Polysubstance Abuse

Polysubstance Abuse

What is Polysubstance Abuse?

Polysubstance abuse is defined as consuming multiple addictive substances at once, usually in an attempt to amplify or prolong their pleasurable side effects. In most cases, those who participate in this behavior will have a specific preferred substance.

With this primary form of substance abuse, the individual will then combine one or more other drugs to enhance the high produced by their preferred toxin. For example, someone abusing cocaine may choose to mix other stimulants with this drug to boost or lengthen their high.

However, while taking more than one drug can enhance their desired effects, this will also significantly increase an individual’s likelihood of experiencing negative consequences, including the development of a polysubstance dependence.

Most of these adverse side effects will be unpredictable, and can in turn cause further health complications in themselves. This is why many people who participate in polysubstance use will need to seek out professional addiction treatment services in order to overcome these habits.

Why Do People Abuse Multiple Substances?

Why Do People Abuse Multiple Substances

When it comes to polysubstance use, there are many reasons as to why a person may engage in this behavior. In many cases, someone may begin taking multiple substances at once due to a genetic influence.

For those with a family history of excessive alcohol or drug use, their risk of becoming problematic substance users themselves is greatly increased. This, of course, includes their likelihood of abusing more than one substance at one time.

A person’s social or home environment may also play a significant role in their likelihood of combining drugs. Young adults, for example, may be highly likely to partake in polysubstance use as a result of negative peer pressure or unstable living conditions.

Because they are so young when their substance use begins, this can have a lasting impact on their still-developing brains, making them more likely to continue these habits into adulthood. This may also make them more prone to abusing other substances in the future.

One of the most common reasons as to why someone will begin abusing multiple substances, however, is to self-medicate the negative thoughts and feelings caused by underlying mental health issues.

Many individuals struggling with alcohol and drug addiction also have co-occurring mental disorders, or dual diagnosis. In these cases, they will need highly specialized treatment in order to overcome both their simultaneous substance use disorders and underlying mental causes.

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Common Forms of Multi-Substance Abuse

Polysubstance abuse infographic by Nicole R.

If someone is simultaneously abusing two or more substances at once, this is defined as polysubstance abuse. This form of drug use can involve any type of addictive substance, although the most common of these include:

  • Stimulants
  • Alcohol
  • Benzodiazepines
  • Prescription Medications


Regardless of the type of drugs being abused, any form of polysubstance abuse will pose the risk of experiencing highly dangerous side effects. For those struggling with this form of addiction, highly specialized treatment will often be required in order to overcome these habits.

Cocaine and Alcohol

One particularly popular form of combined substance use is cocaine and alcohol. These can both increase a person’s social levels, as well as produce temporary euphoric effects. This is what makes them such a desirable combination for many people.

However, mixing these substances together can also have several negative side effects, such as decreased judgment-making abilities and reduced cognitive function. This may also lead to various memory issues, such as blackouts and other forms of memory loss.

Furthermore, when drinking alcohol simultaneously, the amount of cocaine in a person’s system can increase by as much as 30%. This will make both the user’s heart rate and blood pressure increase, which can cause cardiovascular problems as a result of their polysubstance use.

Because of how dangerous this combination can be, those struggling with this form of polysubstance abuse are highly recommended to seek out professional addiction treatment services as soon as possible; before these habits have the chance to get any worse.

Opioids and Benzodiazepines

Another common form of polysubstance use includes the simultaneous consumption of opioids and benzodiazepines, which are both drugs that can act as central nervous system depressants.

This combination can produce extremely euphoric and sedative effects. However, this simultaneous drug use can also cause respiratory depression, as well as several other negative side effects, including:

  • Decreased mobility
  • Cognitive impairments
  • Permanent brain damage
  • Coma
  • Death


Polysubstance use involving the combination of opioids and benzos has greatly contributed to the increasing amount of drug overdose deaths that occur within the United States on an annual basis.

In fact, according to the Centers for Disease Control and Prevention (CDC), opioid overdose cases increased by 6% between the years 2018-2019 alone. This includes both those caused by synthetic and prescribed opioid use, as well as polysubstance use.

Alcohol and Prescription Drugs

Drug and Alcohol Detox

Combining alcohol and prescription medication is never recommended, as it can be an extremely dangerous form of polysubstance use. All too often, combined alcohol use that involves prescription drugs has various adverse health outcomes, such as:

  • Blackouts and memory loss
  • Cognitive dysfunction
  • Respiratory complications
  • Alcohol poisoning
  • Coma


Many individuals will mix alcohol with prescription medications such as Percocet, OxyContin, Xanax, Valium, and many others in order to reduce anxiety or fall asleep more quickly and easily.

However, this combination can also easily lead to a potentially fatal overdose of either or both of these substances. Without fast and proper medical treatment, mixing alcohol with any drugs, both prescription and illicit, can quickly lead to potentially life-threatening consequences.

Street Drugs and Prescription Medications

Mixing drugs with prescription medication is often misunderstood as being somehow safer than simultaneously using other illicit drugs, as these are administered by medical professionals. This, however, could not be further from the truth.

In addition to an increased risk of forming a polysubstance dependence, there is the issue that many prescription drugs will be chemically similar to the formulas used to produce synthetic drugs, making their abuse just as dangerous both on their own and with other substances.

This form of drug abuse may be particularly common with prescription opiates, certain sleeping medications, and promethazine-codeine cough syrup, but can involve various other prescription drugs, as well.

Regardless of the type, combining prescription drugs with illicit drugs will almost always cause adverse side effects. The most common of these health consequences include respiratory depression, cardiovascular complications, and potentially lethal drug overdose.

Immediate Help For Polysubstance Abuse

Adderall and Weed

For many students, this combination is a familiar one, if not on a personal level, then one they have seen classmates indulge in. For many in college, the temptation to take Adderall outside of a prescription can happen with the rigors of scheduling studies and especially come exam time.

The risks of abusing Adderall or its close cousin, Dexedrine, can mount, especially without a prescription. In fact, students that have taken stimulant medication taken on the street have overdosed recently due to its contamination with methamphetamine.

Aside from concerns about heart rate and heart health when using legitimate, medical cannabis and prescribed Adderall, the overarching risk of using illegally obtained Adderall is overdose and death. The illicit drug supply, even for study aids, is increasingly contaminated with meth and fentanyl.

Fentanyl and Meth

For those who intentionally put them in their bodies, a polysubstance addiction of fentanyl and meth is becoming more and more common. Because of the high degree of potency of fentanyl, many users seek to counterbalance it with meth, which is also increasingly a more potent form of the drug known as P2P meth.

In the case of fentanyl and meth use alongside one another, the risk of overdose soars. Because fentanyl can vary in potency greatly, even within the same batch of pills or powder, the potential for fatal overdose is very high. Add in the more potent blend of P2P meth that is also driving record deaths in the US, and you have one of the most deadly chemical combinations known to man.

The Dangers of Polysubstance Abuse

As discussed, polysubstance use can have severe consequences, which may be both short-term and long-term in nature.

While these can significantly vary depending on the specific substances being used, there are several general consequences that may occur from any form of combined drug use.

Possible Increased Severity of Side Effects

Any form of substance abuse will come with the risk of causing adverse health effects. Thus, polysubstance abuse will only cause this risk to become significantly increased, including the potential for these side effects to be far more severe.

While the specific consequences from polysubstance abuse can be unpredictable, varying widely based on the specific drugs being consumed, some general side effects that commonly occur from this behavior may include:

  • Nausea and vomiting
  • Decreased mobility
  • Impaired balance
  • Irregular heart rate
  • Body aches and pain
  • Irregular blood pressure
  • Respiratory issues

Acute Health Problems

Along with the various general side effects that may occur from polysubstance abuse, there are also several long-term health conditions that may result from this form of drug use. These include various different chronic diseases and disorders, such as:

  • Hepatitis C
  • Cardiovascular Disease
  • Cancer
  • Lung Disease
  • Mental Disorders


This may be more common with specific methods of administration; for example, someone who chooses to inject drugs may be more likely to develop certain blood-borne conditions as a result of their substance use.

Greater Risk of Overdose

Any form of substance use will bring with it a risk of overdose; however, this will be significantly increased when engaging in polysubstance abuse. This is because many drug interactions can be unpredictable, often having extremely dangerous side effects on the user, such as overdose.

In many cases, an individual will unknowingly ingest too high a dose of one or both of their combined substances. This is particularly common when mixing substances that may counteract the other’s effects.

Complications Due to Co-occurring Mental Health Issues

For those dealing with underlying mental health conditions, abusing multiple drugs at once can significantly worsen the symptoms of these disorders. In some cases, individuals may end up developing mental health disorders as a result of their substance use.

Recognizing a Substance Use Disorder

HPPD - Hallucinogenic Persisting Perception Disorder

It can be hard to accept when you or a loved one may be abusing one substance, let alone multiple drugs. However, this is absolutely crucial in order to be able to overcome these habits. Recognizing polysubstance abuse, especially the exact substances being used, may be difficult.

However, in many cases, this will be a similar process to diagnosing a singular substance use disorder. Signs that may indicate you or someone else is abusing multiple substances at once include:

  • Loss of Control: Consistently using one or more drugs more often or in larger amounts than originally intended.
  • Inability to Quit Substance Use: Having been repeatedly unsuccessful in attempts to reduce or completely stop using one or more substances.
  • Development of Tolerance: Having to use one or more substances more frequently or in higher amounts in order to achieve the desired effect.
  • Experiencing Withdrawal Symptoms: Developing withdrawal symptoms when attempting to reduce or stop the use of one or more substances.
  • Lack of Interest: Reducing or completely stopping participation in previously enjoyable activities, hobbies, or relationships due to substance use.
  • Self-Destructive Tendencies: Continuing to use one or more substances despite this causing or worsening another physical or mental health disorder.

It is important to understand that a polysubstance addiction refers to a dependence on a particular drug, and the enhancement of its effects through the use of another substance.

This is different from being addicted to two different substances at the same time, which may be used apart from each other. Regardless of which of these issues a person is struggling with, treating their specific substance use disorder (or disorders) will require highly specialized care.

What is Polysubstance Abuse Treatment?

There are many forms of addiction treatment available today, including specific methods of treatment for polysubstance abuse. While the level of care a person may need for this issue will depend on the specific substances they are abusing, this treatment process generally includes:


As a recovering individual’s needs change, so too will the services and treatment options that best fit their needs. A good substance abuse treatment program will adjust their recovery plan and approach as they progress through treatment.

Medical Detox and Polydrug Use

The first step in polysubstance addiction treatment will, for most people, be their participation in a medically supervised detox program. Withdrawing from one substance can be difficult enough on its own; having to struggle through this period for multiple drugs will be even more so.

Certain cases of substance withdrawal will be more difficult to endure than others, including alcohol, benzodiazepine, and opioid withdrawal; many of these drugs, of which, are particularly commonly abused both with each other and various other drugs.

When recovering at a medical detox facility, individuals will be gradually weaned off their abused substances under constant medical supervision. This can help to manage and even prevent many difficult withdrawal symptoms, significantly reducing their risk of relapse.

Throughout their treatment process, clinical professionals will monitor their vital signs and provide regular fluids and nutritional supplements to help ensure their health throughout recovery.

This may also include the administration of addiction medicines, which can help reduce withdrawal symptoms and drug cravings, further preventing relapse. These may include anti-nausea medication, antidepressants, and other stabilizing drugs.

Because the withdrawal period can be so unpredictable for many substances, medical detox is highly recommended regardless of the type or severity of addiction a person is dealing with. This is even more true when it comes to polysubstance abuse.

Inpatient Treatment for Multiple Substances

Inpatient Treatment for Multiple Substances

For those struggling with polysubstance abuse, an inpatient treatment program will likely be their best option for overcoming their addictive habits. This will provide them with 24/7 care and access to recovery resources.

These treatment centers allow individuals to recover in a highly structured and supervised environment. In particular, these facilities will help remove any temptations and stressors from the outside world, keeping their clients focused solely on their recovery and abstinence.

Inpatient programs will generally offer a wide range of clinical, therapeutic, and holistic recovery services to those who receive treatment through them, as well as various educational and essential skill-building programs.

This large variety of services can not only keep individuals focused on their recovery process, but ensure a more well-rounded and successful approach to overcoming their addiction and maintaining their sobriety after leaving their treatment facility.

Outpatient Treatment for Polysubstance Users

Outpatient polysubstance abuse recovery programs offer a more flexible approach to addiction treatment, requiring less of a financial and time commitment than inpatient options would. This may be a better option for those with unavoidable family, work, or other external commitments.

While less intensive and structured than higher levels of care, outpatient programs can still provide useful educational, skill-building, and other addiction recovery resources to those struggling with polysubstance abuse.

When receiving treatment through an outpatient program, individuals will most likely participate in sober support groups and group therapy sessions. Some outpatient centers will also offer individual and family counseling services, as well as medication-assisted treatment options.

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The Importance of Dual Diagnosis Treatment for Polysubstance Abuse

When recovering from polysubstance abuse, individuals will need a comprehensive addiction treatment program that addresses all aspects of their addictive habits. This will include mental health services, such as various therapies and holistic treatment options.

One particular therapy used in addiction treatment is Cognitive Behavioral Therapy (CBT). This therapeutic approach focuses on helping individuals to recognize the negative behavioral and thought patterns which may be contributing to their substance abuse.

Once these have been acknowledged, the recovering individual will then work with their treatment provider to re-shape and overcome these patterns, replacing them with healthier belief systems and coping mechanisms.

When dealing with a co-occurring mental health issue, these will be identified early on in a person’s treatment process, usually during their initial intake assessment for their specific treatment center.

This helps ensure that they will be able to receive proper and effective care that is capable of addressing all of the contributing factors to their addiction, allowing them to better achieve and maintain independent sobriety.

Finding Polysubstance Abuse Treatment

If you or a loved one is struggling with polysubstance abuse, know that you are not alone, and help IS available. At Find Addiction Rehabs, we are dedicated to helping people like you find addiction treatment services that will best serve their personal care needs.

Our hotline is available 24/7 to connect you with substance abuse recovery tools and resources, whenever you need them. So don’t wait; call now and let us help you take the first step on your path to overcoming addiction, where you can achieve a happier, healthier, and sober you, today!

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