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Prevalence and sociodemographic factors associated with polysubstance use: analysis of a population-based survey in Jamaica

Abstract

Background

In Latin America and the Caribbean, there is a dearth of research exploring polysubstance use. This study aims to determine the prevalence, varying combinations and associated sociodemographic characteristics of polysubstance use in Jamaica.

Methods

This study involved a secondary data analysis of the Jamaica National Drug Prevalence Survey 2016 dataset where 4,623 participants between the age of 12 and 65 years from each household were randomly selected as respondents. Statistical analysis was performed to determine the prevalence and the sociodemographic correlates of polysubstance use among Jamaicans.

Results

19.6% of respondents used two or more drugs in their lifetime. Of this amount 68.7% reported past year use and 61.9% reported past month use. Bivariate analyses reported polysubstance use was statistically significantly higher amongst males (U = 54,579, p = 0.000), those living in rural areas (U = 91,892, p = 0.003), non-Christian (U = 89,514, p = 0.014), and married persons (U = 74,672, p = 0.000). Past month polysubstance use was statistically significantly higher among employed persons than unemployed persons were (U = 81,342, p = 0.001). Surprisingly, there was a lack of significant differences between education level, household income and past month concurrent polysubstance use (p = 0.609; p = 0.115 respectively). Logistic regression model indicated males were 3.076 times more likely than females to report past month polysubstance use than females. Also, when compared to those 55–65 years old, participants 35–54 years were 2.922 times more likely and those 18–34 years were 4.914 times more likely to report past month polysubstance use. Additionally, those living in rural areas were 1.508 times more likely than participants living in urban areas to report past month polysubstance use. As it relates to occupational status, when compared to armed forces, skilled workers were 4.328 times more likely and unskilled workers were 7.146 times more likely to report past month polysubstance use.

Conclusions

One in five Jamaicans identified as polysubstance users, predominated by marijuana as the most common factor amongst the polysubstance combinations examined, signalling the need for early marijuana interventions.

Peer Review reports

Background

According to the latest World Drug Report, approximately 275 million people used drugs worldwide in the past year, and is expected to rise unprecedentedly to almost 300 million people by 2030 [1]. Drug use represents a massive public health issue facing the global community [2]. Latin America and the Caribbean are no exception, as more than 5.5 million persons are affected by drug use disorders [3].

Jamaica is the third largest island in the Caribbean and home to just under 3 million inhabitants [4]. Increasing drug use and illicit drug trade is a major problem in Jamaica [5]. Situated 145 km south of Cuba and 161 km southwest of Haiti [6], Jamaica’s location within the Caribbean Sea makes it an ideal transhipment point for drugs, especially from South America. As such, drug trafficking has led to the widespread availability of illicit drugs and given rise to increased domestic consumption, especially in a market where the cost for drugs is significantly below that seen internationally [7].

A multicultural society, the majority of Jamaicans practice Christianity [4] albeit with a growing Rastafarian movement that currently encompasses 29,000 followers [8]. Central to Rastafarian theology is the smoking of marijuana which is utilized as a religious sacrament [9, 10]. However, accompanying tobacco use as a means of “enhancing” the effects of marijuana have been recently documented amongst Rastafarians [11], and is a practice referred to as “boosting” [12] that at least one study has found to contribute to marijuana dependence [13]. Jamaica’s recent population survey indicated that marijuana and tobacco smoking were most prevalent (64.5% and 27.4% respectively) in this religious group, highlighting that targeted interventions are necessary in mitigating disproportionate burden of use amongst these individuals [14]. Furthermore, the frequent use of marijuana mixed with “grabba” or dried tobacco leaves [15] is not surprising, given that the two drugs are amongst the most frequently used by Jamaican youths [16].

Tobacco use is the leading cause of preventable deaths worldwide [17]. In the Caribbean, Jamaica has the second highest prevalence of current tobacco use [18], with smokers spending nearly 40% of their yearly income on tobacco-related products, and those with consequent lung disease spending more than 50% of their annual income treating their condition [19]. The alarming impact prompted Jamaica to sign onto the World Health Organization Framework Convention on Tobacco Control (WHOFTC), to combat the national epidemic of tobacco smoking.

Additionally, alcohol use is deeply embedded in Caribbean societies, rich in historical pastiche and cultural context, encompassing spiritual, social and medicinal roles [20, 21]. Yet excessive alcohol consumption poses a global health challenge [22,23,24]. According to the World Health Organization, Jamaica’s estimated alcohol per capita consumption rose from 4.9 L for both males and females in 2014 [25] to 11.9 L in 2018 [24], with over 40% of all Jamaicans engaging in heavy episodic drinking (HED), that is, consuming 60 or more grams of pure alcohol on at least one occasion monthly. In furtherance, a recent study examining alcohol consumption amongst Jamaicans during the COVID-19 pandemic, reported that approximately 45% and 49% of participants consumed more alcoholic beverages and used alcohol as a means of coping, throughout the pandemic respectively [26].

Notwithstanding, extant literature has predominantly focused on single-use substances, even though many people use more than one drug [27]. Polysubstance use can be defined as the use of more than one drug either concurrently or consecutively to amplify or neutralize another drug’s effect [28]. This study focused on concurrent use and may be defined as the use of two or more drugs within a given timeframe, spanning hours to days or even months [28,29,30].

Polysubstance use creates severe medical issues such as overdose, psychiatric co-morbidities such as depression, as well as more risky social behaviours such as promiscuous sexual practices, when compared to single drug users [31,32,33,34,35,36,37]. Furthermore, studies have concluded that the mortality rate is three times higher with polysubstance use versus singular drug use [38, 39].

Sociodemographic factors associated with polysubstance use include younger age [40,41,42,43,44,45], and male sex [46,47,48,49,50], although a growing body of research suggests a closing of the “gender gap” in overall drug patterns [51,52,53]. In addition, socioeconomic struggle with poverty, lack of housing and education predispose to heavier drinking and multiple drug use [54,55,56,57]. Numerous studies have found that being married and religiosity act as protective factors against drug use [52, 58,59,60,61]. Yet, there has been inconclusive evidence related to the role of employment status as worrisome substance use can result in unemployment [62], or alternatively, employment may perpetuate worrisome drug use and overindulgence due to increased means [63].

In continuing, studies have shown a higher prevalence of polysubstance use in persons with laborious, physical jobs in comparison to professionals and those employed in the armed forces [64,65,66,67]. Akin to employment status, much of the evidence regarding area of residence is debatable, as the literature highlights a diminishing gap between the patterns of substance use. Some studies concluded illicit substance use to be higher among rural individuals [68, 69], while others indicate a greater preponderance in urban areas [54, 70].

Globally, a number of studies have implicated the predominance of alcohol, tobacco and marijuana in polysubstance combinations [55, 56, 70,71,72]. Regionally, one study utilizing data collected from six countries in Latin America reported that the overall lifetime rate of polysubstance use is 21% [73]. In the Caribbean, a few studies have identified a similar predominant pattern of polysubstance use, albeit in smaller sample-sized studies. In Trinidad, Dhanookdhary and colleagues [74] examined substance use patterns amongst university students ranging from 17 to 50 years of age, and reported that 17% and 10% of the total sample indicated that they used a dual combination of alcohol and tobacco, and a triple combination of alcohol, tobacco, and marijuana in the past six-months respectively. In Jamaica, Harrison and colleagues [75] explored simultaneous polysubstance use among undergraduates at one university and reported that alcohol was the most frequent substance when combined with other drugs, followed by marijuana and tobacco. A more recent study utilized school surveys and examined current polysubstance use amongst adolescents in three Caribbean countries; namely Jamaica, Trinidad and Tobago, and the Dominican Republic, and found that 17.4%, 10.0% and 8.5% of participants engaged in polysubstance use respectively [76].

To date, no studies in the Caribbean have used nationally representative data to assess prevalence and the associated sociodemographic factors of polysubstance use. The relevant findings of this study may help provide impetus in prioritizing substance use treatment, especially in a country where almost half of all households live in rural areas [24]. Jamaicans living in rural areas who desire treatment are at a particular disadvantage as most services are concentrated in the urban areas [77], making access hard [78]. Furthermore, persons are usually treated in hospitals by physicians, rather than in a treatment facility with addiction specialists [79]. This can compromise the quality of care and perpetuate the issue of substance use.

The current study examined concurrent polysubstance use in a nationally representative sample of the Jamaican population to: 1) determine the prevalence of polysubstance use in Jamaica; 2) identify varying combinations of polysubstance use; and 3) elucidate the sociodemographic characteristics associated with polysubstance use.

Methods

Study design, participants and data source

The original study consisted of a cross-sectional survey conducted between April and July 2016 of a nationally representative sample of 4,623 participants between the age of 12 and 65 years [14]. The sampling design was developed by experts from the Statistical Institute of Jamaica (STATIN). Jamaica consists of 3 counties, 14 parishes and 5,771 Enumeration Districts (EDs), which are the smallest geographic units that allow for collection of survey data. Enumeration Districts (ED) were chosen in proportion to their numbers within the respective areas of residence. As a result, there were twenty-two (22) EDs per parish, with Sixteen (16) households per ED. The survey employed a stratified multi-stage cluster sampling design with EDs as the primary sampling units (PSU). The sampling interval for the selection of the dwelling from which the participant would be recruited was determined by dividing the total number of dwellings in the PSU by sixteen. A starting point was randomly used to determine the first dwelling from which a participant would be recruited. Using the Kish technique, one participant between the age of 12 and 65 years from each household was randomly selected as the respondent for the survey. Sampling weights were calculated by the probability of selection and non-response weights. Post-stratification weights based on parish level distributions of age and sex categories were applied to ensure that the distribution of the weighted sample matched the population distribution of both sex and age categories [14].

This study involved secondary data analysis of the population based National Drug Prevalence Survey 2016. The current study utilized the entire dataset population and extracted variables relevant to drug/polysubstance use patterns and sociodemographic factors. The sociodemographic data included age, gender, marital status, religious affiliation, geographical location, employment status, occupational description, household income and education. It followed demarcated guidelines that ensured the efficacy and applicability of the findings of retrospective studies [80]. Sequential steps were followed to minimize the limitations and strengthen the reliability of the data [81]. This involved outlining the research question and developing objectives followed by a systematic review of the literature pertinent to polysubstance use. Under established guidelines, a data extraction form was used to identify all the variables that were included in the current study design from the primary data set for analysis. This study contained no identifying data of respondents, and no direct or indirect contact was made with any respondents. There was no compensation in this secondary analysis.

Measures

For this study concurrent polysubstance use was defined as the use of 2 or more of marijuana, tobacco and/or alcohol over a period of time. Lifetime prevalence was defined as any use during the person’s life, while past year prevalence was defined as any use during the previous year. Past month prevalence was examined as any use during the previous month.

Data analysis

Descriptive statistical analysis was performed to determine the prevalence of concurrent polysubstance use as well as to describe the sociodemographic characteristics of participants and represented in frequencies, means and percentages. Concurrent polysubstance use was determined for the periods of lifetime or ‘ever’ use, past year use and past month use for alcohol, tobacco, and marijuana use. This was achieved by using the target variables related to “have you ever used…” for alcohol, tobacco and marijuana for lifetime, past year, and past month. “Yes” responses were coded as one and “No” were coded zero. Statistical computations were performed to score concurrent polysubstance use over each of the three periods. Respondents could only have a score of 0–3 for concurrent polysubstance use for each time. For analysis purposes, the use of 2–3 substances over lifetime, past year, and past month periods were considered concurrent polysubstance use. The limited range in the scoring system made it more prudent to represent concurrent polysubstance use variables as dummy variables. For inferential statistical analysis, past month concurrent polysubstance use, which represents current substance use was utilised as the dependent variable.

The Mann–Whitney U test and Kruskal–Wallis tests were performed to examine bivariate differences between subgroups of selected socio-demographic characteristics and past month concurrent polysubstance use. Binomial logistic regression model was generated to assess the likelihood of past month concurrent polysubstance use based on selected socio-demographic characteristics. The data were presented in the form of tables and text. A p-value of < 0.05 was considered statistically significant.

Patient and public involvement

There was no involvement of patients or members of the public in conceptualisation, design, analysis, or interpretation of the results or write up of the paper.

Ethical considerations

Ethical approval for the study was granted through the Ethics committee of The University of the West Indies, Mona Campus. There were no competing interests.

Results

There were 4623 respondents in the study of which 54.8% (n = 2535) were females and 45.2% (n = 2088) were males. Table 1 shows the socio-demographic characteristic of study respondents. The age range of respondents was between 12–65 years with a mean age of 36.18 years (s.d. ± 14.815). Most respondents lived in rural areas (58.6%), were married (68.7%), Christian (71.0%), unemployed (52.9%), skilled workers (72.1%) and had less than a university level education (82%).

Table 1 Sociodemographic characteristics of study respondents

Substance use

Table 2 demonstrates the prevalence of use of alcohol, tobacco, and marijuana as well as concurrent polysubstance use. Most respondents reported having used alcohol in their lifetime (74.8%). Meanwhile a similar number of respondents reported lifetime use of tobacco and marijuana (28.1% and 28.3% respectively). Among those who reported lifetime use of alcohol, 72.9% reported use in the past year and 54.3% reported use in the past month. Of these three substances the lowest past year and past month use was seen for tobacco. Approximately 20% (n = 907) of respondents reported lifetime ‘ever use’ concurrent polysubstance use and past year and past month use was represented at 68.7% and 61.9% respectively.

Table 2 Substance use prevalence and combination for concurrent polysubstance use

Table 2 also illustrates the combination of substances used among respondents. The most common combination of two or more substances over the past year and past month was those who reported using both alcohol and marijuana without tobacco (12.9% and 15.4% respectively). Those who used both alcohol and tobacco (without marijuana) at 10.9% for past year and 9.1% for past month followed this. The least common combination was for respondents who used alcohol, tobacco and marijuana in the past year or past month at 8.2% and 6.9%.

For bivariate analysis past month polysubstance use was used as the dependent variable (n = 907). A test of Skewness and Kurtosis on the target variable for past month polysubstance use revealed skewness of -0.0.489 and kurtosis of -1.765 indicating that the data is slightly skewed. Consequently, non-parametric statistics were used to analyse the data to produce the most accurate results. Mann–Whitney U tests were performed to analyse the difference between the dichotomous independent variables related to sociodemographic factors and past month concurrent polysubstance use. The data indicates that past month polysubstance use was statistically significantly higher among males than females (U = 54,579, p = 0.000), those who lived in rural areas than urban (U = 91,892, p = 0.003), non-Christian than Christian (U = 89,514, p = 0.014), married than unmarried (U = 74,672, p = 0.000) and employed than unemployed (U = 81,342, p = 0.001) (Table 3).

Table 3 Mann–Whitney U test of selected sociodemographic factors and past month concurrent polysubstance use

Additionally, Table 4 shows results from Kruskal–Wallis tests which indicated significant differences between age group, occupation status and past month concurrent polysubstance use (χ2 = 33.479, p = 0.000; χ2 = 35.262, p = 0.000 respectively). As it relates to age group and past month concurrent polysubstance use, Dunn’s pairwise tests carried out (adjusted using the Bonferroni correction) for the four pairs of groups found that the age group 35–54 years had a statistically significant difference in mean rank than those in the age group 55–65 years (mean ranks = 461.25; 359.31 respectively, p = 0.000) for past month polysubstance use. A statistically significant difference was also found between the means for respondents 18–35 years and those 55–65 years (mean ranks = 482.34; 359.31 respectively, p = 0.000).

Table 4 Kruskal–Wallis test of selected sociodemographic factors and past month concurrent polysubstance use

There was no other statistical significance noted between other age groups and past month concurrent polysubstance use.

As for occupation status and past month concurrent polysubstance use, Dunn’s pairwise tests (adjusted using the Bonferroni correction) found statistically significant differences between three groups. Skilled workers had significantly higher means than professionals did for past month polysubstance use (mean rank = 290.18; 161.52, respectively, p = 0.000). Unskilled workers also had significantly higher means than professionals did for past month polysubstance use (mean rank = 309.31; 161.52, respectively, p = 0.000) as well as those respondents working in the armed forces (mean rank = 309.31; 192.00, respectively, p = 0.000).

There was no other statistical significance noted between other occupation groups and past month concurrent polysubstance use. Table 4 also illustrates that no significant differences were found between education level, household income and past month concurrent polysubstance use (p > 0.05 respectively).

Table 5 shows the results of a binomial logistic regression analysis performed to assess associations between concurrent past month polysubstance use and sociodemographic factors of gender, age, geographical location, marital status, religious beliefs, and occupation status. The categories for age were modified to exclude those 12–17 years as this represented a singular case and outlier in the analysis.

Table 5 Logistic regression of selected sociodemographic factors and past month concurrent polysubstance use

The model illustrated that males were 3.076 times more likely than females to report past month polysubstance use than females. Also, when compared to those 55–65 years old, participants 35–54 years were 2.922 times more likely, and those 18–34 years were 4.914 times more likely to report past month polysubstance use. Additionally, those living in rural areas were 1.508 times more likely than participants living in urban areas to report past month polysubstance use. As it relates to occupational status, skilled workers were 4.328 times more likely and unskilled workers were 7.146 times more likely to report past month polysubstance use. This model indicated no significant associations between marital status and religious status and past month polysubstance use.

Discussion

This is the first study in Jamaica and the Caribbean that demonstrates the prevalence of concurrent polysubstance use, combinations of substances used, and associations with sociodemographic factors. This research found that approximately 1 in every 5 Jamaicans aged 12–65 years used two or more drugs in their lifetime. This is comparable to our Latin American neighbours that undertook a similar survey and reported that 21% of participants combined at least two substances [73]. However, inconsistent with other international findings that report alcohol and tobacco as the most prevalent combination, this study highlighted alcohol and marijuana as the predominant combination in the Jamaican population [82, 83].

Although alcohol, marijuana and tobacco were the most common three-substance combination in Latin America, the prevalence ranged from 0.1% to 1.9% for all six countries [73]. In Jamaica, the current use of alcohol, marijuana, and tobacco combination was 6.9%. This represents a more than three times increase relative to our regional neighbours. Our study indicates that marijuana plays a primary role in the combinations reported. The strong predilection towards marijuana use is likely multi-factorial, reflective of recent decriminalization legislation that one study indicated had a positive association with the use of marijuana [84], and strong socio-cultural validation and Rastafarian ideology and influence [9, 84,85,86]. Notwithstanding, these findings are indicative of a polysubstance pattern that is noteworthy and contrasting to our regional and international counterparts. This represents a unique challenge to stakeholders that requires further research to elucidate appropriate reduction strategies.

As it relates to socio-demographic factors correlated with concurrent polysubstance use, bivariate analysis revealed that gender, age, geographical location, religious beliefs, marital status, employment status and occupational status were associated factors. The multivariate logistic regression analysis indicated that being an unskilled worker, younger age, male gender and living in rural areas were predictive of concurrent polysubstance use.

Unskilled workers were approximately seven times more likely and skilled workers were four times more likely to report past month concurrent polysubstance use than the persons working in the armed forces. This is in keeping with the literature that found skilled and unskilled labourers had the highest figures of drug and alcohol use [64,65,66]. In addition, persons in the armed forces were less likely to engage in past month concurrent polysubstance use as the Jamaica Defence Force and Jamaica Constabulary Force (JCF) have instituted random drug testing since 2000 [87]. In Jamaica, high levels of substance use amongst unskilled workers is a major concern, as most unskilled labourers are daily wagers or are paid on a weekly basis. Furthermore, informal sector workers tend to be compensated on a lower pay scale than their counterparts [88, 89]. Hence, if these workers have a substance use habit, it will reduce a major share of their income and could prove a hindrance to economic sustenance.

Additionally, respondents between the ages of 18–34 and 35–54 years were approximately five and three times more likely, than those in the older age group 55–65 years respectively, to report past month concurrent polysubstance use. These findings are comparable to global literature that suggests young adults as being the predominant polysubstance users [37, 56, 72, 90], with most of the problematic drug users being in their 20’s [91], and with use becoming less frequent as persons become older [92]. This may be linked to a greater willingness among young people to experiment and use drugs to enhance social interactions [93].

Moreover, gender was also found to be predictive of concurrent polysubstance use with females being three times less likely to report use than males [48,49,50, 73, 90]. This underscores the need for crafting and implementing gender-based strategies in dealing with the issue of polysubstance use in the general population.

Past month polysubstance use was also higher amongst those who lived in rural than urban areas, with those living in rural areas being approximately one and a half times more likely to report use. This is in keeping with other research that suggests drug use including polysubstance use, have increased in the rural environment, and have in fact outpaced their urban counterparts [68, 69]. This finding is likely as a result of population distribution where almost half of all Jamaican households live in rural habitats [24]. However, to the detriment of Jamaicans living in rurality and desirous of treatment, most services are concentrated in the urban areas [77] and this represents a barrier to access [78]. Lack of access and available options means that persons tend to have to pay more for substance abuse treatment and may not be able to afford it [79, 94, 95]. Also, rural life does not lend to anonymity and as such, the social stigma associated with having a drug problem and/or requiring treatment for same, makes seeking treatment difficult, especially if they know the professional offering them treatment [79, 95, 96].

Although, not reflected in the logistic regression model, bivariate analysis indicated associations between marital status, religious beliefs, and employment status and past month concurrent polysubstance use. Concurrent polysubstance use was higher among the married than unmarried population. This contrasts with the literature that posits being married as a protective factor associated with better drug abuse outcomes [52, 97, 98]. One possible explanation is that the survey limited questions regarding marriage to marital status rather than the nature of the marital relationship between individuals, that the literature suggests may predict lower rates of drug use [98]. Notwithstanding, at a societal level, divorce still carries a stigma while conversely, marriage represents a status marker for both Jamaican men and women that is associated with a level of societal prestige that is otherwise unattainable [99]. These findings suggest the need for further research to examine the role of substance use amongst married persons, and whether it serves as a means of coping with possible marital discord.

Additionally, past month polysubstance use was higher among non-Christian than Christian persons. This finding is in keeping with what has been reported previously, endorsing the protective role of religious affiliation [58, 60, 61]. In our study, the non-Christian population would have included persons who prescribed to other religious affiliations like Rastafarianism and/or were non-religious. The island’s most recent survey highlighted marijuana use as being most prevalent amongst Rastafarians [14]. Further local studies may provide evidence of the impact of marijuana as a possible gateway drug [100] correlated with developing other drug use in these individuals. This may prove insightful in generating a local public health response, targeting church-based and other local religious populations.

As it relates to employment, past month polysubstance use was higher among employed than unemployed persons. This is in keeping with more recent studies, which note higher polysubstance use in individuals who are employed [101, 102].

Notably, there was a lack of significant differences between education level, household income and past month concurrent polysubstance use (p > 0.05). These findings are contrary to the literature that reports a strong association between socioeconomic struggle and polysubstance use, particularly amongst persons with a lower household income and having less than a high school education [55, 56]. This finding is likely due to the socio-cultural validation of alcohol and marijuana use in Jamaica and the Caribbean at large [20, 21, 85, 103]. Pre-existent literature highlights that society’s approval of drug use is influential and permissive of use [43, 104, 105].

Conclusions

The present study suggests widespread polysubstance use amongst the Jamaican population, predominated by the presence of marijuana as the most common factor within the combinations examined, and signal the need for early marijuana interventions.

The sociodemographic associations seen amongst polysubstance users suggest the need for a more inclusive approach by not just limiting the focus to single-use substances, but rather further widening the scope of enquiry, assessment, treatment, and rehabilitative efforts, to include and subsume polysubstance use in the restructuring and reformation of drug policies and programmes.

Strengths and limitations of this study

The is the first study in Jamaica to examine the issue of polysubstance use from a nationally representative sample, by eliciting a sociodemographic profile of individuals engaging in polysubstance use and determining prevalence rates. The strength of the secondary analysis conducted was augmented by the utilization of the entire dataset population. This study was a cross-sectional design and thus is limited to creating association. This study utilised a self-report survey related to substance use behaviour and thus findings may suffer from underreporting bias. Additionally, the household survey questionnaire focused mostly on single substance use disorders and lacked specific questions related to polysubstance use. Moreover, the measure for concurrent polysubstance use may have been limited in its scope, necessitating a broad definition of the term to be utilised in this study to provide baseline extrapolation about its use in Jamaica. This approach provides a foundation for future research.

Recommendations and future research

The term polysubstance use, inclusive of its definition, social and health impact, has not been included in the messaging by the relevant bodies, as part of addressing substance use education on a national scale. Dissemination of information as part of a prevention strategy could help to improve awareness and knowledge regarding polysubstance use, and contribute to mitigating its impact at a societal level.

Future epidemiological research can incorporate measures of frequency and severity to expand the measures of substance use in further establishing the profile of the polysubstance user. Consideration to conducting a cohort study, examining patterns of polysubstance use longitudinally as individuals’ transition from adolescence to young adulthood, and subsequently older adulthood, may prove invaluable.

The initial national household survey was conducted shortly after the amendment to the Dangerous Drugs Act in Jamaica, which allowed for new provisions regarding the possession and smoking of marijuana, its use for therapeutic/scientific purposes and its use by persons of the Rastafarian faith. As such, further studies can be done to ascertain whether marijuana decriminalization has extended influence towards polysubstance use, given that a worthwhile period would have elapsed since the initial study.

Availability of data and materials

The data that support the findings of this study are available from the National Council on Drug Abuse, Jamaica, and the Inter-American Drug Abuse Control Commission (CICAD) but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of the National Council on Drug Abuse, Jamaica, and the Inter-American Drug Abuse Control Commission (CICAD). For access to the database, contact Mrs. Uki Atkinson, research analyst, at uatkinson@ncda.org.jm.

References

  1. United Nations. World Drug Report 2021. Vienna: United Nations publication; 2021.

    Google Scholar 

  2. Ogbu UC, Lotfipour S, Chakravarthy B. Polysubstance Abuse: Alcohol, Opioids and Benzodiazepines Require Coordinated Engagement by Society, Patients, and Physicians. West J Emerg Med. 2015;16:76.

    PubMed  Article  Google Scholar 

  3. Pan American Health Organization. Drug use epidemiology in Latin America and the Caribbean: a public health approach. Washington DC: PAHO; 2009.

    Google Scholar 

  4. Caribbean Community (CARICOM) Secretariat, Jamaica Ministry of Health, Ministry of Education (Jamaica), Ministry of Transport, Works and Housing (Jamaica), Planning Institute of Jamaica, Statistical Institute of Jamaica, University of the West Indies. Jamaica Population and Housing Census 2011. Kingston: Statistical Institute of Jamaica; 2011.

  5. Ministry of National Security Jamaica. National Drug Prevention and Control Master Plan 2015-2019. A five year strategy for tackling the illicit drug problem in Jamaica. Kingston: Ministry of National Security; 2014.

  6. Embassy of Jamaica to the United States of America, Geography of Jamaica. https://www.embassyofjamaica.org/about_jamaica/geography.htm. Accessed 22 May 2022.

  7. Eells TD. Handbook of Psychotherapy Case Formulation. 2nd ed. New York: The Guilford Press; 2010.

    Google Scholar 

  8. United States Department of State - Office of International Religious Freedom. International Religious Freedom Report for 2021. Washington: United States Department of State; 2021.

  9. Ahkell J. Rasta: Emperor Haile Selassie and the Rastafarians. Chicago: Frontline Distribution International; 1999.

    Google Scholar 

  10. Erskine N. From Garvey to Marley: Rastafari Theology (History of African-American Religions). Florida: University Press of Florida; 2007.

    Google Scholar 

  11. Waldstein A. Smoking as communication in Rastafari: reasonings with ‘Professional’ smokers and ‘Plant Teachers.’ Ethnos. 2020;85(5):900–19. https://doi.org/10.1080/00141844.2019.1627385.

    Article  Google Scholar 

  12. Lee JP, Battle RS, Lipton R, et al. ‘Smoking’: use of cigarettes, cigars and blunts among Southeast Asian American youth and young adults. Health Educ Res. 2010;25:83.

    CAS  PubMed  Article  Google Scholar 

  13. Ream GL, Benoit E, Johnson BD, et al. Smoking tobacco along with marijuana increases symptoms of cannabis dependence. Drug Alcohol Depend. 2008;95:199.

    PubMed  PubMed Central  Article  Google Scholar 

  14. Younger-Coleman N, Cumberbatch C, Campbell J, et al. Jamaica National Drug Use Prevalence Survey 2016. Kingston: Ian Randle Publishers; 2017.

    Google Scholar 

  15. Myrie S. An exploration of factors that contribute to drug use among dropout girls in inner city communities in Kingston and St. Andrew, Jamaica. Saskatoon: University of Saskatchewan; 2017.

    Google Scholar 

  16. Atkinson U, Abel W, Whitehorne-Smith P. Current Trends in Adolescent Substance Use in Jamaica. WIMJ Open. 2015;2:15–8. https://doi.org/10.7727/WIMJOPEN.2014.262.

    Article  Google Scholar 

  17. Samet JM. Tobacco smoking: the leading cause of preventable disease worldwide. Thorac Cardiovasc Surg. 2013;23:103–12.

    Google Scholar 

  18. Pan American Health Organization. Report on Tobacco Control in the Region of the Americas, 2018. Washington DC: PAHO; 2018.

    Google Scholar 

  19. Crawford TV, McGrowder DD, Barnett JD, et al. Tobacco-related chronic illnesses: A public health concern for jamaica. Asian Pac J Cancer Prev. 2012;13:4733–8.

    PubMed  Article  Google Scholar 

  20. Smith F. Caribbean rum : a social and economic history. Gainesville: University Press of Florida; 2005.

    Google Scholar 

  21. Reid SD. Time for a regional alcohol policy - A literature review of the burden of normative alcohol use in the Caribbean. J Public Health Policy. 2015;36:469–83.

    PubMed  Article  Google Scholar 

  22. Reisdorfer E, Büchele F, Pires ROM, et al. Prevalence and associated factors with alcohol use disorders among adults: a population-based study in southern Brazil. Rev Bras Epidemiol. 2012;15:582–94.

    PubMed  Article  Google Scholar 

  23. Osaki Y, Kinjo A, Higuchi S, et al. Prevalence and Trends in Alcohol Dependence and Alcohol Use Disorders in Japanese Adults; Results from Periodical Nationwide Surveys. Alcohol Alcohol (Oxford, Oxfordshire). 2016;51:465–73.

    Article  Google Scholar 

  24. World Health Organization. Global status report on alcohol and health 2018. Geneva: World Health Organization; 2018.

    Google Scholar 

  25. World Health Organization. Global status report on alcohol and health 2014. Geneva: World Health Organization; 2014.

    Google Scholar 

  26. Andrew Bourne P, Allen D, Bennett J, et al. Impact of Alcohol Consumption on the Psychological Well-being of Jamaicans during the Coronavirus Disease-19 (COVID-19) Pandemic. Int J Collab Res. 2021;13(9):32–42.

    Google Scholar 

  27. Morley KI, Ferris JA, Winstock AR, et al. Polysubstance use and misuse or abuse of prescription opioid analgesics: a multi-level analysis of international data. Pain. 2017;158:1138–44.

    CAS  PubMed  Article  Google Scholar 

  28. World Health Organization. Lexicon of alcohol and drug terms. Geneva: World Health Organization; 2014.

    Google Scholar 

  29. Collins RL, Ellickson PL, Bell RM. Simultaneous polydrug use among teens: prevalence and predictors. J Subst Abuse. 1998;10:233–53.

    CAS  PubMed  Article  Google Scholar 

  30. Lenton S, Boys A, Norcross K. Raves, drugs and experience: Drug use by a sample of people who attend raves in Western Australia. Addiction. 1997;92:1327–37.

    CAS  PubMed  Article  Google Scholar 

  31. Hedegaard H, Bastian BA, Trinidad JP, et al. Drugs most frequently involved in drug overdose deaths: United states, 2011–2016. Natl Vital Stat Rep. 2018;67(9):1–14.

    PubMed  Google Scholar 

  32. Warner M, Trinidad JP, Bastian BA, et al. Drugs most frequently involved in drug overdose deaths: United States, 2010–2014. National vital statistics reports; vol. 65, no. 10. Hyattsville: National Center for Health Statistics; 2016.

  33. Hedden SL, Martins SS, Malcolm RJ, et al. Patterns of illegal drug use among an adult alcohol dependent population: Results from the National Survey on Drug Use and Health. Drug Alcohol Depend. 2010;106:119–25.

    CAS  PubMed  Article  Google Scholar 

  34. Connor JP, Gullo MJ, Chan G, et al. Polysubstance Use in Cannabis Users Referred for Treatment: Drug Use Profiles, Psychiatric Comorbidity and Cannabis-Related Beliefs. Front Psychiatry. 2013;4:79.

    PubMed  PubMed Central  Article  Google Scholar 

  35. Medina KL, Shear PK. Anxiety, Depression, & Behavioral Symptoms of Executive Dysfunction in Ecstasy Users: Contributions of Polydrug Use. Drug Alcohol Depend. 2007;87:303.

    PubMed  Article  Google Scholar 

  36. Paquette R, Tanton C, Burns F, et al. Illicit drug use and its association with key sexual risk behaviours and outcomes: Findings from Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). PLoS ONE. 2017;12:e0177922.

    PubMed  PubMed Central  Article  CAS  Google Scholar 

  37. de Oliveira LG, Alberghini DG, dos Santos B, et al. Polydrug use among college students in Brazil: A nationwide survey. RevistaBrasileira de Psiquiatria. 2013;35:221–30.

    Google Scholar 

  38. Staiger PK, Richardson B, Long CM, et al. Overlooked and underestimated? Problematic alcohol use in clients recovering from drug dependence. Addiction (Abingdon, England). 2013;108:1188–93.

    Article  Google Scholar 

  39. de la Fuente L, Molist G, Espelt A, et al. Mortality risk factors and excess mortality in a cohort of cocaine users admitted to drug treatment in Spain. J Subst Abuse Treat. 2014;46:219–26.

    PubMed  Article  Google Scholar 

  40. Subbaraman MS, Kerr WC. Simultaneous Versus Concurrent Use of Alcohol and Cannabis in the National Alcohol Survey. Alcohol Clin Exp Res. 2015;39:872–9.

    PubMed  PubMed Central  Article  Google Scholar 

  41. Connor JP, Gullo MJ, White A, Kelly AB. Polysubstance use: diagnostic challenges, patterns of use and health. Curr Opin Psychiatry. 2014;27(4):269–75.

    PubMed  Article  Google Scholar 

  42. McCabe SE, Cranford JA, Morales M, et al. Simultaneous and concurrent polydrug use of alcohol and prescription drugs: prevalence, correlates, and consequences. J Stud Alcohol. 2006;67:529–37.

    PubMed  PubMed Central  Article  Google Scholar 

  43. Frone MR. Workplace Substance Use Climate: Prevalence and Distribution in the US Workforce. J Subst Use. 2012;71:72.

    PubMed  PubMed Central  Article  Google Scholar 

  44. Frone MR. Employee alcohol and illicit drug use: scope, causes, and organizational consequences. In: Barling J, Cooper CL, editors. The SAGE handbook of organizational behavior: Volume I - micro approaches. California: SAGE Publications Ltd.

  45. Osilla KC, Hunter SB, Ewing BA, et al. The effects of employment among adolescents at-risk for future substance use. Addict Behav. 2013;38:1616–9.

    PubMed  Article  Google Scholar 

  46. Briere FN, Fallu JS, Descheneaux A, et al. Predictors and consequences of simultaneous alcohol and cannabis use in adolescents. Addictive behaviors. 2011;36:785–8.

    CAS  PubMed  Article  Google Scholar 

  47. Terry-McElrath YM, O’Malley PM, Johnston LD. Alcohol and Marijuana Use Patterns Associated With Unsafe Driving Among U.S. High School Seniors: High Use Frequency, Concurrent Use, and Simultaneous Use. JSAD. 2014;75:378.

    Google Scholar 

  48. McCabe SE, West BT, Jutkiewicz EM, Boyd CJ. Multiple DSM-5 substance use disorders: a national study of US adults. Hum Psychopharmacol. 2017;32(5). https://doi.org/10.1002/hup.2625.

  49. Höhne B, Pabst A, Hannemann T, Kraus L. Patterns of concurrent alcohol, tobacco, and cannabis use in Germany: prevalence and correlates, drugs: education, prevention and policy. 2014;21(2):102–9.

  50. Byqvist S. Patterns of drug use among drug misusers in Sweden. Gender differences. Substance use & misuse. 2006;41(13):1817–35. https://doi.org/10.1080/10826080601006805.

  51. Schinke S, Di NJ, Schwinn T, et al. Drug Abuse Risk and Protective Factors among Black, Urban Adolescent Girls: A Group Randomized Trial of Computer-Delivered, Mother-Daughter Intervention. Psychol Addict Behav. 2006;20:496.

    PubMed  PubMed Central  Article  Google Scholar 

  52. Merline AC, O’Malley PM, Schulenberg JE, et al. Substance Use Among Adults 35 Years of Age: Prevalence, Adulthood Predictors, and Impact of Adolescent Substance Use. Am J Public Health. 2004;94:96.

    PubMed  PubMed Central  Article  Google Scholar 

  53. Steinhoff A, Bechtiger L, Ribeaud D, et al. Polysubstance Use in Early Adulthood: Patterns and Developmental Precursors in an Urban Cohort. Front Behav Neurosci. 2021;15:797473. https://doi.org/10.3389/FNBEH.2021.797473.

    Article  PubMed  Google Scholar 

  54. Hanson CL, Novilla MLLB, Barnes MD, et al. Using the Rural-Urban Continuum to Explore Adolescent Alcohol, Tobacco, and Other Drug Use in Montana. J Child Adolesc Subst Abuse. 2009;18:93–105. https://doi.org/10.1080/15470650802544289.

    Article  Google Scholar 

  55. Redonnet B, Chollet A, Fombonne E, et al. Tobacco, alcohol, cannabis and other illegal drug use among young adults: The socioeconomic context. Drug Alcohol Depend. 2012;121:231–9.

    PubMed  Article  Google Scholar 

  56. Midanik LT, Tam TW, Weisner C. Concurrent and simultaneous drug and alcohol use: results of the 2000 Alcohol Survey. Drug Alcohol Depend. 2007;90:72–80.

    PubMed  PubMed Central  Article  Google Scholar 

  57. Windle M, Mun EY, Windle RC. Adolescent-to-young adulthood heavy drinking trajectories and their prospective predictors. J Stud Alcohol. 2015;66:313–22. https://doi.org/10.15288/jsa200566313.

    Article  Google Scholar 

  58. Van der Meer Sanchez Z, De Oliveira LG, Nappo SA. Religiosity as a protective factor against the use of drugs. Subst Use Misuse. 2008;43:1476–86.

    Article  Google Scholar 

  59. Crano WD, Siegel JT, Alvaro EM, et al. The at-risk adolescent marijuana nonuser: Expanding the standard distinction. Prev Sci. 2008;9:129–37.

    PubMed  PubMed Central  Article  Google Scholar 

  60. Bartkowski JP, Xu X. Religiosity and teen drug use reconsidered: a social capital perspective. Am J Prev Med. 2007;32(6 Suppl):S182–94. https://doi.org/10.1016/j.amepre.2007.03.001.

    Article  PubMed  Google Scholar 

  61. Edlund MJ, Harris KM, Koenig HG, et al. Religiosity and decreased risk of substance use disorders: Is the effect mediated by social support or mental health status? Soc Psychiatry Psychiatr Epidemiol. 2010;45:827–36.

    PubMed  Article  Google Scholar 

  62. Henkel D. Unemployment and substance use: A review of the Literature (1990–2010). Curr Drug Abuse Rev. 2011;4:4–27.

    PubMed  Article  Google Scholar 

  63. Storti CC, De Grauwe P, Sabadash A, et al. Unemployment and drug treatment. Int J Drug Policy. 2011;22:366–73.

    PubMed  Article  Google Scholar 

  64. Roche A, Lee N, Battams S, et al. Alcohol use among workers in male-dominated industries: A systematic review of risk factors. Elsevier. 2015;78:124–41.

    Google Scholar 

  65. Damari B, Sarami H, Alikhani S, et al. A National survey on substance use among Iranian industrial workers. Med J Islam Repub Iran. 2020;34:20.

    PubMed  PubMed Central  Google Scholar 

  66. Gleason PM, Veum JR, Pergamit MR. Drug and alcohol use at work: a survey of young workers. Mon Labor Rev. 1991;114(8):3–7.

    Google Scholar 

  67. Bray RM, Pemberton MR, Lane ME, Use S, Among MHT, U.S. Military Active Duty Personnel: Key Findings From the, et al. DoD Health Behavior Survey. Mil Med. 2008;2010(175):390–9.

    Google Scholar 

  68. Lambert D, Gale JA, Hartley D. Substance abuse by youth and young adults in rural America. J Rural Health. 2008;24:221–8.

    PubMed  Article  Google Scholar 

  69. Warner L. Rural-urban differences in substance use and treatment utilization among prisoners. Am J Drug Alcohol Abuse. 2001;27:265–80.

    CAS  PubMed  Article  Google Scholar 

  70. Warren JC, Smalley KB, Barefoot KN. Recent Alcohol, Tobacco, and Substance Use Variations between Rural and Urban Middle and High School Students. J Child Adolesc Subst Abuse. 2017;26:60.

    PubMed  Article  Google Scholar 

  71. Falk DE, Yi H, Hiller-Sturmhöfel S. An Epidemiologic Analysis of Co-Occurring Alcohol and Tobacco Use and Disorders: Findings From the National Epidemiologic Survey on Alcohol and Related Conditions. Alcohol Res Health. 2006;29:162.

    PubMed  PubMed Central  Google Scholar 

  72. Schlienz NJ, Lee DC. Co-use of cannabis, tobacco, and alcohol during adolescence: policy and regulatory implications. Int Rev Psychiatry (Abingdon, England). 2018;30:226.

    Article  Google Scholar 

  73. Reyes JC, Pérez CM, Colón HM, et al. Prevalence and patterns of polydrug use in Latin America: Analysis of population-based surveys in six countries. Review of European Studies. 2013;5:10–8.

    Article  Google Scholar 

  74. Dhanookdhary AM, Gomez AM, Khan R, et al. Substance use among university students at the St Augustine campus of the University of the West Indies. West Indian Med J. 2010;59:641–9.

    CAS  PubMed  Google Scholar 

  75. Harrison J, Simich L, Strike C, et al. PROFILE OF SIMULTANEOUS POLY-SUBSTANCE USERS OF UNDERGRADUATE STUDENTS AT ONE UNIVERSITY. KINGSTON-JAMAICA. 2012;21:63–70.

    Google Scholar 

  76. Peltzer K, Pengpid S. Polysubstance use among national samples of in-school adolescents in Dominican Republic, Jamaica, and Trinidad and Tobago. J Psychol Afr. 2022;32:187–93. https://doi.org/10.1080/1433023720222028078.

    Article  Google Scholar 

  77. Ministry of Education, Youth, and Culture, Jamaica. Situation Assessment Report Youth in Jamaica 2001. Aleph SA, Futures Group International; 2002.

  78. Gale J, Lenardson J. Distribution of substance abuse treatment facilities across the rural-urban continuum. University of Southern Maine; 2007.

  79. Dotson JA, Roll JM, Packer RR, et al. Urban and rural utilization of evidence-based practices for substance use and mental health disorders. J Rural Health. 2014;30:292–9.

    PubMed  Article  Google Scholar 

  80. Hess DR. Retrospective studies and chart reviews. Respir Care. 2004;49(10):1171–4.

    PubMed  Google Scholar 

  81. Gearing RE, Mian IA, Barber J, et al. A Methodology for Conducting Retrospective Chart Review Research in Child and Adolescent Psychiatry. J Can Acad Child Adolesc Psychiatry. 2006;15:126.

    PubMed  PubMed Central  Google Scholar 

  82. Olszewski D, Matias J, Monshouwer K, Kokkevi A. Polydrug use among 15- to 16-year olds: similarities and differences in Europe. Drugs: Education, Prevention and Policy. 2009;17(4):287–302.

  83. National Advisory Committee on Drugs and Alcohol. Drug use in Ireland and Northern Ireland 2010/11 drug prevalence survey. Dublin: National Advisory Committee on Drugs and Alcohol; 2014.

  84. Spencer N, Strobl E. The impact of decriminalization on marijuana and alcohol consumption in Jamaica. Health Policy Plan. 2020;35:180–5.

    PubMed  Article  Google Scholar 

  85. Chevannes B. Criminalizing cultural practice the case of Ganja in Jamaica. In: Klein A, Day M, Harriott A, editors. Caribbean Drugs: From Criminalization to Harm Reduction. London: Zed Books; 2004. p. 67–81.

  86. Golding JM. The Dangerous Drug (Amendment) Act 2015, The Jamaica Gazette Supplement Proclamations, Rules And Regulation. Kingston: Jamaica Printing Service; 2015.

  87. International Business Incorporated. Jamaica: Doing Business and Investing in ... Guide Volume 1 Strategic, Practical Information, Regulations, Contacts. USA International Business Publications; 2015.

  88. Torero M, Robles M, Hernandez M, De la Roca J, Webber M, Thomas D. The informal sector in Jamaica. Economic & Sector Study Series 2006 RE3-06010, Inter-American Development Bank.

  89. Miller D. "Impact of the Informal Sector on Trade & Competition.” Presentation to V Annual Meeting of the Working Group on Trade & Competition of the Latin America & the Caribbean; 2015.

  90. Smith GW, Farrell M, Bunting BP, et al. Patterns of polydrug use in Great Britain: findings from a national household population survey. Drug Alcohol Depend. 2011;113:222–8.

    PubMed  Article  Google Scholar 

  91. Buchmueller TC, Zuvekas SH. DRUG USE, DRUG ABUSE, AND LABOUR MARKET OUTCOMES. HEALTH ECONOMICS Health Econ. 1998;7:229–45.

    CAS  PubMed  Article  Google Scholar 

  92. MacDonald P. The wages of sin? Illegal drug use and the labour market. Labour. 2000;14:657–73.

    Article  Google Scholar 

  93. Boys A, Marsden J, Strang J. Understanding reasons for drug use amongst young people: a functional perspective. Health Educ Res. 2001;16:457–69.

    CAS  PubMed  Article  Google Scholar 

  94. Borders B. Research on rural residence and access to drug abuse services: where are we and where do we go? J Rural Health. 2007;23(Suppl):79–83.

    PubMed  Article  Google Scholar 

  95. Borders TF, Booth BM, Curran GM. African American Cocaine Users’ Preferred Treatment Site: Variations by Rural/Urban Residence, Stigma, and Treatment Effectiveness. J Subst Abuse Treat. 2015;50:26.

    PubMed  Article  Google Scholar 

  96. Fortney J, Mukherjee S, Curran G, et al. Factors associated with perceived stigma for alcohol use and treatment among at-risk drinkers. J Behav Health Serv Res. 2004;31:418–29.

    PubMed  Article  Google Scholar 

  97. Heinz AJ, Wu J, Witkiewitz K, et al. Marriage and relationship closeness as predictors of cocaine and heroin use. Addict Behav. 2009;34:258–63.

    PubMed  Article  Google Scholar 

  98. Sinha N. Effect of martial status on substance abuse - a review. Int J Recent Sci Res. 2018;9(5):27012–5.

    Google Scholar 

  99. Douglas-Harrison EB. When Wives Migrate and Leave Husbands Behind: A Jamaican Marriage Pattern. CUNY Academic Works; 2014.

  100. Fergusson DM, Boden JM, Horwood LJ. Cannabis use and other illicit drug use: Testing the cannabis gateway hypothesis. Addiction. 2006;101:556–69.

    PubMed  Article  Google Scholar 

  101. Carter JL, Strang J, Frissa S, et al. Comparisons of polydrug use at national and inner city levels in England: associations with demographic and socioeconomic factors. Ann Epidemiol. 2013;23:636–45.

    PubMed  Article  Google Scholar 

  102. Quek L-H, Chan GCK, White A, et al. Concurrent and Simultaneous Polydrug Use: Latent Class Analysis of an Australian Nationally Representative Sample of Young Adults. Front Public Health. 2013;1:61.

    PubMed  PubMed Central  Article  Google Scholar 

  103. Decorte T, Lenton S, Wilkins C. Legalizing cannabis: experiences, lessons and scenarios. New York: Routledge; 2020.

    Book  Google Scholar 

  104. Frone MR, Brown AL. Workplace Substance-Use Norms as Predictors of Employee Substance Use and Impairment: A Survey of U.S. Workers. J Stud Alcohol Drugs. 2010;71:526.

    PubMed  PubMed Central  Article  Google Scholar 

  105. Seddon T. Drugs, crime and social exclusion: Social context and social theory in British drugs-crime research. Br J Criminol. 2006;46:680–703.

    Article  Google Scholar 

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KL contributed to the conception, design, drafting of the work; interpreted the data that was analysed; critically revised the work for important intellectual content; and approved of the final version to be published. PWS contributed to the analysis and interpretation of data for the work and approved the final version to be published. GW contributed to the conception of the work; analysis and interpretation of data for the work; critically revised it for important intellectual content; and approved the final version to be published. JM contributed to the conception of the work; analysis and interpretation of data for the work; and approved the final version to be published. GM critically revised the work and contributed to the final review of the paper and approved the final version for publication. WA contributed to the conceptualizing of the design of this paper, writing of first and subsequent drafts of the paper and critically revised the work for important intellectual content; and approved of the final version to be published. All authors read and approved the final manuscript and have agreed both to be personally accountable for the author’s own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

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Lalwani, K., Whitehorne-Smith, P., Walcott, G. et al. Prevalence and sociodemographic factors associated with polysubstance use: analysis of a population-based survey in Jamaica. BMC Psychiatry 22, 513 (2022). https://doi.org/10.1186/s12888-022-04160-2

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Keywords

  • Polysubstance use
  • Jamaica
  • Household survey
  • Prevalence
  • Sociodemographic factors