OBJECTIVES: Polysubstance use (PSU) that involves marijuana use in women of reproductive age is associated with psychosocial harm and social sequelae. Limited research, however, exists on the effect of concurrent use of stimulants, opioids, tobacco, and alcohol binge drinking among women marijuana users. The purpose of this study was to (1) assess the prevalence of PSU in women of reproductive age who reported recent marijuana use; and (2) examine the association between PSU and social sequelae, including getting in trouble with the law, relationship difficulty with others, and lower achievement in job or educational settings, in this group of women.

METHODS: We used data from the 2015-2019 National Survey on Drug Use and Health (NSDUH) which included 11,895 non-institutionalized women of reproductive age (18-49 years old) with reported use of marijuana in the past month. Descriptive statistics, chi-squared tests, and multivariable logistic regression analyses were conducted to describe the sample and assess associations between PSU and social sequelae.

RESULTS: Nearly 76.71% of the women who used marijuana in the past month were involved in PSU or concurrent use of psychoactive stimulants, opioids, tobacco, and alcohol binge drinking. Women who used two of four substances along with marijuana had higher odds (AOR=1.54, 95% CI 1.09, 2.18) of social sequelae relative to their monosubstance counterparts (marijuana use only). Women who used three of the four substances along with marijuana had higher odds (AOR=2.74, 95% CI 1.83, 4.12) of social sequelae relative to monosubstance users.

CONCLUSIONS: Concurrent use of multiple substances was significantly associated with higher odds of social sequelae among women marijuana users. Healthcare professionals and public health officials need to enhance awareness of PSU harm among women of reproductive age.