What Is Polysubstance Dependence? What Are the Symptoms

If you or a loved one are suffering from multiple substance use disorder, you may have polysubstance dependence. Read on to learn more.

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What is Polysubstance Dependence?

Polysubstance dependence is a type of substance use disorder in which an individual abuses three or more different classes of substances with no particular drug of choice within a one-year period.1

Polysubstance dependence is included as a substance disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-4). The DSM-4 is a manual used by mental health professionals that contains all the substance abuse disorder criteria for diagnosis.

polysubstance dependence

What Is the Difference Between Polysubstance Dependence and Abuse?

Polysubstance dependence often refers to when someone takes multiple different types of drugs and have then developed a physical dependence to the substances, meaning their body thinks it needs the drugs to function normally. This dependence often differs depending on the user and what types of substances they take.

Polysubstance abuse, however, develops as a result of polydrug addiction. Polysubstance abuse describes a situation where the motivation of the user has shifted to a constant need for the drug in order to function, and it comes with many behavioral changes in the user.

What are the signs of Polysubstance Dependence?

Polysubstance abuse symptoms and side effects are generally worse than those for a single substance use disorder. When your body develops dependency from polysubstance misuse, you may show the following polysubstance dependence symptoms:


Developing a tolerance refers to a situation where the user needs a higher dose of the substance to achieve the desired high because the previous dose became less effective.


Withdrawal is what happens when your body stops receiving the drug after it has become accustomed to getting it for so long. These symptoms can start happening soon after your last dosage, and often means that your body will undergo other symptoms until it gets the drug again.

Inability to Stop Using/Loss of Control

This is when the user shows addictive behaviors and almost all attempts to stop using or cut down use of the drugs are unsuccessful. This loss of control or inability to stop using is classified as a behavioral symptom.


This sign is when the user invests a lot of time learning about drugs, getting drugs, using drugs, and recovering from the drugs’ effects.

Interference with Activities

As a result of drug use, the user now spends less time engaging in social, recreational, or professional activities, even though they know their drug usage is causing harm to other areas of their life.

Harm to Self

This is when, despite having a clearly visible physical or psychological issue that was either caused or exacerbated by drug use, the person continues to use the substances.

According to the DSM-4, in order to achieve the diagnostic standards for drug dependence, three or more polysubstance dependence symptoms must manifest at any point over the course of a year and significantly impair or distress the patient.

Most Commonly Poly-Abused Drugs

A person who suffers from polydrug addiction can be said to be addicted to intoxication itself, meaning that the act of getting intoxicated and feeling its effects is a motivation for the person.

Polysubstance use disorder causes combined drug intoxication as a result of polydrug toxicity. The effects may vary depending on the drugs used, and can be very dangerous depending on the person and what drugs are mixed. The drugs abused could be a combination of various different substances, including:

  • Alcohol
  • Marijuana
  • Cocaine
  • Methamphetamines
  • Heroin
  • Benzodiazepines such as Xanax, Ativan, Klonopin

Causes of Polysubstance Dependence

Although very little is documented about the causes of polysubstance disorder, research on the
prevalence and patterns of substances discuss factors that increase the risk of polysubstance disorder. They include:2

  • Age (younger people often have a higher risk)
  • Lower levels of education
  • Unemployment
  • Being White
  • Living with a disability
  • Anxiety
  • Depression and other mood disorders
  • Severe tobacco or alcohol use

Why is Polysubstance Dependence Dangerous?

Polysubstance abuse can be very dangerous, as mixing drugs, even by accident, can have a fatal effect on users. Polydrug abuse implies more intense side effects due to the combination of different harmful substances.

Combining medications can have an additive effect, meaning that the results of the chemicals are multiplied (polysubstance intoxication). It can also be synergistic, which describes what happens when one substance increases the potency of another. This eventually leads to polysubstance dependency.3 Polysubstance use disorder may also cause cognitive health problems and acute polydrug intoxication, which can cause death. There also has been a reported increase in deaths and complications from polysubstance usage.4

Polysubstance Abuse Risks

Polydrug addiction and dependence also pose damage to vital organs such as the heart, liver, kidneys, and lungs. The combined effects of polysubstance chemical dependency also enhance the likelihood of the following:

  • Risk of overdose
  • Mental health issues
  • Health complications
  • Medical emergencies
  • Relationship problems

Treatment for Polysubstance Dependence

polysubstance dependence

Multiple substance use disorders are generally more difficult to treat due to the diverse range of physical and mental effects of each substance.5

Therefore, extensive treatment, including inpatient detox, may be needed for anyone suffering from polysubstance use disorder. Behavioral therapy is also an important part of polysubstance abuse treatment. With the increasing rate of polysubstance overdose deaths, it is necessary to get treatment for polysubstance abuse disorder as soon as possible. Treatment may include the following:

Individual Psychotherapy

Individual therapy, which usually involves the use of cognitive behavioral therapy as well as other therapies, is essential in treating polysubstance dependence, as it helps patients understand the emotional and behavioral link to addiction. It also teaches how to effectively manage risks that may encourage the addiction.


Medications are necessary mostly for polysubstance misuse that involves alcohol and opioids. The medications help to reduce withdrawal symptoms and cravings for the substances. Using medications in the treatment of polysubstance dependence also helps to reduce the chances of relapse.

Group Sessions

Those in treatment or recovery may find solace in group sessions because they provide a more social side to addiction treatment, allowing them to witness the recovery process of others and feel less alone in their quest for sobriety.

Family-Focused Therapy

Family therapy entails any therapy approach that involves assessment and engagement of the family as a whole. There is evidence to support the idea that those who have family support are more likely to continue their treatment, stop abusing drugs, and maintain their sobriety.6

12-Step Programs

A 12-step program is a method of rehabilitation that can assist you in overcoming addiction, preventing relapse, and leading a healthy life.

As a person progresses through the healing process, they may use the 12-step approach as a healthy coping technique.


Holistic therapy is a treatment approach that takes into account the patient’s overall well-being including the mind, body, and spirit.

Nutrition, exercise, and meditation are used at treatment facilities that provide holistic therapy to assist patients in overcoming their addiction.

Overcome Polysubstance Dependence at Soledad House

Polysubstance misuse, even when unintentional, poses life-threatening risks. While treatment for polysubstance abuse disorder may be complicated, it is treatable. At Soledad House, we are committed to giving you the best care and treatment to ensure you lead a healthy life.

Our team is trained in the treatment of multiple substance use disorders and is obliged to help you live a better life. Contact us today.