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Our study aimed to: (i) identify the shared substance use classes among young people at treatment admission, (ii) determine which mental health symptoms, quality of life (QoL) and service types were associated with the identified substance use classes, and (iii) prospectively determine which substance use classes and service types were more likely to complete treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional and prospective study using service and outcome data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Substance use treatment services in Queensland and New South Wales, Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>De\u2010identified service and outcome measure data were extracted from the files of 744 clients aged 18\u201335\u2009years (48% male) admitted into seven residential and four day\u2010treatment programmes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Substance use and severity among tobacco, alcohol, cannabis, cocaine, amphetamine\u2010type stimulants, opioids, sedatives and inhalants. Other variables included: depression, anxiety, post\u2010traumatic stress and psychotic symptoms, as well as QoL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Latent class analysis identified three polysubstance use classes: wide\u2010ranging polysubstance users (WRPU; 22.45%), primary amphetamine users (56.45%) and alcohol and cannabis users (21.10%). The WRPU class had higher odds of psychotic symptoms than the alcohol and cannabis use class [odds ratio (OR)\u2009=\u20091.30; 95% confidence interval (CI)\u2009=\u20091.11\u20131.11]; and double the odds of residential programme enrolment than those in the amphetamine use class (OR\u2009=\u20092.35; 95% CI\u2009=\u20091.50\u20133.68). No other class differences on mental health or QoL variables were found. Clients enrolled in day\u2010programmes had higher odds of completing treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There appear to be high levels of polysubstance use among young people entering substance use treatment in Australia. Wide\u2010ranging polysubstance users were more likely to report psychotic symptoms and be enrolled into a residential programme than primary amphetamine users and alcohol and cannabis users.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16008","type":"journal-article","created":{"date-parts":[[2022,7,19]],"date-time":"2022-07-19T03:13:20Z","timestamp":1658200400000},"page":"3110-3120","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Polysubstance use in young people accessing residential and day\u2010treatment services for substance use: substance use profiles, psychiatric comorbidity and treatment completion"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1541-9168","authenticated-orcid":false,"given":"Valeriya","family":"Mefodeva","sequence":"first","affiliation":[{"name":"School of Psychology University of Queensland  Brisbane Queensland 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