r/science • u/CUAnschutzMed University of Colorado Anschutz Medical Campus • 1d ago
Health A study from researchers at CU Anschutz reveals that nearly one in five U.S. adults have used multiple drugs in the past year, showing that substance use is fairly common and more complex than just using one drug at a time. The results were published in the American Journal of Public Health.
https://news.cuanschutz.edu/news-stories/study-finds-one-in-five-u.s.-adults-use-multiple-drugs-revealing-new-patterns-in-substance-use365
u/twistthespine 1d ago
The article stated that more than half of that 1 in 5 only used prescription drugs as ordered by a doctor plus "some cannabis." Given how much of the US has legal cannabis, this seems like a silly thing to group in with the other categories, especially since they didn't even ask people about other legal drugs like alcohol or nicotine.
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u/ForceItDeeper 1d ago
weed also has a fairly benign interaction with most drugs. i wouldnt consider someone taking prescription pills as directed by a doctor and smoking weed as someone out to mix drugs. I mean, they are mixing multiple drugs but so are people drinking jagerbombs but thats not included. I just dont get the point of this study
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u/multiballs 1d ago
Don’t bash alcohol and nicotine as drugs if you won’t include caffeine or sugar.
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u/Kylynara 1d ago
Sugar would not be reasonable to include in a study like this. It's not possible to consume zero sugar and nothing that metabolizes into sugar. It is a necessity for our bodies. They would end up with a finding that everyone takes drugs.
It's like when people are addicted to eating. It's not something they can just decide not to do anymore (the way alcoholics do), they still have to eat.
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u/CupcakesAreMiniCakes 1d ago
This is why I have heard that food addiction is so difficult to treat. It's the only one that is absolutely required to survive so multiple times a day you're basically having to give yourself just a little hit and expected to not overdo it.
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u/twistthespine 1d ago
Caffeine won't ruin your life like the others, and most experts don't consider sugar to truly be a drug.
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u/AlligatorVsBuffalo 1d ago
Caffeine wont ruin lives but it is has a moderately notable impact on anxiety, and a major impact on sleep that many people overlook due to chronic usage. That being said, alcohol and nicotine are much more harmful than caffeine. And typical caffeine sources seem to improve outcomes as well.
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u/SwampYankeeDan 1d ago
I have severe anxiety. I drink one cup of regular coffee in the morning, it fortunately doesn't make my anxiety worse. I have tested it by quitting twice. Now if I have any more I try to drink decaf. A second cup is a 50/50 on anxiety and more than that is a big no for me. If I have a real cup after 6pm it effects my sleep and gives me bedtime anxiety. My general anxiety is worst in the morning and then in the evening but my social anxiety can come at anytime when I'm around people.
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1d ago
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u/twistthespine 1d ago
Nicotine itself is incredibly bad for your health, not just smoking.
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1d ago
Any addiction can ruin your life.
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u/twistthespine 1d ago
Yeah but we don't call couch cushions a drug just because that one girl from My Strange Addiction couldn't stop eating them.
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u/TurtleMOOO 1d ago
Does that make video games and Reddit drugs, too?
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1d ago
I mean if you actually have ever suffered from addiction you would know the answer and not ask that question like a pompous prick.
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u/SwampYankeeDan 1d ago
I have experienced severe multi-drug addiction and you sound stupid. Video games and reddit may become coping mechanisms but they are not full out addictions like with substance abuse.
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1d ago
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u/JHMfield 1d ago
No.
It's not a direct contributor to anything except rapid energy production within the body. And it's necessary. Even if you cut out 100% of all sugars from your diet, your body will simply make its own, which will be effectively identical to the sugar you eat. It's that important for our body. Our organs, most notably the brain, simply cannot do without.
It's the excess consumption that leads to caloric excess and the pushing out other foods and nutrients, coupled with sedentary lifestyle, is what leads to problems.
Sugar is not the root of all evil. It's the people who can't moderate their intake that are to blame.
In fact, when a person is drinking alcohol, their bodies metabolize alcohol into sugar.
No, our body does no such thing.
Ethanol (alcohol) -> Acetaldehyde -> Acetate -> water and CO2
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u/namisysd 1d ago
Adding that the acetate is what your body trys to convert to energy theough a couple of different processes, which if unneeded converts to fat. This is where rhe calories from alcohol represent; ideally 7 calories per gram though due to inefficincy it’s less than that in practice.
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u/TurtleMOOO 1d ago
Could you give me a source that says alcohol becomes sugar when we drink it? Because I know you won’t find one
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u/jsonne 1d ago
Oof, you're way off key here.
I understand the resentment and vitriol towards dietary sugar. Some foods are loaded w unnecessarily high amounts of sugar and fake sugar sweeteners can be just as bad.
But sugar and glucose production is an essential component for life to happen. Our bodies will make the sugar it needs to function if we don't get enough of it in our diet. Our brains would literally not be able to do their thing without it.
So to lump it in categorically with other drugs, or to call it that, is just inaccurate. All of the things you mentioned: tooth decay, heart disease, diabetes, obesity. Sugar is only a factor in those if it's consumed in excess (for the most part). Whether or not that's addictive at that point is another discussion, but sugar ain't a drug.
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u/i_says_things 1d ago
I love beer as much as Kavanaugh, but pretending alcohol isn’t literally the worst drug is just ignoring all evidence.
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u/disharmony-hellride 1d ago
Alcohol just has the best lobbyists
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u/ADHD_Avenger 1d ago
America's view of alcohol can be summarized pretty easily with our president - who claims not to use any substance due to his brother dying from alcoholism, and yet sells several branded alcohols.
I'm not sure the specific lobbyist matters - it's the giant pile of cash it is connected to - and this is true in the histories of many countries. Vodka practically defines much of Russian history - there is at least one great video of it on YouTube.
Alcohol use has gone down for Gen Z - and I have seen several financial interests with questionable moral panic about marijuana - I would not be surprised if this study is one funded by them.
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u/ChemsAndCutthroats 1d ago
Majority of people can enjoy alcohol responsibly. Gambling can do much more damage.
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u/i_says_things 1d ago
Thats just objectively false.
Alcohol is a known carcinogen, has huge effects on the overall health of a person, and has very real consequences for pregnant women and their babies.
I drink, but Im not gonna pretend there aren’t risks.
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u/Verystrangeperson 1d ago
That's not really true.
Majority of people can gamble responsibly too.
Both the gambling industry and the alcohol industry make most of their money from a small fraction of the consumer base.
Not to diminish the very real problems gambling can cause.
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u/ChemsAndCutthroats 1d ago
I guess it's like going into a bar or casino. Majority of people partaking are doing so in moderation and responsibly. A small percentage have a problem.
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u/DalisaurusSex 1d ago
Sugar is a drug exactly as much as you're a useful commenter in this subreddit.
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u/wintermoon007 1d ago
The comment is not “bashing” alcohol and nicotine… it’s literally just pointing out the contradiction of including cannabis without the other two psychoactive drugs. Caffeine you can make a case for but sugar? It just doesn’t fit the category.
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u/ADHD_Avenger 1d ago
I'm surprised it's not more than one in five. I used insulin, caffeine, and a statin today alone along with a few more my doctor insists on.
But if we are talking about intoxicants, we're including alcohol, right? One of the most deadly and problematic for society. Otherwise this is more politics than science.
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u/Andreiisnthere 1d ago
They do include alcohol (I followed the link to the original study). They don’t include caffeine, statins, insulin, BP meds, etc. For some reason they include antidepressants, which I find questionable, at best. Yes, there are psych drugs that are potentially problematic, but I don’t see SSRIs, SNRIs or Wellbutrin falling into that category. Now, if you want to talk about Soma, gabapentin, promethazine or some mood stabilizers or anti-psychotics that’s a different story.
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u/ADHD_Avenger 1d ago
I followed from what you mentioned and got more, though not all data, and from what I can tell, yes, something like cocaine and alcohol is poly substance for them, but not cigarettes and alcohol or red bull and vodka, etc. etc. which I think needs an emphasis on the political nature. Someone who smokes marijuana twice a year and does mushrooms on their birthday is (typically) better off than someone who is living an upper and downer cycle of acceptable intoxicants - and I'm not endorsing marijuana or other drugs of abuse here so much as I'm tired of the acceptability of alcohol abuse and the treatment of drug schedules as science. Most things can be abused in some fashion - even the insulin I use as a diabetic is abused by body builders (which is, of course, incredibly dangerous). Alcohol is the gateway drug for most. But good caveat that they do include it in some fashion, which was unclear from the article.
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u/SwampYankeeDan 1d ago
Ive heard of people and met people that have used Gabapentin to get high because it didn't show up on drug tests. Im a recovering alcoholic/addict and have been prescribed Gabapentin (800mg three times a day) since before I got sober and I tried taking a few extra and I don't get it, it did nothing for me. It does however stop the alcoholic neuropathy in my feet from hurting as bad and makes it less constant.
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u/Andreiisnthere 1d ago
It supposedly makes the effect of opiates last longer. Some people also say that it makes them spacey. My point is, it probably has more potential for misuse than something like Prozac. Especially for someone who is already misusing opiates. Most people take seem to take it as prescribed.
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u/ADHD_Avenger 1d ago
Many drugs are simply abused because they are available. I have seen the gabapentiniods (gabapentin and pregabalin) often spoken about in certain internet circles - but I think in a similar manner to how people huff spray paint - there are better drugs, both in enjoyment and safety, but sometimes ease of access is peak. Perhaps as you said, there are benefits as a polysubstance abuse, but generally, this is part of why limiting availability of recreational drugs can have unintended consequences. I'm not sure how bad abuse of these are - but definitely not risk free.
It's easy to find cases of Prozac abuse online. Here is one.
"Shortly after fluoxetine was prescribed, the patient experienced a family crisis. For a few days, she took an extra 20 mg of fluoxetine and drank 2 cans of beer daily on an empty stomach; she experienced a “speedlike” effect characterized by increased energy, talkativeness, mood elevation, and slight jitters, but she reported that it was unlike “speed” because she also felt numb and calm. Within a few days, she discontinued the use of alcohol because of a strong family history for alcoholism and her consequent fear of becoming an alcoholic. She continued to take 80 to 100 mg of fluoxetine daily on an empty stomach, however, for several more weeks. She hoarded pills and “doctor shopped” because she feared that her physician would retire and then she would be unable to obtain fluoxetine and the other prescription medications that she was taking."
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u/ADHD_Avenger 1d ago
These SSRIs are also problematic when taken according to directions if the person also adds in something that may affect serotonin immediately - that's why serotonin syndrome is a risk. So, if a study is talking about polysubstance, taking a SSRI and occasionally taking a serotonin agonist as a substance alone could be treated as polysubstance.
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u/ADHD_Avenger 1d ago
As a recovering addict, I'm sure you know, most anything can be abused by taking massive amounts, but with massive health risks, and personal chemistry can affect a person's drug of choice. Congrats on realizing the benefits of recovery. Gabapentin also did nothing for me - not even the effects it was supposed to have, but there are lots of variation in biochemistry.
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u/tristanjones 1d ago
Yeah 1 in 5 include prescriptions or weed. I figured they meant 1 in 5 had done some mushrooms, or Xanax they weren't prescribed.
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u/JHMfield 1d ago
The real issue with all these classifications is that the common stuff, like Caffeine and Alcohol are almost everywhere, in everyday foods and drinks.
Traces of alcohol can be found in most fruits and vegetables, juices, and breads.
Similarly, traces of caffeine or even straight up notable quantities, can be found in so many places.
People worry about coffee, when simple tea, both black and green, is also plenty full of caffeine. Certain black teas have almost as much as most coffees you're likely to drink.
Do you enjoy chocolate? Yeah that has caffeine in it too.
So... there are Drugs and then there are "drugs". The line gets real damn blurry. When I'm consuming a cup of tea while reading a book, saying that I'm consuming drugs is kind of a stretch, even though I am technically consuming a notable amount of caffeine.
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u/Adeptobserver1 1d ago
The term drugs is taken to mean intoxicants. Caffeine and tea do not qualify. Neither does tobacco. Can you use the substance in significant amounts and safely drive and operate dangerous machinery? Not an intoxicant.
There are a couple of drugs that straddle the line, mostly notably speed. Taken in small amounts, it is performance enhancing. But taken persistently or in large amounts, speed becomes an intoxicant. That classification is correct all the moreso because speed is addictive.
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u/ADHD_Avenger 1d ago
This is lack of understanding of what makes something an intoxicant or addictive or similar. This is why many people are "functional addicts." This is why in many fields uppers are used by truckers, athletes, and similar. This is why pain killers and soma and similar were used by wrestlers to manage to perform a match despite injury. Nirvana's unplugged set was Kurt Cobain under the influence of benzodiazepines - the cognitive effects of which may have pushed him towards suicide (as they later did for Chris Cornell). Tobacco works a bit like speed, but is far more problematic health wise, particularly if consumed as smoke particulate. Several drugs also are mind altering but different in speed of effect or addiction risk and we treat them differently because the slower effect on neurotransmitters and thought processes. I don't think caffeine is particularly problematic - but the line gets pushed, particularly when taken in a polysubstance fashion - either as an upper/downer cycle where you wake in the morning with caffeine and tamp down later anxiety with alcohol or where the two combined are used like red bull and vodka and older, now typically illegal, formulations of four loko. If this study is supposed to be about polysubstance issues, what polysubstance use is needs more than arbitrary decisions on what is what.
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u/Adeptobserver1 1d ago
I acknowledged the use of speed as performing enhancing and in that capacity, it is not intoxication. The decisions about which drugs are OK and which are not is fairly well balanced. Neither tobacco nor caffeine should be in this discussion. They are nootropics.
This drugs realm is an increasing minefield because so more recreational drugs are being discovered and created. March 2025: Proliferation of synthetic drugs is a major threat to public health and is reshaping illicit drug markets, says the International Narcotics Control Board. Erowid now lists 150-plus substances.
Some people favor legalizing all substances and they find value in blurring the distinction between hard drugs and substances like caffeine. That blurring is not hard to do.
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u/ADHD_Avenger 23h ago
This is the thing, if speed does not seem intoxicating to you, neither will small doses of several other drugs like benzodiazepines or opioids. This is why addictions form - people don't think they are impaired or dependent. Dose is incredibly important - it's not like people haven't died from caffeine or nicotine. Calling something a nootropic does not change this. Standards for inclusion and non-inclusion of drugs needs to have certain standards, which don't seem to be used here. I do not favor legalizing all substances - I encourage rigorous science even on substances that are legal because the legal classifications are generally garbage originating in culture, and little more. And I'm guessing from your statements that you also see them having certain value in specific dosage and method of consumption.
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u/Adeptobserver1 16h ago edited 16h ago
That's true about the small doses. If everyone used drugs that way, or at maximum was a restrained recreational user, including hard drugs, we could entertain legalization. Unfortunately many users inevitably slip into more use. Not necessarily full on addiction, but regular use that hinders people from holding a job.
That's a primary reason why drugs are illegal. Long before many users become really dysfunctional (like homeless addicts), they are at the partying stage and do things like not showing up for work. China's opium addicts in the mid-1800s were one of the first example -- large scale opting out of working.
Determining what should be legal and not is challenging because, again, so many drugs. Many drugs have aficionados, arguing for their substance-of-choice. An interesting write up: UK professor in 2010: Alcohol 'more harmful than heroin'.
If we include violent behavior, Nutt could be right that alcohol is the most harmful. This was done in 2010, but look at the harm-score list Nutt compiled. It was barely 20 drugs -- a fraction of the substances available today. Add up the harm from each one. Individually each harm might be small but the total is troubling for having an orderly society. That's one of the drivers that prompts drug control people to oppose more legalization, even from relatively innocuous drugs like psychedelics.
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u/ADHD_Avenger 1d ago
I agree about the blur - but that's my issue - if you are creating lines, state why you have the line you have - and generally, afterwards we can use that to say is it a scientific one or cultural and political - DMT is also in tons of things we consume - I think we know the difference between alcohol as intoxicant and trace substance.
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u/Diet_Christ 1d ago
Nearly one in five U.S. adults is honest
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u/Adeptobserver1 1d ago edited 1d ago
A surprising number of people use hard drugs with restraint. Society does not hear about them much because they control their habits, hold jobs and otherwise contribute to society. Interesting stats from a drug policy report from 2005:
Most people who try any drug, even heroin, use it only experimentally or continue use moderately and without ill effect...It has been estimated that (only) 23 percent of those who try heroin, 17 percent of those who try cocaine....become clinically dependent...
Based on more recent knowledge, this is probably underestimating, and, separate to this, the poisoning of the illegal drug supply with highly addictive fentanyl has spiked the overall addiction rate.
Many people working in drug counseling and law enforcement say addiction rates for hard drugs are upwards of 90%. Whether they are correct is debatable, but where they are right is asserting that casual hard drug use is a big part of America's drug problem. Some percent of casual users will always become addicted. A never-ending flow of new addicts.
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u/Rovcore001 1d ago
It’s always interesting, how whenever these kinds of articles pop up there will be, without fail, reflexive what about alcohol/caffeine it’s way worse but not talked about responses in the comments. Especially if weed is among the subjects of said study.
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u/Kylynara 1d ago
If they're counting medication prescribed by a doctor and used as prescribed as drug use, it's hypocritical not to include alcohol at the bare minimum. Caffeine is a grey area for me.
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u/Rovcore001 1d ago
The thing is, they did include alcohol. The linked abstract states that concomitant alcohol use was among the variables examined.
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u/FUNNY_NAME_ALL_CAPS 1d ago
Because it is factually true that caffeine is a psychostimulant that should also be included when discussing drug use.
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u/Finnman1983 1d ago
"Nerds study cool kids and realize cool kids are way cooler than originally thought."
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u/DestruXion1 1d ago
Caffeine is a psychoactive drug right? So that plus a prescription is probably half of Americans
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u/_Green_Kyanite_ 1d ago
I mean, if you take Synthroid (Levothyroxine) and something to lower cholesterol, you use multiple prescription drugs.
Throw in a cup of caffeinated coffee, and now you're using multiple perscription & recreational drugs.
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u/DrawSignificant4782 1d ago
It looks like they are trying to re write history of what drug use is. I only reason I said this is because Colorado has the highest cocaine use. I was writing a paper about the different drug markets in America, and I decided this morning to call the higher end market of cocaine the Colorado Cocaine market.
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u/sonostreet 1d ago
"WARNING: If you're Gambling your money away, most likely your brain is hacked by a.i."
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