{
  "abstract": "Objective: Drug use after trauma is common, but polydrug use patterns, motives, and associations with subsequent symptoms are poorly understood. We examined these associations among mass-casualty terror attack survivors, 72% of whom used drugs immediately before trauma exposure. Methods: Survivors of the October 7, 2023 Nova Festival attack reported use of six drug types (alcohol, cannabis, ketamine, stimulants, MDMA, psychedelics) and motives (avoidance, emotional regulation, self-medication, sleep, recreation) longitudinally at three timepoints (TP): 1-6 months (N=772), 8-12 months (N=453), and 17-24 months (N=302) post-attack. Separate latent class analyses of TP2 data characterized drug use, motives, and their combination. Linear regression and mixed-effects models examined associations between class membership and PTSD Checklist for DSM-5 (PCL-5) scores, adjusting for age, sex, time since trauma, and TP1 PCL-5 scores. Results: At TP2, 70% reported polydrug use, 17% used one drug, and 13% reported no use. The high drug-load class (mean 4.6 drug types) had lower PCL-5 scores than the low drug-load class (mean 1.5 drug types); this difference was evident among participants using [≥]4 drug types and persisted through TP3. The self-medication-motive class had higher PCL-5 scores than the recreational-motive class. In joint analyses, recreational-motive users at both low and high drug loads had lower PCL-5 scores than participants reporting self-medication motives and primarily cannabis use. Conclusions: Polydrug use was common among the mass-trauma survivors in our study. Self-medication motives were associated with higher PTSD symptom severity than recreational motives. Unexpectedly, higher polydrug use was associated with lower PTSD symptom scores.",
  "abstract_shown": true,
  "affiliations": [
    "School of Psychological Sciences, University of Haifa, Haifa, Israel; Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel;"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "name": "N. Magal"
    },
    {
      "name": "O. Netzer"
    },
    {
      "name": "D. H. Epstein"
    },
    {
      "name": "Y. Shaham"
    },
    {
      "name": "D. Repantis"
    },
    {
      "name": "S. Lev-Ran"
    },
    {
      "name": "A. Harduf"
    },
    {
      "name": "R. Admon"
    },
    {
      "affs": [
        0
      ],
      "name": "R. Salomon"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8947kz7vdn7y0.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.29.26366805",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.29.26366805v1.full",
  "id": "8947kz7vdn7y0",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.29.26366805v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "psychiatry and clinical psychology"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.29.26366805v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/8947kz7vdn7y0.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T00:21:04Z",
      "native_id": "10.64898/2026.10.29.26366805",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.29.26366805v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:psychiatry and clinical psychology",
      "subfield": "psychiatry"
    }
  ],
  "title": "Polydrug use and recreational motives are associated with lower posttraumatic symptoms in survivors of a mass trauma event",
  "title_text": "Polydrug use and recreational motives are associated with lower posttraumatic symptoms in survivors of a mass trauma event",
  "type": "preprint",
  "updated_at": "2026-11-05T00:20:36Z",
  "url": "https://research.draconitic.com/paper/8947kz7vdn7y0",
  "venue": "medRxiv",
  "versions": []
}