Improving Delivery of Healthcare Services for Polysubstance Use


The Research Need 

The nation’s opioid crisis has evolved significantly, now reflecting use of drug combinations, potent synthetic opioids, and stimulants. Toward finding durable solutions to the opioid crisis, research approaches must recognize these shifting patterns of use. 

About the Program 

This program will support research to expand what we know about drug combinations as well as how to prevent and treat addiction and overdose resulting from these new use trends. An important focus will be research to better understand the causes, patterns, and implications of polysubstance use. That includes which substances are commonly used together, how polysubstance use affects individuals taking medications for pain or for treatment of opioid use disorder, and what role polysubstance use plays in overdose deaths and suicide.  

This research will explore health outcomes of individuals who use drug combinations, particularly those who are treated for one or more substance use disorders. This research will consider the perspectives not only of patients, but also of clinicians, payors, and policy makers. 

The program will support clinical trials to study service delivery and treatment approaches for people who use multiple substances at the same time, with a particular focus on opioids and/or stimulants. This research will pave the way for larger clinical trials by developing research methods and interventions.   

Program Details

Through the Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®, NIH has awarded research grants and administrative supplements to increase understanding of, and enhance service delivery for, polysubstance use. These awards are administered by multiple NIH Institutes and Centers.

Research Examples

Research examples supported by this program include: 

  • Determining the extent of polysubstance use 
  • Clarifying the role of synthetic opioids and other drugs in the transition to polysubstance use 
  • Identifying appropriate outcome measures for polysubstance treatment responses and recovery  
  • Developing and testing the feasibility of sequential treatment approaches 

  • Friends Research Institute, Inc. – Maryland 
  • Johns Hopkins University – Maryland 
  • New York University School of Medicine – New York 
  • Oregon Social Learning Center – Oregon 
  • RBHS-Robert Wood Johnson Medical School – New Jersey 
  • University of Maryland, College Park – Maryland 
  • University of Michigan – Michigan 
  • University of Washington – Washington 
  • Yale University – Connecticut 

Funded Projects

The Short and Long-Term Dynamics of Opioid/Stimulant Use: Mixed Methods to Inform Overdose Prevention and Treatment Related to Polysubstance Use
Sep 19, 2022
Motivational Interviewing and Mindfulness-Oriented Recovery Enhancement for Tobacco Dependence and Other Drug Use in Methadone Treatment
Sep 19, 2022
Preferences and Predictors Driving Opioid-Involved Polysubstance Use Profiles and Trajectories: Implications for Improving Care
Sep 19, 2022
Patient Navigator plus Remote mHealth Adherence Support with Incentives to Improve Linkage and Retention among Hospitalized Patients with Opioid and Methamphetamine Use Who Initiate Buprenorphine
Sep 19, 2022
Treating Polysubstance Use in Methadone Maintenance: Application of Novel Digital Technology
Sep 19, 2022