What is Polysbusance Abuse?

Polysubstance abuse is a risky behavior that can cause serious, potentially life-threatening damage.

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Defining Polysubstance Abuse

Polysubstance abuse refers to the improper use of two or more drugs at the same time, typically for recreational purposes or in an attempt to self-medicate. It can include legal substances such as alcohol, cannabis, and prescription pills, as well as illicit drugs such as heroin, cocaine, and methamphetamine.

This behavior is sometimes also referred to as polysubstance misuse and polydrug abuse.

Why Do People Engage in Polysubstance Abuse?

There’s no way to know the motivations of everyone who engages in polysubstance abuse. But two common reasons are to either intensify or offset the effects of the drugs.

Intensifying effects

When someone becomes addicted to alcohol or another drug, they often develop tolerance. This means that they have to use larger amounts of the drug before they feel its effects.

Some people may respond to tolerance by using multiple drugs that have similar effects in order to achieve the high they’re seeking. For example:

• Alcohol and benzodiazepines are both depressants.
• Both substances can cause effects such as elevated mood, diminished anxiety, and reduced inhibitions.
• If a person has become tolerant to alcohol, they may try to hasten the onset of these effects by taking a benzo while they’re drinking.

Offsetting effects

Coming at polysubstance abuse from the opposite direction, some people may use drug combos as a way of reducing or offsetting certain effects.

One example of this would be to use a cocaine when drinking:

• People often experience an increase in energy and alertness when they first start drinking. However, as noted above, alcohol is a depressant, so these effects will eventually be replaced by drowsiness and diminished cognition. 
• Someone who wants to stay awake longer in order to continue drinking may use cocaine, which is a stimulant. 
• As alcohol’s depressant properties begin to take hold, cocaine can counteract these effects and give the person an artificial boost.

Unintentional polysubstance abuse

In some cases, people may ingest multiple substances without even realizing that they’re doing so. Three potential scenarios involving unintentional polysubstance abuse are:

• A person has been taking a prescription medication, but continues to drink because they don’t realize they should avoid alcohol while taking the drug. 
• Someone purchases what they believe to be oxycodone pills from an illicit dealer. Unbeknownst to them, the person who manufactured the pills added fentanyl to the oxycodone.
• A predator adds Rohypnol, GHB, or another drug to someone’s alcoholic drink as a precursor to assaulting them.

Dangers of Polysubstance Abuse

Regardless of why a person uses more than one drug at the same time, doing so can be quite dangerous.

Using any recreational drug can put a person at risk of several immediate and long-term problems. Combining multiple drugs may only increase this risk, especially if this behavior becomes a habit.

Potential dangers of polysubstance abuse include:

• Injuries due to impaired coordination, perceptions, and judgement
• Being attacked or assaulted due to a diminished ability to fight back or remember what happened
• Being arrested, fined, and/or jailed due to the possession of certain substances or actions taken while impaired
• Becoming addicted to one or more of the drugs
• Onset or worsening of medical or mental health problems

The most severe immediate danger of polysubstance abuse is overdose and death. As noted by the following statistics, the risk appears to be especially high among people who combine opioids with alcohol, stimulants, or benzodiazepines:

• The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has reported that alcohol use may have been a factor in 17.1% of all opioid overdose deaths in the U.S. in 2020.
• According the to the U.S. Centers for Disease Control and Prevention (CDC), fentanyl and other synthetic opioids contributed to 69,893 overdose deaths in the U.S. in 2022. More than half of these deaths (53.6%) involved people who had cocaine or another stimulant in their system when they died.
• A JAMA Open Network study from April 2020 found that 21% of all opioid overdose deaths in the U.S. in 2017 also involved benzodiazepines. Among those who died after overdosing on prescription painkillers, the rate of benzo involvement was 33.1%.

Is Polysubstance Abuse a Type of Addiction?

Polysubstance abuse is not a type of addiction, but using multiple substances at the same time can be a sign that a person has become dependent on a drug.

As established in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the criteria for substance use disorders (addictions) include recurrent use of a drug in situations in which it is physically hazardous.

One example of physically hazardous drug use is driving while under the influence of the substance. Another circumstance that could meet this criteria is combining the drug with other substances.

Combining drugs once or twice may simply be evidence of impulsivity or poor decision-making. But if a person frequently engages in polysubstance abuse, that increases the likelihood that they have become addicted to at least one of the drugs.

If you suspect that someone in your life has developed an addiction to alcohol or any other drug, a good first step is to have them assessed by their doctor or another qualified professional. 

In addition to determining if they have an addiction, completing an evaluation can also help them understand the severity of the problem. Also, the expert who conducts their assessment should be able to recommend appropriate treatment options.

Get Help for Polysubstance Abuse in Jacksonville

If your polysubstance abuse leads to or is caused by an addiction, Design Recovery is here to help.

Our addiction treatment center in Jacksonville, FL, offers personalized outpatient care for adults who have become dependent on alcohol and other drugs. We also serve individuals who have anxiety, depression, and other co-occurring mental health concerns.

Treatment options at Design Recovery include a partial hospitalization program (PHP), an intensive outpatient program (IOP), and a virtual (online) IOP. When you contact our center, we can discuss the features and benefits of each option with you, then help you determine which ones can best prepare you for a healthier future in recovery.

To learn more about how we can help you or a loved one, or to schedule a free assessment, please visit our Admissions page or call us today.