use. The study has four primary objectives. First, we aim to identify and characterize the prevalence and patterns of polysubstance use across various demographic groups. Second, we will examine the long-term health outcomes and comorbidities associated with polysubstance use through a retrospective cohort study, focusing on the development of substance use disorders (SUDs) and other comorbid conditions. Third, we will investigate how early adolescent polysubstance use influences the development of SUDs and other health outcomes in adulthood, assessing risk factors and early indicators within this cohort. Lastly, we will explore sex differences in polysubstance use outcomes and trajectories, comparing prevalence, patterns, and health impacts between male and female patients. This pioneering study will provide robust analyses and detailed estimates of individual substance-type combinations and their related factors. By utilizing laboratory tests and clinical diagnoses among a large national sample, our research aims to fill significant gaps in current knowledge, ultimately guiding more effective public health policies and prevention strategies. The anticipated findings will contribute to improved health outcomes, reduced illness, and prolonged life for those affected by polysubstance use. Furthermore, our results will offer crucial insights into how demographic factors influence polysubstance use and its associated health risks, paving the way for targeted interventions. By addressing these gaps, our study aims to transform the understanding of the behavioral mechanisms underlying polysubstance use, thereby providing a scientific foundation for new approaches to prevention and treatment.
