Polysubstance use is the spontaneous or simultaneous use of multiple substances (illicit drugs, legal substances, or prescription medication). These substances are ingested in close succession or over a short period. Polysubstance misuse can be intentional when a combination of drugs is taken to enhance or mitigate the effects of another drug. It could also be unintentional; when drugs that have been cut or mixed with other substances are accidentally consumed.
Polysubstance abuse is marked by an indiscriminate combination of multiple substances without restriction to change how the body or the brain works. For example, polysubstance abuse can include combining alcohol with cigarette usage or heroin with prescription painkillers.
Like any other substance use disorder, polysubstance abuse disorder is a medical condition that arises when compulsive substance use interferes with day-to-day life and bodily functions. Abusing multiple substances is extremely dangerous and can be fatal. Multiple drugs caused about 50% of all drug overdose deaths in 2019.1
Polydrug abuse has been linked to various reasons, including experimentation, peer pressure, socioeconomic conditions, and a desire for an extra “high” for daily activities. In addition, researchers have proposed several theories to explain why drugs are abused.
The learning and personality theories stipulate that drug misuse generally results from conditioning, social learning, and perceived self-worth. These theories argue that people with low self-esteem and poor impulse control are more likely to abuse drugs.
While there are many different reasons why different drugs are combined and misused, the main driver behind polydrug abuse is enhanced desired effects. Since many substances act on the same receptors in the brain and produce similar effects, combining them multiplies these effects and delivers a more intoxicating feel.
For example, mixing drugs such as alcohol with benzodiazepines induce sedation, and stimulants like caffeine and methamphetamine can lift low moods. In addition, since each chemical has a different effect, there is a propensity to combine them and produce multiple effects simultaneously.
Substance use disorders result from changes in the brain due to repeated usage, modifying the brain circuits responsible for pleasure, learning, stress, decision-making, and self-control.
Polysubstance dependence is defined as the body adjusting and becoming dependent on multiple substances to function properly, particularly within a 12-month window. Every substance has a slightly different effect on the brain. Still, all addictive drugs (e.g., alcohol, opioids, cocaine) cause a pleasurable surge of the neurotransmitter dopamine in the basal ganglia.
As misuse of these substances occurs continually, progressive brain structure and function changes, known as neuroadaptations, occur. These neuroadaptations compromise brain function and drive the transition from controlled, occasional substance use to chronic misuse and eventual dependence.
While the difference between polysubstance abuse and polysubstance dependence can sometimes be ambiguous, there are clear-cut distinctions between them. For one, polydrug abuse is using multiple substances in doses and ways that are not intended, so it does not always result in dependence.
In contrast, polysubstance dependence is the continuous use (overuse) of substances to the point where the brain or body cannot function without them. This polysubstance chemical dependency becomes an issue, as brain and bodily functions are inhibited without regular consumption.
There are numerous detectable polysubstance abuse symptoms and signs. Among them are the following:
Polydrug toxicity and mental health have a two-way relationship because the changes in the brain’s frontal cortex due to recurrent substance use cause or trigger symptoms of mental health conditions and alter how some brain circuits function. This process can also disrupt various bodily functions that ultimately result in poor social behaviors and an increased likelihood of engaging in risky behaviors.
In addition to personal adversities, polysubstance abuse disorder may jeopardize many aspects of a person’s life. For example, keeping up with attention-demanding responsibilities like office or schoolwork and maintaining relationships becomes nearly impossible with prolonged substance use.
Polysubstance abuse symptoms usually show up in the form of withdrawal from any social activity that requires relating with other people, including hobbies that were once enjoyed. This is a natural consequence of polydrug addiction. In extreme cases, it eventually creates paranoia and a violent disposition toward others, ultimately destroying friendships.
Certain drug classes, particularly immunomodulatory drugs and benzodiazepines, frequently cause mood swings and irritability. This is due to the ability of drugs to either suppress or overly excited emotions in their extremes, resulting in fits of rage, erratic mood swings, and a constant feeling of irritability.
People who engage in polysubstance use while trying to conceal their drug use exude a sense of secrecy that extends beyond what can be considered private.
Polysubstance abuse frequently results in a state of intoxication that can be easily spotted by people around. Loud speech, crude behavior, slurred speech, and damp or clammy skin are all common polysubstance abuse symptoms that point to intense levels of polydrug toxicity.
Multiple substance use disorders have been known to induce stealing to aid drug-seeking behavior. It is not uncommon to see people with polydrug addiction engage in various levels of theft to afford more drugs, particularly when met with refusal.
Prescription drug abuse is using a prescription medication unusually or illicitly. Polysubstance abuse can influence a tendency to exaggerate symptoms or outright lie about them to have a valid reason to visit pharmacies and doctors regularly to get a refill or try new drugs.
Polysubstance abuse can lead to withdrawal from traditional relationships, which is characterized by cutting contact with loved ones and friends, disappearing for extended periods, and generally exhibiting reclusive behaviors in an attempt to conceal substance use.
Lung or heart disease, seizures, stroke, mental confusion, and brain damage are just a few long-term effects of polydrug addiction on the human body. Multiple substance use disorders can also impair judgment, vision, and coordination, increasing the risk of injury. Studies reveal that 35% to 50% of people in emergency rooms with a traumatic brain injury struggle with alcohol or drug abuse.2
The root etiology of polysubstance abuse disorder is highly speculative. Recurrent substance use and built-up tolerance usually serve as substance abuse disorder criteria, resulting in greater substance use; however, genetics are estimated to be responsible for between 40% and 60% of the risk.3
Additional causes of polysubstance abuse will be detailed below.
Polysubstance abuse disorder is highest among teens and young adults. In addition, the National Institute on Drug Abuse (NIDA) reported a noticeable rise in substance abuse among people in their late teens and early twenties in 2019. This led to the conclusion that people in this age range experience changes in neuronal structure and function in brain regions associated with reward and habit formation much more quickly than adults, which may influence their susceptibility to substance dependence.
Education is a vital factor in health and has always been a significant predictor of socioeconomic status. Although the link between educational attainment and polysubstance disorder has been hotly contested, research has conclusively proven that less education increases the likelihood of substance abuse. This occurs because it indicates a failure to meet social expectations, expressed through substance use as a coping mechanism.
Pain and disability are usually substance abuse disorder criteria. However, according to research, having a disability raises the prevalence of polysubstance disorder as many may turn to substances or alcohol to numb the mental and physical pain.
According to studies, anxiety disorders are associated with acute polydrug intoxication. Given that symptoms of either condition can exacerbate the symptoms of the other. An anxiety condition is more likely to cause substance misuse as individuals can take these substances to self-medicate or reduce anxiety symptoms.
The most prevalent psychiatric comorbidities among individuals with substance abuse are mood disorders, such as depression and bipolar disorder. This is not surprising given that controlled medications are sometimes used to treat these mental disorders. Substance abuse can lead to a dependency cycle that may lead to chronic substance use.
Alcohol and tobacco are the two psychoactive substances most often used globally. Tobacco is sometimes referred to as a gateway drug that can result in using and misusing other substances.
Each drug has short- and long-term side effects, but mixing drugs can eventually result in polydrug toxicity. In addition, long-term drug misuse inevitably wears down the body, posing various health hazards. These risks can be moderate (poor judgment, slurred speech), severe (organ damage, cognitive health problems), or anywhere between. Other factors that make polysubstance abuse dangerous include:
A polysubstance overdose may occur when multiple substances are consumed in higher doses than recommended. Combining alcohol with prescription pharmaceuticals or illicit substances increases the risk for polysubstance intoxication and eventual polysubstance overdose.
Problems with mental health and polysubstance misuse frequently coexist, with one condition triggering the other. According to reports in the Journal of the American Medical Association, nearly 50% of people with mental health conditions develop substance use disorders.6
Polysubstance abuse is frequently linked to several health issues. While some drugs, like inhalants, damage nerve cells in the brain or peripheral nervous system, others raise the possibility of acquiring infections like HIV and hepatitis C, which can be acquired via sharing injectables.7
Polysubstance misuse can result in severe consequences, such as injury, overdose, and mental health issues, causing thousands of hospitalizations all year round.
Relationships are eventually impacted by the emotional distance established when polysubstance use intensifies. For instance, methamphetamine, a common poly abused drug, can lead to aggressive behavior and violent tendencies. The use of drugs can also cause trust issues, bruised feelings, and stress in a relationship.
Polysubstance abuse has repeatedly been linked to worse treatment outcomes, such as lower rates of treatment retention and higher rates of relapse.
Substance abuse is responsible for many issues. Physical issues like brain damage and liver, lung, and heart disease are just a few complications that can arise from recurrent polysubstance intoxication.
While some substances can harm the immune system and increase the risk of infections, others can even result in congenital disabilities. For example, amphetamine users are more likely to experience strokes and paranoia, and hallucinogens can briefly put a person into a psychotic state. The effects of multiple substance use disorders extend to the social system, as long-term use can harm relationships with one’s coworkers, family, and friends.
Risk factors can have a variety of effects on drug abuse because substance abuse is more likely to occur among people predisposed to certain risk factors. For example, genetics, environment, medical history, age, the substance of choice, drug type, and method of use are some risk factors for polysubstance abuse. Additionally, those who have gone through trauma or abuse (physical, emotional, mental, or sexual) are more likely to develop a substance use disorder.
Depending on the patient’s needs, there is no one-size-fits-all approach to treating polysubstance use disorder. Nevertheless, some typical therapies for polysubstance abuse that have productively led patients to recovery include:8
Good substance abuse treatment programs always include psychotherapy. Mental health disorders (such as those that arise from prolonged substance abuse) are treated psychologically rather than medically during psychotherapy. During individual psychotherapy sessions, a trained professional works one-on-one with the patient to tackle substance abuse issues and ultimately inspire change and improve quality of life.
The use of medication is crucial for recovery from polysubstance intoxication. Some medications can be used, especially in the beginning stages of treatment, to lessen cravings, lift moods, and ease withdrawal symptoms in patients with severe physical dependence.
People can achieve successful treatment for polysubstance intoxication with the help of group therapy sessions. Group settings allow participants to learn by watching others, receiving coaching from others, and honing their skills in a welcoming environment. Additionally, the social support in group services encourages a sense of community among participants.
Family therapy is an essential component of substance abuse treatment because sustained recovery occasionally necessitates the participation of all family members. Family therapy offers relatives the chance to learn everything there is to know about the disorder and how they can be of assistance. As a result, it equips families with the necessary tools to build a better functioning home environment capable of navigating recovery for lasting change.
A 12-Step program is a crucial component of treating substance use disorder for most people in recovery. This type of group therapy starts with acknowledging that substance use disorders can have detrimental effects on social, emotional, spiritual, and physical aspects of life. Then the program progresses to acceptance, submission to a higher power, and involvement in regular group meetings.
More cutting-edge holistic treatments are available now because they are seen as an effective alternative to conventional medicine. Therapists can utilize various techniques to treat physical and mental symptoms and emotional and nutritional imbalances. Holistic recovery aims to harmonize the mind, body, and spirit.
Women with substance use disorders are the focus of care and treatment provided by Soledad House. We provide highly effective, personalized polysubstance use disorder treatment programs in a therapeutic environment.
The main objective of treatment at Soledad House is to achieve and maintain abstinence. We emphasize relapse prevention, faith-based rehab programs, and various addiction treatment therapies designed to help you or a loved one regain what you’ve previously lost to substance use.
Please contact us if you have any questions or concerns about polysubstance use. We’d be happy to walk you through our treatment options and help you choose the one that best meets your needs.