A case against purity: prioritizing translational polysubstance use research

PURPOSE OF REVIEW: Preclinical (nonhuman) research on neurobehavioral underpinnings of addiction often focuses on one addictive drug studied in isolation, however, this does not reflect real-world substance use patterns of polysubstance use (PSU). Here we make a case against purity, incorporating patterns of clinically relevant PSU into preclinical models. We argue that the meaningful inclusion of people with living experience as integral collaborators in translational addiction models is critical to advance the identification of novel efficacious therapeutics to reduce the harms associated with PSU.

RECENT FINDINGS: Substance use disorders are complex as clinically defined and diagnosed. Further, PSU is highly prevalent and individuals may use multiple substances within the illicit drug supply which continually evolves and is tracked via surveillance efforts (e.g., the National Drug Early Warning System). Preclinical models often model monosubstance use patterns which do not reflect real world drug use and omits expertise from people who use drugs in driving preclinical addiction science.

SUMMARY: Here, we argue a case against purity in the development, design, and implementation of preclinical translational studies of addictive drugs, a need for inclusion of individuals with living experience, and highlight the need for additional research on PSU across the translational spectrum.