What Is Polysubstance Abuse?
Polysubstance abuse, also called polydrug use, occurs when a person abuses more than one substance (or drug) at a time. The abuse can occur with both drugs in one incident or at separate times during the same period of abuse. A person may, for example, take two drugs together for their intended opposing effects, or may take one drug after another to counteract the effects of the first.
Polysubstance abuse comes with a unique set of risks in addition to the risks and dangers associated with each substance, including increased risk of overdose, increased mental health issues or chance of developing such issues, and risky behavior due to acute intoxication, which can lead to serious injury or accidents.
Treatment for polysubstance abuse and addiction must be comprehensive and based on the individual’s needs.. Individuals in recovery should receive treatment for any and all substance use disorders to ensure the greatest chance at achieving sobriety and entering recovery fully-equipped to avoid relapse and live a full, healthy life.
Polysubstance Abuse Vs. Addiction
It’s important to first understand the difference between polysubstance abuse and addiction. Abuse of a substance can take a few different forms. For instance, if a substance is illicit (illegal), such as heroin or cocaine, then use of it is always considered abuse.
Other forms of abuse occur when a person takes a prescription drug, such as the opioid, oxycodone (OxyContin), or the benzodiazepine, diazepam (Valium), in a way other than intended by doctors. Abuse of prescription drugs include: changing method of administration (such as crushing a pill and snorting it for faster effects), changing dosage, changing frequency of dosage, or taking someone else’s prescription.
If a person abuses a drug for an extended period of time, or a highly-addicting drug several times, addiction can result. Risk of addiction is especially high when abusing multiple substances, as each instance of abuse puts a person at further risk for developing an addiction.
Addiction is a chronic disease which affects the brain and causes relapse. Drugs interrupt brain communication pathways by binding to receptors and altering the processes in the brain. They also cause physical effects which make the person feel a surge of euphoria and other pleasurable effects, prompting the person to seek the drug or drugs again and again.
When a person becomes addicted to a drug, he or she is affected by compulsive drug-seeking and use. With time, the effects of continued abuse take their toll on a person’s psychological, physical, emotional, and behavioral well-being.
Who Is Affected By Polysubstance Abuse?
The National Institute on Drug Abuse (NIDA) explains that addiction, like many other diseases, will affect each person differently. A person’s vulnerability to addiction depends on a number of risk factors, including: aggressive behavior in childhood, lack of parental supervision, lack of or poor social skills, instance of drug experimentation, how available drugs are to a person in their youth, and poverty level.
Other factors include environmental ones, such as the influence of home on a person during their childhood, i.e. if a child has access to a stable home and support from family, he or she will be less likely to fall into addiction.
People who began using substances at an early age are more likely to develop addiction later in life, the NIDA states. How a person abuses a drug is also a factor—when a person abuses a drug by a method of administration that produces instant effects, such as by smoking or injection, he or she is more likely to quickly develop an addiction to it.
It is not known exactly how many people in the United States are affected by polysubstance abuse and addiction. However, one study of more than 69,000 clients in publicly-funded treatment admissions from 1998 to 2004 found that 51.3 percent of admissions reported mono-drug use (abuse of a single drug) while 48.7 percent reported polydrug abuse.
While this may point to a roughly equal number of people abusing multiple substances compared to those abusing one substance, not enough research exists on polysubstance abuse, its effects, or related matters for a full conclusion. In any case, at the least, tens of thousands of people are affected by polysubstance abuse and addiction each year, with a suspected larger number, who become exposed to the risks and dangers associated with these illnesses.
Signs And Symptoms Of Polysubstance Abuse And Addiction
Because each drug affects each person differently, and each person reacts to drugs in his or her own way based on a number of biological and psychological factors, polysubstance abuse can be hard to spot. For example, the signs of abuse of a stimulant, such as cocaine, will differ greatly from signs of abuse of a depressant, such as alcohol. Combining two substances such as this can mask the effects of each, making identifying the specific drug of abuse more challenging.
Signs of abuse can be physical, behavioral, psychological, or external (how drug abuse affects a person’s life). No matter the substance combination, people abusing drugs tend to experience vast changes in one area or more of their health or personal life once drug-seeking and using becomes the top priority due to addiction.
General signs and symptoms of polydrug abuse and addiction include:
- acute intoxication
- extreme hangovers
- increased risky behavior, such as driving while intoxicated
- increased instances of accidents and injuries, such as falls
- violent behavior, such as getting into physical fights
- development of mental health issues, or worsened mental health issues
- signs of physical dependence: experiencing withdrawal symptoms when not using a substance
- signs of tolerance: taking a substance, or multiple substances, more often, increasing the dosage, or needing more to feel the desired “high” or to function
- physical effects, such as signs of intravenous use
- instances of paraphernalia, or items used for drug abuse, such as spoons, lighters, loose powder, pipes, etc.
More specific signs of polysubstance abuse can be found according to the effects of certain polydrug combinations, such as cocaine and alcohol or cocaine and heroin.
Dangers Of Polysubstance Abuse
The dangers associated with polysubstance abuse and addiction occur according to which drugs were abused. Each drug produces certain mind-altering and physical effects, and mixing these effects when combining different drugs can have taxing effects on the brain and body.
Research from Edith Cowan University explains, “Sometimes using some drugs together can lead to greater effects than would be expected from simply adding up the effects of each drug. This is called synergism. It happens when one drug actually makes the other drug work more strongly.”
Abuse of one drug can cause typical effects of abuse for that drug, but when a person abuses another drug at the same time, the effects may be amplified causing increased intoxication. The University goes on to explain that, “as a result, the effects of combined drug use can be very unpredictable and dangerous.”
Commonly Abused Drug Combinations
The following are common polysubstance abuse combinations and the effects and dangers associated with taking them together.
Mixing Depressants And Stimulants
Depressants and stimulants have opposing effects on the body. This means that while depressants work to slow down body functions like heart rate, respiratory rate, and brain function, stimulants are working to speed these body functions up.
Because of these opposing effects, a person may be driven to take more of the drugs so they can feel a more intense high. This leads to an increased risk of overdose because the user doesn’t accurately feel the effects that the drugs are having on their body.
Here are some of the most common combinations of depressants and stimulants:
- Alcohol and stimulants
- Benzodiazepines and stimulants
- Opioids and stimulants
Mixing Depressants With Other Depressants
Mixing multiple depressants together is extremely dangerous because these drugs work to depress the central nervous system which regulates heart rate, respiratory rate, and brain function.
Combining depressant drugs with other depressants can cause fatal consequences such as overdose, coma, and death.
Below are some of the most common depressant drug combinations:
- Alcohol and depressants
- Opioids and benzodiazepines
- Benzodiazepines and benzodiazpines
- Opioids and opioids
Other Common Drug Combinations
There are more drug combinations than fall into the categories above.
Below are some other common drug abuse combinations:
- Alcohol and Prednisone
- Alcohol and Antidepressants
- Alcohol and Marijuana
- Alcohol and Hallucinogens
- Cocaine and MDMA
- Cocaine and Adderall
- Cocaine and Meth
- Cocaine and Caffeine
- Cocaine and Ritalin
- Cocaine and Vyvanse
- Heroin and Marijuana
- Cocaine and Marijuana
- Cocaine and Ketamine
- Cocaine and Ambien
- Cocaine and Gabapentin
- Cocaine and Trazodone
- Cocaine and Wellbutrin
- Cocaine and Zoloft
- Cocaine and Ecstasy
- Cocaine and LSD
Polysubstance Abuse And Co-Occurring Disorders
In addition to the physical risks of polysubstance abuse and addiction, such as overdose, abusing more than one substance at a time may worsen the symptoms of a mental disorder or contribute to the development of one.
Co-occurring disorders, formerly called a dual diagnosis, occur when a person suffers with both a substance use disorder and a mental health disorder. According to the National Alliance on Mental Illness (NAMI), either the substance use disorder or the mental health disorder can occur first, and having one disorder may make a person more likely to develop the other.
For example, people experiencing mental health issues, such as anxiety or depression, may try to self-medicate by abusing drugs or alcohol. However, research has found that instead of helping alleviate the symptoms of the mental health disorder, substance abuse tends to make them worse.
As of 2014, 7.9 million people had a co-occurring mental disorder and substance use disorder, NAMI reports. Treating co-occurring disorders can be more challenging, as it’s important that both disorders are properly diagnosed and treated or a person’s recovery outcome may be affected.
A comprehensive treatment plan within an inpatient drug rehab center can help individuals overcome polysubstance abuse and learn to manage their mental disorder.
Medical Detox For Polysubstance Abuse And Addiction
Depending on the substance of abuse, a person may require a medical detoxification before proceeding to addiction treatment. Alcohol, barbiturates, benzodiazepines, and opioids can all cause physical dependence, which means when a person tries to go off the drugs, they experience uncomfortable and, in some cases, dangerous withdrawal symptoms.
Depending on the severity of abuse and duration of addiction, a person may need a medical detox, which involves constant monitoring and medical support.
Within a medically-supervised detox program, a person will be monitored for vital functions, have access to medication as needed, and receive medical aid depending on their individual needs, such as nutritional and vitamin deficiency support.
Some drugs can cause life-threatening forms of withdrawal, including alcohol, while others aren’t always life-threatening but can be so uncomfortable a person is likely to relapse without medical help in detox.
Detoxification allows a person to flush out harmful toxins from polysubstance abuse and prepare for formal treatment and recovery.
Treating Polysubstance Abuse And Addiction
While a medical detox may be the necessary first phase of addiction treatment, a formal treatment program should always follow detox to ensure the best chance for a successful recovery outcome, especially in the case of polysubstance abuse and addiction.
Inpatient addiction treatment programs can provide the environment an addicted individual needs to make a great change in their life. Learning to manage addiction can be difficult, and with abuse of more than one drug, a person will likely need an intensive program tailored to their specific needs.
Many drug rehab centers now provide dual diagnosis treatment programs to target the unique needs of people in recovery from more than one disorder. A full assessment of both disorders and a treatment plan that takes into account the individual’s medical history, as well as other factors, is necessary for treatment success.
Finding the right addiction treatment program in a facility that cares about and supports each individual can be detrimental to a person’s recovery outcome. Continued care for polysubstance abuse and addiction is as important as the treatment itself, so when finding a drug rehab center, it’s important to consider this factor as well.
Learn more about polysubstance abuse and addiction treatment and the best rehab centers which provide it.
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- CBS News — Mixing opioids and popular sedatives may be deadly
- Edith Cowan University — Polydrug use
- National Alliance on Mental Illness — Dual Diagnosis
- National Institute on Alcohol Abuse and Alcoholism — Mixing Alcohol With Medicines
- National Institute on Drug Abuse for Teens — Real Teens Ask About Speedballs