Analysis of Single and Polydrug Profiles in the All of Us Cohort: Self-Reported Health, Wearable Sleep Metrics, and Family History

Substance use remains a major public health concern in the United States, with diverse patterns of single- and multi-drug use linked to varying health outcomes across populations. Leveraging multimodal data from the All of Us Research Program, including survey responses, electronic health records, and Fitbit-derived metrics, this study examines associations between drug use categories and indicators of general health, sleep quality, physical activity, and family history of substance use. Polydrug and stimulant users reported significantly lower health ratings, greater sleep fragmentation, and reduced activity levels, while cannabis-only users showed comparable outcomes to non-users. Elevated family history among polydrug users supports hypotheses of intergenerational risk transmission. Wearable-derived sleep metrics emerged as sensitive indicators of substance-related health disparities and underscore the value of passive monitoring in addiction research. These findings highlight the potential of integrated behavioral data to inform personalized prevention strategies and scalable digital health interventions.