What is Polysubstance Use?
Polysubstance use refers to the consumption of a variety of substances—ranging from illegal drugs and legally available substances to prescription medications—either all at once or over a brief period. Individuals may engage in this behavior intentionally, combining substances to amplify or negate the effects of each, or unintentionally, such as when taking drugs that have been inadvertently laced with other agents.
The essence of polysubstance abuse lies in the indiscriminate combination of various substances to influence physiological or psychological states. This might involve mixing alcohol with nicotine, or combining street drugs like heroin with prescription pain relievers.
The goal behind abusing multiple substances typically revolves around achieving certain desired feelings—be it euphoria, an altered state of consciousness, or profound relaxation. Polysubstance abuse amplifies these sensations, either by using one substance to moderate the effects of another or by enhancing the overall impact through combined usage.
Polysubstance abuse carries significant risks, driven by the quest for stronger sensations or the unique experiences derived from mixing different substances. Individuals engaging in this form of abuse are also prone to other hazardous behaviors.
Frequently combined substances include depressants (e.g., alcohol and benzodiazepines), stimulants (such as ecstasy and cocaine), or a mix of stimulants and depressants (for instance, cocaine with alcohol). Those who abuse multiple substances simultaneously may become dependent or addicted to one or several of the drugs involved.
Causes Contributing to Polysubstance Abuse
Substance abuse represents a complex public health challenge, further complicated by the prevalence of polysubstance use, where individuals consume multiple drugs concurrently.
Investigations into substance use patterns have identified various factors that increase the risk of falling into polysubstance abuse. Key risk factors include:
- Age: Younger people tend to be more susceptible.
- Educational level: Those with lower educational achievements are at greater risk.
- Employment status: Being unemployed is associated with higher risk.
- Ethnic background: White individuals have been observed to have a higher prevalence of polysubstance use.
- Disabilities: Both physical and mental disabilities can elevate the risk.
- Mental health: Conditions such as anxiety, depression, and other mood disorders are significant factors.
- Substance use: The heavy consumption of tobacco or alcohol can lead to polysubstance abuse.
Additionally, genetics, a family history of substance misuse, stress, trauma, and the accessibility of drugs significantly influence the likelihood of engaging in polysubstance use.
Dangers of Polysubstance Abuse
The risks tied to polysubstance abuse are manifold and vary depending on the combination of substances involved. However, some general dangers are universally recognized:
- Intensified Adverse Effects: Different substances come with their own risks and side effects. When combined, these can enhance and complicate the adverse effects, leading to more severe and sometimes unique symptoms such as increased nausea, vomiting, bodily discomfort, issues with balance, and significant changes in heart rate, respiration, and blood pressure.
- Elevated Health Dangers: Mixing substances can impede the body’s ability to metabolize these drugs effectively, resulting in heightened concentrations in the bloodstream and greater toxicity. This mix can also give rise to new, potentially dangerous metabolites. Consequently, individuals engaging in polysubstance abuse are at an increased risk for a variety of health issues. For example, chronic illnesses such as hepatitis C are notably more common in those who combine heavy alcohol use with drug injection. Similarly, those who smoke tobacco while using cocaine face a higher risk of experiencing heart attacks, as reported by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).
- Exacerbated Mental Health Issues: People facing concurrent disorders, where a substance use disorder exists alongside another mental health issue, are particularly vulnerable to the pitfalls of polysubstance abuse. The abuse of multiple drugs can worsen existing mental health conditions, while these mental health issues can, in turn, amplify the propensity for substance abuse. The dynamic interplay of these factors often complicates both the treatment process and the journey to recovery, presenting a significant challenge that needs comprehensive care and intervention.
Common Substances in Polysubstance Abuse
Polysubstance abuse often involves a combination of specific drugs, some of the most frequently abused include:
- Alcohol
- Marijuana
- Cocaine
- Methamphetamines
- Heroin
- Synthetic substances like Spice/K2, bath salts, and gravel
- Prescription Opioids such as OxyContin, Oxycodone, and Vicodin
- Benzodiazepines, including Xanax, Ativan, and Klonopin
- Party drugs like MDMA (Molly, Ecstasy)
- Recreational inhalants, often referred to as “poppers” (amyl nitrate)
- Psychedelics such as LSD and psilocybin mushrooms
Engaging in the use of three or more of these substances, with the exception of nicotine and caffeine, is considered polysubstance abuse.
Teenagers and young adults are especially prone to polydrug use, often due to difficulties in securing a steady supply of drugs and a propensity for exploration to achieve different euphoric states. The challenges and stresses associated with adolescence further contribute to drug use as a form of escapism among this age group.
Interactions and Risks of Mixing Specific Drugs
Polysubstance use disorders often involve combining drugs, which can result in distinctive sets of symptoms.
Cocaine and Alcohol
A common mix, alcohol can boost the body’s cocaine levels by up to 30%, creating cocaethylene. This substance has a longer lifespan in the bloodstream and can increase heart rate and blood pressure, potentially leading to cardiovascular complications. Cocaine may also diminish the felt effects of alcohol, prompting greater consumption of alcohol.
Opioids and Cocaine
The effects of opioids (depressants) contrast sharply with those of cocaine (a stimulant) on the central nervous system. Users may combine them to mitigate the negative side effects of one or both drugs, such as using opioids to calm down from the stimulation of cocaine. However, the ability of each drug to obscure the other’s effects raises the danger of overdose and additional risks.
Opioids and Benzodiazepines
As both substances depress the central nervous system, their combination can critically lower respiratory function, leading to potentially lethal overdoses. The mix can also result in oxygen deprivation to the brain, causing lasting damage or death. The slower metabolism of benzodiazepines in older adults further increases the risk of respiratory issues.
According to a 2014 report by SAMHSA, close to one million emergency department visits between 2005 and 2011 involved benzodiazepines, either alone or combined with alcohol or opioids, showing a 24-55% rise in the likelihood of severe outcomes from such mixes. Deaths related to benzodiazepine often happen when they are used with other drugs.
Prescription and Illicit Drugs
The misuse of prescription drugs, often wrongly considered safer than street drugs, poses grave dangers. These medications, closely related to illicit drugs in makeup, can result in serious health issues or death when abused, especially if combined with alcohol, other prescription drugs, or illegal substances.
Over-the-counter medications, such as cough syrups containing dextromethorphan (DXM), can induce hallucinations at high doses, and promethazine-codeine cough syrup is known for its sedative properties. As per NIDA, these drugs are frequently misused with alcohol or marijuana, highlighting the perils of polysubstance abuse involving prescription drugs.
Signs and Symptoms of Polysubstance Abuse
The signs of polysubstance abuse can vary, reflecting the specific substances involved and often indicating an increasing pattern of drug consumption. Advanced research, including studies using artificial intelligence and machine learning, has traced typical trajectories of drug escalation, such as:
- Moving from using alcohol, cannabis, and/or opioids to cocaine.
- Shifting from benzodiazepine and cocaine use to cannabis.
- Evolving from alcohol, cocaine, and cannabis use to opioids.
Cocaine typically elevates mood and energy, while benzodiazepines like Valium (diazepam) or Xanax (alprazolam) serve as sedatives, commonly prescribed to aid sleep. The combination of various substances results in a diverse array of polysubstance abuse symptoms.
Physical Signs
Individuals involved in polysubstance abuse might show:
- An escalation in drug tolerance, needing larger quantities to achieve the desired effect.
- Withdrawal symptoms when stopping use, such as insomnia and gastrointestinal issues.
- Physical harm due to accidents or falls while intoxicated.
- Overdose risks, potentially leading to critical conditions like opioid-induced respiratory depression.
- Chronic health problems, including liver damage from alcohol, seizures, or addiction to pain medication.
Psychological Signs
Polysubstance use can lead to notable psychological and mental health shifts, such as the anxiety commonly observed in methamphetamine users, a substance often used alongside others. Other psychological impacts include:
- Significant mood swings.
- Behavioral changes.
- Experiencing anxiety, depression, or isolating from social contacts.
- Strong cravings and an obsession with acquiring and consuming drugs, influencing personal and social priorities.
Social and Emotional Effects
Polysubstance abuse often causes considerable disturbances in personal and professional spheres, manifesting in legal and financial issues. Common repercussions of this form of addiction include:
- Neglecting daily responsibilities.
- Damaging or losing relationships.
- Continual drug-seeking actions.
- Challenges in moderating or ceasing drug use.
Recognizing these indicators is essential for identifying polysubstance abuse and initiating prompt and effective intervention.
Understanding Polysubstance Dependence
Polysubstance dependence develops through changes in how the brain functions, prompted by continuous use of drugs. This condition disrupts the brain circuits responsible for pleasure, learning, stress management, decision-making, and self-control.
It is characterized by the body’s need for multiple drugs to maintain what feels like normal functioning, particularly noticeable over the span of a year. Different substances may have varied effects on the brain, but addictive ones—such as alcohol, opioids, and cocaine—often lead to a surge of dopamine in the basal ganglia, creating sensations of pleasure.
Origins of Polysubstance Dependence
The journey to polysubstance dependence begins with ongoing substance abuse, which alters both the physical structure and functionality of the brain. These changes, known as neuroadaptations, compromise the brain’s ability to function properly, transitioning a person from occasional, controlled use to frequent misuse and addiction.
Difference Between Polysubstance Abuse and Dependence
Though closely related, polysubstance abuse and dependence are distinct conditions. Polysubstance abuse refers to the consumption of multiple drugs in ways or amounts not medically recommended, which does not automatically result in dependence.
On the other hand, polysubstance dependence is characterized by ongoing use of several drugs, reaching a point where the person’s brain and body cannot function normally without them. This dependency significantly disrupts regular mental and physical operations, underscoring the severity of dependence compared to abuse.
Treatment for Polysubstance Abuse
Achieving recovery from polysubstance addiction is possible but requires a customized approach due to the intricacies of managing multiple substance dependencies. The first step towards recovery is undergoing a phase of detoxification and withdrawal management. This stage is critical, as the involvement of multiple substances can result in unpredictable withdrawal symptoms and associated risks. Therefore, choosing a treatment facility well-versed in the complexities of polysubstance withdrawal is essential.
After successfully navigating through a medically-guided detox process, the next phase is comprehensive treatment, tailored to the severity and specifics of the polysubstance abuse. This treatment period can last anywhere from 3 to 6 months and includes a variety of therapeutic interventions:
- Individual Therapy: A cornerstone of recovery, these sessions leverage evidence-based strategies like cognitive behavioral therapy, dialectical behavior therapy, contingency management, and rational emotive behavior therapy to tackle root causes and cultivate effective coping strategies.
- Medication-Assisted: In instances where substances such as opioids or alcohol are involved, medication-assisted treatment (MAT) plays a crucial role in reducing the likelihood of relapse.
- Group Therapy: Participation in group therapy provides a supportive environment for sharing experiences and challenges, facilitating a sense of community among those in recovery.
- Family Therapy: Family engagement is critical to the healing process, with therapy focusing on enhancing communication, resolving conflicts, and setting healthy boundaries.
- Holistic Therapy: Approaches like meditation, yoga, massage, acupuncture, mindfulness, and art therapy complement traditional treatments by fostering relaxation and overall well-being.
West Georgia Wellness Center offers a full spectrum of residential treatment services in Atlanta, GA. Our team is committed to supporting you through every step of your recovery journey, ensuring a path towards lasting wellness. Contact West Georgia Wellness Center today to start your journey to recovery.
