Polysubstance abuse is a common practice. Although any type of drug use can be detrimental to a person’s health and well-being, polydrug abuse is associated with a significant number of negative health and societal issues.
What is Polysubstance Abuse?
Polysubstance abuse is a type of substance use disorder that is characterized by the regular abuse of at least two or more different substances without preference for any single one.1,2 People who struggle with polysubstance abuse don’t have a regular go-to drug. Instead, they regularly abuse multiple different types of drugs to achieve a high.
Polysubstance abuse may be intentional or unintentional and may involve illegal drugs, over-the-counter drugs, and prescription medications. Some people may unintentionally abuse multiple drugs at once, such as taking a prescription medication and then drinking an alcoholic beverage without realizing the medication should not be combined with alcohol.
In other instances, a person may engage in polysubstance abuse intentionally for the purpose of enhancing the effects of the primary substance. For example, a person may take prescription painkillers and benzodiazepines like Ambien, Valium, or Xanax together to enhance the sedating effects of the narcotics.
Risks and Side Effects of Polysubstance Abuse
There are many different health-related risks associated with specific drug and alcohol combinations, but generally speaking, any kind of polysubstance abuse has many risks and harmful side effects. Here are some of the biggest risks of polydrug use:
- Overdose – People who abuse multiple types of drugs simultaneously have a higher risk of overdosing. Although overdose is always a risk when any drug use is involved, most overdoses occur when substances are mixed with sedating drugs like opioids.2
- Accidents – Polydrug abuse causes more severe side effects. This increases the risk of accidents and unintentional injuries.
- Addiction – Drug users who abuse multiple different substances regularly are much more likely to develop a tolerance, physical dependence, and addiction, especially if they abuse several different drugs on a long-term basis.
- Mental health problems – Polysubstance abuse can amplify the effects of a mental health problem and people with mental disorders may abuse drugs to self-medicate.3 As the cycle continues, mental health problems and addiction can continually worsen.
- Higher rates of academic failure – According to the Department of Health and Human Services, people who suffer from polysubstance abuse are more likely to have employment problems and legal issues, as well as academic problems. They may also be more likely to drop out of school or fail to complete a program.4
- Increased likelihood of physical violence – Polydrug abuse can cause unpredictable effects, especially when it comes to the mood and behavior of the drug user. As a result, using multiple substances simultaneously may increase a person’s risk of becoming physically violent toward friends, family members, or strangers.
- Complex treatment needs – Since the physical and psychological side effects of polysubstance abuse are unpredictable, the treatment process is also more complex. Quitting drugs “cold turkey” can quickly become life-threatening and treating the symptoms of polysubstance withdrawal is a complicated process that requires medical assistance and continued care.
Causes of Polysubstance Abuse
There is a lack of research and data concerning the cause of polysubstance abuse, but according to the Mayo Clinic, general substance abuse is often caused by several different contributing factors, such as:
- Home and social environment
- Exposure to drugs, alcohol, and substance abuse
- A family history of addiction
- Mental health disorders like depression, ADHD, or PTSD
- Lack of family involvement
- Early use of drugs and/or alcohol5
Dangerous Polydrug Combinations
Alcohol, cocaine, and marijuana are the most commonly abused drugs, both alone and in conjunction with other substances. Alcohol, in particular, is frequently abused with cocaine, marijuana, and opioids.6 Other common polydrug combinations include:
- Benzodiazepines and prescription opioids: This combination is very common but also very dangerous. Benzodiazepines like Ativan, Xanax, and Klonopin are dangerous when misused on their own, but when combined with prescription opioids like OxyContin, Vicodin, and hydrocodone, the result can be life-threatening.
- Alcohol and prescription drugs: Abusing alcohol and any kind of prescription drug simultaneously can cause alcohol poisoning, loss of consciousness, breathing problems, and sometimes death. Risky behaviors like drunk driving or unplanned sex are also common.
- Ecstasy and alcohol: This is a particularly dangerous combo. Ecstasy (also referred to as molly) raises body temperature and alcohol dehydrates the body, which can easily lead to heatstroke, water poisoning, or heart failure. Long-term effects include liver damage, brain damage, cognitive problems, and clinical depression that can last long after the drug use has ended.
- Heroin and sedatives: Although many drug users combine heroin with other sedatives because of the complementary effects the two drugs provide, when they are used together, the side effects can be dangerously intensified. The user may experience difficulty breathing, decreased heart rate, coma, cardiac arrest, or even death.
- Amphetamines and depressants: Using amphetamines (illegal or prescription forms) with other sedatives such as alcohol can easily cause accidents or overdose, which may result in seizures, heart failure, stroke, or death.
Who Has the Highest Rate of Polysubstance Abuse?
Research shows adolescents are much more likely to be polydrug users than middle age or older adults and polysubstance abuse declines greatly after age 25.7 One study also found that drug users in urban areas are more likely to be polydrug users than drug users in rural areas, although there is a general lack of research on that topic.6
Drug users who regularly abuse certain substances may also be more likely to use several different drugs simultaneously. For example, one study conducted in 14 European countries found that 60 percent of cocaine users were polydrug users, and of those, 42 percent used alcohol, 28 percent used cannabis, and 16 percent used heroin.2
Another study, which took place in the U.S., found that nearly 50 percent of treatment admissions were for polysubstance abuse, illustrating the likelihood that drug users may eventually use multiple substances simultaneously, even if they initially only start out with one primary substance of abuse.2
Treatment for Polysubstance Abuse: Detox and Rehab
Detox for polysubstance abuse poses several unique challenges that must be addressed before addicted individuals can reach a stable state of sobriety.8 Most often, inpatient detox is recommended, as polysubstance detox is much more complex and the side effects of withdrawal are very unpredictable.
During inpatient polydrug detox, clients are monitored round-the-clock by a staff of nurses and a supervising physician. Depending on the severity of the client’s substance abuse and dependence, the treatment team can provide a period of safe, medical monitoring or medication-assisted treatment to relieve physical and psychological symptoms of drug withdrawal.
In some instances, opioid replacement therapy may be used to reduce the severity of opioid withdrawal. This may be achieved with drugs like methadone or Suboxone. Drug detox for polysubstance abuse involving benzodiazepines may also include a tapering method, to gradually wean the client off of the drugs and into a safe and stable state.
Since detox for polysubstance abuse is so complex and unpredictable, a personalized medical detox program is the best and safest way to get sober. Continued care is also essential, as some withdrawal symptoms may linger for weeks or even months. A continued care program like inpatient or outpatient rehab can help clients learn how to cope with cravings, implement relapse prevention strategies, and resolve trauma or negative thoughts and behaviors that have contributed to their substance abuse.