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Polysubstance Abuse And Addiction

David Hunter, MA.Ed, LPC

Medically reviewed by

David Hunter, MA.Ed, LPC

March 29, 2019

Polysubstance abuse greatly increases the risks of side effects and dangers of each drug, including risk of overdose. A comprehensive treatment program can help individuals learn to manage both substance use disorders and enter recovery.

Millions of people in the U.S. and all over the world are affected by substance abuse every day. Polysubstance abuse, or abusing multiple substances at once, is also a widespread problem.

Polysubstance abuse, or polydrug abuse, happens when individuals abuse combinations of drugs either together or within the same time period (such as a few hours).

Abuse of a substance always comes with a set of risks and consequences. Polysubstance abuse puts a person at risk for a combined set of dangers and consequences.

Reasons People Abuse Multiple Drugs

People may abuse multiple drugs at once for a variety of reasons. No matter the reason, polydrug abuse exposes a person to the effects of both drugs at once, increasing risk of dangers such as overdose.

Possible reasons for polysubstance abuse include:

  • Tolerance: individuals may abuse two drugs at the same time if they have grown tolerant to the effects of a drug. Abusing two drugs of the same kind, such as two opioids, is believed to help bypass the tolerance level.
  • Amplified side effects: when individuals abuse two substances at once, it tends to amplify the effects of both, producing a more drastic and lasting “high.”
  • Counter-effects: some individuals may abuse two substances at once to counter the effects of each. Cocaine, a stimulant, can produce low periods of depression and anxiety after the initial high, so it is often abused with heroin, a depressant.

Dangers Of Polysubstance Abuse And Addiction

Abuse of any drugs, with any frequency, puts a person at risk of adverse consequences. When mixing substances, individuals are far more at risk of adverse effects.

Risks Of Polysubstance Abuse And Addiction

Developing a tolerance — Tolerance with polysubstance abuse is dangerous in that it prompts individuals to take more frequent and higher doses of drugs. This increases risks of overdose for certain drugs.

Increased side effects — Increased side effects may seem an obvious consequence of polysubstance abuse, but can have a drastically negative impact.

For example, abuse of opioids leads to slowed breathing and heart rates. Abuse of two opioids or opioids with other depressants could slow breathing and heart rates to dangerously low levels.

Increased long-term health issues — All substance abuse comes with risks to both physical and mental health, so polysubstance abuse greatly increases this risk. Treatment is often more complicated for individuals who are addicted to or dependent on multiple substances.

Risk of developing addiction — While polysubstance abuse will not lead to addiction for every person, it greatly increases the risk of addiction.

When a person is addicted to a substance, quitting use of it without help is difficult. This is doubly true for addiction to more than one substance.

Risk of developing physical dependence — Certain highly addictive drugs can cause individuals to become physically dependent on use of them. These include opioids, heroin, alcohol, and benzodiazepines.

Physical dependence results in harrowing withdrawal symptoms, which are often a large reason for continued abuse of these substances.

How Polysubstance Abuse Leads To Addiction

Addiction is a disease which produces changes in brain chemistry and causes a person to form a mental reliance on something. Polysubstance abuse greatly lends to the development of substance use disorders, as addiction is now called.

People who abuse multiple substances are likely abusing drugs more often than those who engage in mono-substance abuse, or abuse of only one drug.

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Frequent drug abuse means an individual is exposed to the side effects of a drug often. Perceived positive side effects, such as euphoria, central nervous system depression, and feelings of calm and relaxation can contribute to addiction.

Most substances work by interrupting the natural flow of feel-good chemicals in the brain. With time, the brain comes to rely on the drug to produce these feelings, rather than producing them naturally.

When this happens, a person has become addicted. If a person is abusing multiple substances at once, the addiction only becomes more severe and difficult to manage without proper care.

How Polysubstance Abuse Leads To Physical Dependence

Highly addictive drugs can cause both the brain and the body to rely on drug abuse in order to properly function.

Just as polysubstance abuse can quickly lead to addiction, it can also quickly lead to physical dependence. Physical dependence is just as dangerous, if not more so, than addiction. Individuals who are physically dependent on a drug are already addicted to it.

Physical dependence on multiple substances means an individual will experience withdrawal symptoms when not using those drugs. For some drugs, withdrawal symptoms can be dangerous to life-threatening.

Polysubstance Abuse And Co-Occurring Disorders

Co-occurring disorders is the term for an individual who has both a substance use disorder (addiction or physical dependence) as well as a mental health disorder.

Substance abuse can aggravate or increase the symptoms of a mental health disorder and vice versa. Polysubstance abuse enhances this risk.

For example, an individual may drink to help symptoms of anxiety or depression. However, this may actually worsen those symptoms, creating a dangerous mental low. An individual may then try to take a stimulant to increase his or her mood.

With time, this becomes an endless cycle of substance abuse, increasing the effects of mental health disorders and risk of overdose.

Polysubstance Abuse And Risk Of Overdose

Many drugs of abuse, both legal prescriptions which have been diverted for misuse and illicit use of legal and illegal drugs, can lead to overdose.

Polysubstance abuse lends to overdose risk in that most overdoses are the result of more than one substance.

This is especially true for polysubstance abuse of multiple opioids, like heroin and fentanyl. Fentanyl-laced heroin overdose death rates have been steadily increasing in the U.S. since 2014.

Overdose death rates involving opioids in combination with psychostimulants (such as methamphetamine), cocaine, benzodiazepine medications, or antidepressant medications have all been increasing since 2014 as well.

Polysubstance abuse is not only a dangerous form of drug abuse, but a major health concern on the rise due to its role in the overdose death rate.

List Of Polysubstance Abuse Combinations

Individuals abuse all combinations of two or more drugs. Below is a list of commonly poly-abused drugs in the U.S.

Commonly Poly-Abused Drugs

Who Is At Risk For Polysubstance Abuse And Addiction?

Some people may be at risk by knowingly abusing two substances, such as those who drink alcohol and also abuse drugs.

Others may be unaware of the risk of addiction or dependence if they are taking certain prescription medications while also drinking alcohol or abusing drugs.

A certain amount of cross-tolerance exists for those who abuse drugs which have similar effects. If a person drinks regularly and is also taking an anti-anxiety medication or an opioid for pain, they may develop tolerance unknowingly.

Tolerance may cause a person to increase how much they drink or start taking higher or more frequent doses of their medication. Before long, they may be addicted to or dependent on both substances.

Groups will each be affected differently by polysubstance abuse. Some may be more at risk of polysubstance abuse due to life experiences, while others may be more likely to abuse substances due to genetic characteristics.

Women And Polysubstance Abuse

The chemistry in men’s and women’s bodies causes them to respond to drug abuse differently. Below is a list of substance abuse characteristics common to women which may affect their risk of or participation in polysubstance abuse.

Women often use drugs for less time and in smaller amounts before addiction occurs. This means polysubstance abuse could lead to addiction even more quickly for women.

Women may experience more drug cravings than men (which can lead to substance abuse). For women addicted to more than one substance, cravings and other withdrawal symptoms may be extremely heightened.

Women may be more likely to relapse after treatment, prompting them to engage in substance abuse. People who stop substance abuse, rid their body of the substance, and lower tolerance levels are likely to overdose if they go back to abuse.

Men And Polysubstance Abuse

Gender characteristics can also play a role in the risk of or participation in polysubstance abuse in men.

Men are more likely than women, overall, to abuse illicit drugs. This could result in more exposure to a range of illicit drugs and possibly polysubstance abuse.

For most age groups, men have higher rates of addiction and physical dependence than women. This is why many men who enter alcohol and drug rehab facilities are seeking treatment for abuse of more than one drug.

Men have higher rates of alcohol use for most age groups. Because drinking is often not perceived as substance abuse, men may abuse drugs in combination with drinking without considering the risks.

Teens And Polysubstance Abuse

Teens may currently be less at risk of polysubstance abuse than ever before.

Overall, teen drug abuse, including polysubstance abuse, has been decreasing in the past few years. For example, teen alcohol-drinking rates have lowered considerably, yet vaping rates have increased.

Many teens do not perceive smoking cigarettes or use of marijuana to be substance abuse and may abuse these substances alongside vaping.

Efforts to decrease rates of illicit drug use and drinking in teens seems to be working and lends to decreased rates of polysubstance abuse in teens.

Now, prevention efforts should be aimed at targeting abuse of substances which are perceived as harmless and educating teens on risks and side effects, such as polysubstance abuse of e-cigarettes and marijuana.

Polysubstance Abuse In The LGBTQ Community

Social stigma, sex or gender discrimination, and other factors put individuals who identify as LGBTQ at increased risk for a range of behavioral health issues. These include substance abuse, mental health disorders like anxiety and depression, and co-occurring disorders.

In fact, individuals who are considered a sexual minority are more than twice as likely to have abused a drug in the past year than those not in a sexual minority.

LGBGTQ individuals also have a higher likelihood of having comorbid disorders, such as multiple substance use disorders, or a substance use disorder and a mental health disorder.

With such high risks of developing addiction or dependence, polysubstance abuse in LGBTQ individuals is highly likely to occur.

Treating Polysubstance Abuse And Addiction

Treating substance abuse requires a comprehensive rehab program which covers all aspects of addiction, physical dependence, any co-occurring disorders, and any other health concerns at the same time.

For polysubstance abuse and addiction, treatment must carefully work to address side effects, withdrawal symptoms, cravings, and triggers of all and any substance use disorders.

Failure to treat one disorder could have a negative impact on treatment outcome. When all substance abuse issues are properly addressed, individuals can:

  • stop substance abuse
  • learn to manage cravings
  • modify behavior for lasting life changes
  • change lifestyle to remain substance-free

Detox Programs For Polysubstance Abuse And Addiction

For those who have become physically dependent, detox is the first step in a polysubstance abuse rehab program.

Medically supervised detox programs can aid individuals in safely ridding their bodies of substances with little discomfort or pain.

Once detox is complete, individuals can focus more clearly and are ready for treatment. Medications such as buprenorphine (Suboxone, Zubsolv), naltrexone (Vivitrol), and methadone (Methadose) are available to aid with difficult withdrawal symptoms.

Residential Rehab Programs For Polysubstance Abuse

While many types of rehab programs exist for substance abuse, the most effective type of treatment for polysubstance abuse is likely residential treatment.

Within an inpatient rehab program, individuals remain on-site at a rehab facility for the duration of treatment.

They will be given their own space or room and attend courses, therapy, and counseling during the day. Individuals have access to 24-hour medical care and staff support.

Residential addiction treatment programs are effective for polysubstance abuse because they immerse individuals in the treatment environment, allowing them to focus solely on healing.

Inpatient treatment allows addicted individuals to heal free from substance use, triggers, and surrounded by a supportive group of peers and staff. After leaving these programs, individuals are typically equipped with all the skills and tools necessary to enter recovery.

To learn more about polysubstance abuse and addiction treatment programs, contact one of our addiction treatment specialists today.

National Institute on Drug Abuse - Comorbidity

National Institute on Drug Abuse - Overdose Death Rates

National Institute on Drug Abuse - Sex and Gender Differences in Substance Use

National Institute on Drug Abuse - Substance Use and SUDs in LGBT Populations

National Institute on Drug Abuse - Substance Use In Women

National Institute on Drug Abuse - Understanding Drug Use and Addiction

National Institute on Drug Abuse for Teens - Teens’ Drug Use is Lower Than Ever (Mostly)

U.S. National Library of Medicine: National Institutes of Health - Mono- versus polydrug abuse patterns among publicly funded clients

U.S. National Library of Medicine: National Institutes of Health - Prevalence and Patterns of Polysubstance Use in a Nationally Representative Sample of 10th Graders in the United States

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