Polysubstance abuse, or polydrug abuse, is the abuse of two or more drugs. This can include illicit drugs, prescription and over the counter medications, alcohol, and inhalants. Taking multiple drugs at different times of the day, week, month, or year, can still have negative impacts, even if the drugs aren’t taken at exactly the same time.
Even though they are stimulants, caffeine and tobacco usually aren’t included in the definition of polysubstance use.|
Polysubstance abuse can be an intentional mixing of illicit or prescription drugs. This is often viewed as an innocent thing, like someone taking medication with some alcohol to make it stronger or “work better”. While not classified as polysubstance abuse, street drugs are often mixed, or “cut”, with some other drug to enhance the effect.
The reasons someone might use more than one type of drug include:
Polysubstance use can also happen accidentally. One of the most common examples is drinking alcohol while taking your prescription that shouldn’t be mixed with alcohol. Another example of accidental mixing is taking multiple prescriptions from different doctors without letting the doctors know about the past prescription. This can have a fatal effect. Avoid this by going over all the precautions of a new medication and be 100% honest with your doctor about all the medication you are taking.
Mixing drugs can be extremely hazardous to your health and can even be deadly. It’s incredibly important to take this seriously. The risks and what exactly will happen largely depend on the types of drugs mixed and your body. Here are some of the common dangers of polysubstance abuse.
Mixing drugs can cause increased side effects. Sometimes, the strength of the side effects will be equal to the side effects of the individual drugs added together. These are called additive effects. Often, mixing drugs can lead to side effects that are stronger than the individual drug side effects added together, known as synergistic effects.
Polysubstance abuse can damage your health more than individual drug use. The interaction between the drugs can reduce your metabolism, which increases the concentration of the drug in your system. This increases the toxicity and can make those toxic effects last longer.
When mixing drugs, the risk of overdosing increases significantly. This can be from similar types of drugs increasing the effects, like alcohol and cannabis. Or, taking different types of drugs can mask the effects, making you unable to discern how impaired you are. This could lead to consuming much higher amounts of drugs than usual.
Many drugs impair your decision making and lead to riskier decisions – such as taking more of another drug than you normally would because you are drinking alcohol.
Treating a polysubstance overdose is more complicated. To treat an overdose, you need to have an idea for what is causing the overdose. Otherwise, you could be not treating the correct problem. Some substances can even interfere with the overdose treatment for other drugs. Benzodiazepines, stimulants, or alcohol all reduce the effectiveness of naloxone to treat an opioid overdose.
Treating polysubstance abuse at a treatment center is also complicated. Much like treating an eating disorder and a drug addiction, treatment for all the substances used must happen at the same time.
Substance abuse and mental health issues can make the other condition worse. Polysubstance abuse can increase these effects.
Alcohol with illicit or prescription drugs is one of the most common combinations. Alcohol is combined with other substances to increase the strength of the high or to help counteract the effect of the other drug. Alcohol is a depressive substance, so when mixed with uppers, the person can continue to take both.
A study done by the University of Michigan found that those who have alcohol use disorders are 18 times more likely to abuse prescription drugs. The study found that those under 25 years old are especially likely to abuse alcohol and prescription drugs at the same time.
Mixing prescription and street drugs can be especially concerning because many don’t view prescriptions as dangerous when compared to street drugs. Since a doctor often prescribes them, people view them as safer. This is not true – they can be just as dangerous as illicit drugs.
However, due to this view many have, they might not be as cautious when mixing prescription drugs with any other substance. Over-the-counter medication, such as cough syrup, is often abuse and mixed with other substances.
Both these substances are central nervous system depressants and combining them can quickly lead to a fatal overdose due to depressed breathing. In fact, in a report released by the Substance Abuse and Mental Health Services Administration in 2014, mixing benzodiazepines with alcohol or opioids resulted in more deaths and hospitalizations from overdose versus overdosing on only one substance. The risk of death or hospitalization jumps 24 to 55 percent.
These substances are often combined to counteract the side effects of the other. Cocaine is used when alcohol or opioids are making a person tired and alcohol or opioids are used when coming down from cocaine is making the person too jumpy. Using alcohol together with cocaine can create new compounds in the body, namely Cocaethylene.
Cocaethylene is much stronger and longer lasting than either alcohol or cocaine alone. However, it is also very toxic to the heart, liver, and other major organs, and that toxicity lasts longer. Cocaethylene increases the risk of immediate death 18 to 25-times higher than cocaine alone.
It is not advised to attempt to detox from multiple substances on your own. Polysubstance detox is much more complex. It comes with a higher risk of complications or even death when compared with detox from a single substance.
Detoxing in a facility will allow you to be monitored 24 hours a day and quickly receive medical help for any problems that come up during detox. Additionally, the doctors in a treatment facility can help determine which medications will help you through your detox.
Detox should be followed with a full treatment program to be effective in the long run. Treatment for polysubstance abuse will look like treatment for single substance abuse – just more complicated.
A treatment program will often use a Cognitive Behavioral Therapy (CBT) program. CBT helps you address thoughts and patterns that encourage the drug use. Often you will have to work through therapy for each of the substances, as it’s common to have different habits or reasons that bring you back to using that drug.