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Understanding Polysubstance Use And Addiction

Dr. Gerardo Sison

Medically reviewed by

Dr. Gerardo Sison

April 1, 2019

While individuals typically have their drug of choice, it is common for a person suffering from substance abuse to use more than one type of drug which is often lead by the pursuit of whatever is cheapest and most available. Using multiple drugs, especially at the same time, increases the dangers and risk of a polysubstance overdose.

According to the National Institute on Drug Abuse, about 105 people die every day from drug overdoses in the U.S. In fact, drug overdoses kill more people than guns, falls, and car accidents. But fatal overdoses don’t just affect those who are addicted, and it is important to note that it is more dangerous and life-threatening to mix drugs or take multiple types of substances over time.

What Is Polysubstance Use?

Polysubstance dependence is listed as a substance disorder in the Diagnostic Manual of Mental Disorders (DSM-IV-TR) and describes polysubstance use as a dependence on a group of at least three different types of substances within a 12-month period. The use of multiple drugs indiscriminately is also characterized as polysubstance use.

According to the National Library of Medicine National Institute of Health, polysubstance use is quite common and is found most often in younger age groups and subcultures. It is associated with an increased risk of psychiatric and physical health problems.

The Different Types Of Polysubstance Use

Someone can abuse all different types of drugs; here are some of the most common and most dangerous polydrug use combinations.

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Alcohol and drugs: When taken with other drugs, alcohol can worsen the person’s reaction to the drugs. Alcohol can cause severe liver damage that, over time, can cause the use of other drugs to be fatal because the liver cannot break them down. Alcohol also impairs judgment and can cause a person to lose track of how much of a drug they are using, leading to overdose.

Alcohol and cocaine: This combination creates a new chemical in the body, called cocaethylene. It is formed when cocaine is broken down in a body where there is also alcohol, and when the body would normally eliminate the byproducts of the cocaine. The chemical cocaethylene can cause liver damage, seizures, immune system damage, and an immediate risk of death that is 20 times higher than cocaine use by itself.

Alcohol and ecstasy: Individually, these substances cause dehydration, which can increase a person’s risk of heatstroke. The combination can also damage the liver and kidneys, and can impair a person’s judgment.

Alcohol and other stimulants: The combination of alcohol and stimulants like Ritalin, Adderall, and methamphetamines and amphetamines can conceal the sedating effects of alcohol, allowing a person to drink more without realizing their intoxication. Overheating is also a risk, and the combination of alcohol and stimulants can cause a person to become aggressive and irritable.

Alcohol and benzodiazepines: This combination sky rockets the sedative effects of the substances and causes confusion, irritability, impaired memory, dizziness, aggression, loss of consciousness, coma, and death.

Opiates and cocaine: Some people take this combination to benefit from the stimulant effect of the cocaine to avoid falling asleep from taking opiates. This combination puts more stress on the cardiovascular system than cocaine alone. And because the cocaine helps alleviate the sleepy effects of the opiates, the person may be confused and take more opiates thinking they didn’t take enough.

Cocaine and ecstasy: Both of these drugs are potent stimulants and can impair the body’s ability to defend against stress and overheating. This combination can harm the cardiovascular system and lead to stroke. The severe overheating can also cause organ shutdown.

Opioids, benzodiazepines, and alcohol: All three substances slow down the nervous system and suppress breathing. The combination of these drugs can cause the user to stop breathing while asleep.

What Are The Health Effects Of Polysubstance Use?

Specific substances cause many dangerous health risks on their own, such as alcohol, nicotine, marijuana, opioids, cocaine, amphetamines, and heroin. But, according to the National Institute on Drug Abuse, the combination of drugs is often the most dangerous practice. When a person takes two or more types of drugs that suppress breathing, they can suffocate due to the stronger effect. The use of multiple stimulants can fatally damage the cardiovascular system.

Additional side effects of combining drugs include brain damage, seizures, heat stroke, coma, stomach bleeding, suppressed breathing, heart problems, liver damage and failure, and respiratory failure.

The Signs And Symptoms Of Polysubstance Use

The symptoms of polysubstance use are virtually the same as singular substance use disorders and include tolerance, withdrawal, loss of control over use, and continued use despite any negative consequences. But someone with a polysubstance use disorder may experience these symptoms at an elevated scale due to the combined effects of the drugs.

Who Is Most Affected By Polysubstance Use?

Young adults between the ages of 18 and 24 are the most at risk for developing a substance use disorder, including polydrug abuse. According to the National Library of Medicine and National Institute of Health, polysubstance use is common in subcultures like “ravers” (dance club goers) and those who already suffer from substance abuse.

What Is The Difference Between Polysubstance Use And Addiction?

According to the National Institute on Drug Abuse, someone with a substance use disorder may use drugs repeatedly to produce pleasure, alleviate stress, or avoid difficulties in life. Addiction occurs when a person cannot control the impulse to use drugs despite any negative consequences.

Nearly all addictive drugs flood the reward system with dopamine, the feel-good neurotransmitter. For the body to control the surge of dopamine, the brain will either decrease its production or reduce the number of receptors that receive the signal, leading to a crash in dopamine and feelings of depression. This creates a vicious cycle that will lead the person to seek drugs again to refuel their dopamine levels.

Polysubstance use multiplies the rewarding effects of drugs, increasing the chances of addiction. The serious health concerns associated with combining drugs accounts for the majority of drug-related visits to the ER/ED every year, according to the Drug Abuse Warning Network report titled Outcomes of Drug-Related Emergency Department (ED) Visits Associated with Polydrug Use.

Polysubstance Use Is Dangerous. Prevent Addiction With Our Help.

If you are concerned about your polydrug use, or you suspect a loved one is taking multiple substances, treatment is key to preventing addiction and other serious health issues. If you would like more information on polysubstance use and preventing addiction, contact us at We can help you achieve the drug-free lifestyle you desire and prevent addiction for a healthy and fulfilling life.

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