Psychoactive substance co-use, non-medical drug use and polypharmacy among Ukrainian outpatients: a brief report

Background Psychoactive substance co-use, non-medical drug use and polypharmacy, including the concurrent use of medicines with alcohol or other psychoactive substances, may increase medication-related harms. Alcohol is a causal factor in numerous disease and injury conditions, and risky medicine-substance combinations contribute to adverse events and drug – substance interactions. This brief report assessed patterns of psychoactive substance co-use, non-medical drug use and polypharmacy among Ukrainian outpatients and explored practice implications.Methods An anonymous cross-sectional questionnaire survey was conducted among Ukrainian outpatients (N = 120). The questionnaire assessed polypharmacy (≥5 medicines), alcohol use in the past 12 months, medicine-alcohol co-use, medicine-alcohol plus ≥1 additional psychoactive substance co-use, and non-medical drug use. Data were analyzed descriptively.Results Polypharmacy (≥5 medicines) was reported by 56.7% of participants. Alcohol use in the past 12 months was reported by 55.0%. Medicine-alcohol co-use occurred in 28.3%, and medicine-alcohol plus ≥ 1 additional additional psychoactive substance co-use in 20.8%. Overall, 51.7% met the study’s operational definition of non-medical drug use. Non-medical drug use appeared more common among participants reporting psychoactive substance co-use and among those exposed to polypharmacy.Conclusions In this outpatient sample, polypharmacy and psychoactive substance co-use were common and clustered with non-medical drug use. Integrating brief screening, targeted medication review and clear counseling on interaction risks into outpatient care may strengthen medication safety.