Polysubstance Abuse

Estimated reading time: 34 minute(s)

Substance abuse remains a common problem worldwide, affecting millions of people of all genders, age groups, ethnicities, and races. While most people are dependent on a single substance at a time, some try experimenting with multiple drugs at once to enhance the experience or under peer pressure. As a result, they end up acquiring a disorder called polysubstance abuse.

Polysubstance abuse describes the intentional or unintentional use of various substances together. Also known as multiple drug intake or combined drug intoxication, the process may involve illegal substances like marijuana or heroin, prescription medications like stimulants and opioids, and alcohol. It is imperative to understand that polysubstance abuse brings very high risks to a user’s safety and can potentially lead to irreversible, life-threatening damage. Hence, if you or someone you love has been engaging in this practice, familiarizing yourself with the nature of polysubstance abuse and knowing the risk factors and potential treatment options is crucial for a long, healthy, and happy life.

What is Polysubstance Abuse? An Outline

In simple words, polysubstance abuse describes a phenomenon where a person develops a habit of consuming different substances together and becomes dependent on them. These people may be fighting a primary substance abuse addiction, such as alcohol addiction, but add other substances, like Xanax, cocaine, or Adderall, to enhance the overall psychoactive effects. Polysubstance abuse differs from a co-occurring disorder as it includes an indiscriminate use of different substances than having two main abuse substances.

For instance, one day, an individual may decide to drink alcohol at a party, followed by using MDMA mixed with cocaine. The next day, they may start drinking alcohol at a friend’s house, followed by smoking marijuana, and end the day with Xanax. Shortly after, they may be seen enjoying ketamine and MDMA at a rave party. This binging pattern and misuse of different substances eventually lead to polysubstance abuse, interrupting their everyday life. Such people are not addicted to any one substance but are dependent on getting high. Hence, they are willing to try different combinations of substances to achieve this effect.

Prescription drug abuse disorders are often a part of polysubstance abuse, where people suffering from it may mix their regular anxiety medications with street drugs to amplify the overall effects. Regardless of the choice of drugs, polysubstance dependence is not safe as the combinations can lead to unpredictable side effects, such as seizures, respiratory depression, organ failure, psychosis, and heart attacks. In the long run, people fighting this disorder may acquire anxiety and depression in addition to experiencing a compounding of trauma secondary to the risky behaviors and situations they find themselves in.

Signs & Symptoms of Polysubstance Abuse

Unfortunately, as polysubstance abuse DSM-5 recent edition, the phenomenon is no longer a recognized diagnosis. However, it is still possible to pinpoint its occurrence in an individual based on certain signs and symptoms. Following are the signs that someone may be silently struggling with polysubstance abuse:

  • Mood swings
  • Intoxication 
  • Changes in behavior 
  • Overdose 
  • Difficulty maintaining relationships
  • Neglecting personal and professional responsibilities
  • Legal and financial trouble 
  • Engaging in drug-seeking behavior
  • Health problems

In addition to the signs mentioned above, a person fighting polysubstance use may notice the following symptoms:

  • Cravings and constant urges to use drugs
  • Difficulty controlling substance use
  • Thinking about and planning to use
  • Experiencing withdrawal symptoms after stopping use
  • A need to mix or use greater amounts of substances to achieve desired effects
  • Anxiety, depression, or isolation
  • Facing trouble at home, work, or school

The Dangers of Polysubstance Abuse

A person mixing various drugs and alcohol to stimulate or depress the central nervous system constantly risks their health. The following are the serious health consequences associated with polysubstance use and abuse:

Health Issues

Both alcohol and drugs can significantly harm physical health while putting them at risk of worsening health issues. These consequent health issues can either be long- or short-term and may target the vital organs in the body, such as the liver and brain. Some physical health issues related to polysubstance use include the following:

  • Seizures
  • Heart attack
  • Brain injury
  • Stroke

Worsening Mental Disorders

In many people, polysubstance use can trigger mental health issues, while others may rely on these substances to manage their mental health symptoms. Regardless of the situation, taking multiple drugs at once can severely aggravate mental health issues, making them much more and potentially long-term. 


Polysubstance abuse can make it extremely difficult for people to be compliant with addiction treatment. It can also significantly increase the risk of a relapse, making it difficult to maintain long-term sobriety.


The risk of an overdose is very high when a person is using multiple drugs at a time. The effects on the body can differ depending on the type of drugs they are using. People often rely on polysubstance use to intensify the overall effects. However, they may end up over-consuming multiple substances of the same nature, pushing the body into an overdose.

An overdose can turn life-threatening for anyone as it can significantly lower the breathing rate, shut down the vital processes needed to maintain important body functions and send a user into a comatose state.

Polysubstance Abuse & Detox: How it Works?

Detoxification is usually the first step of most addiction treatment programs and is described as thoroughly cleansing the body of any remaining underlying drug. While the process is straightforward in people with a simple addiction disorder, those with polysubstance abuse may require extra care to avoid potential complications. Hence, most rehabs recommend inpatient medical detox to overcome polysubstance use.

As a part of a medical detox, clients remain on site for the entire duration of the program under the supervision of highly-trained medical professionals. This supervision ensures constant monitoring of vital signs and prompt action in any medical emergencies. Additionally, the supervising addiction team may administer certain medications to manage the uncomfortable withdrawal symptoms, such as the following:

  • Antidepressants for mood fluctuations
  • Anti-nausea medications for intestinal upset and persistent vomiting
  • Sleep supplements for insomnia

In some cases where withdrawal symptoms are severe, experts may consider putting patients on long-term maintenance medications. For instance, if an individual was using prescription painkillers, such as Vicodin, with cocaine, the team may provide them with an opioid replacement medication, such as buprenorphine or methadone, to control the opioid withdrawal symptoms. Since cocaine withdrawal symptoms are not as severe, the staff members will only keep an eye on them and provide medications as needed. In other cases, such as people undergoing a benzodiazepine withdrawal, experts may recommend a tapering approach where they slowly reduce the dosage of a long-acting benzodiazepine over time, allowing clients to get off it with lesser severity of withdrawal symptoms.

Withdrawal secondary to polysubstance abuse brings a high potential of unpredictability; hence, constant medical monitoring is advisable. Additionally, a good rehab always provides necessary mental and physical support and encouragement to make the process easier while decreasing the likelihood of a relapse.

Polysubstance Abuse Treatment: The Rehabilitation Phase

Polysubstance abuse is highly treatable, no matter how risky and dangerous it may be. The recovery process generally begins with a detox and comprehensive withdrawal management, as mentioned above. The process needs extra supervision and monitoring as there is a high risk of unpredictability in terms of what happens since there are multiple substances involved. Therefore, people seeking professional treatment for polysubstance abuse should carefully choose a rehabilitation center with expertise in managing their underlying issues.

An individual is ready to enter a rehabilitative phase following a medically-monitored detox process. This phase is usually long-term and runs for three to six months. However, the exact duration can vary depending on how intense the addiction is and how well a person responds to treatment. Following are some common elements of rehabilitative treatment for polysubstance abuse:

Individual Psychotherapy

One-on-one psychotherapy or talk therapy remains the core aspect of polysubstance abuse recovery treatment. Different rehabs incorporate various evidence-based psychotherapies in their programs, such as cognitive behavioral therapy, contingency management, dialectical behavior therapy, rational emotive behavioral therapy, and motivational interviewing.


Medication-supported recovery (MSR) is a common part of polysubstance abuse management as it helps reduce the risk of a relapse. The choice of medication varies depending on personal circumstances and the severity of all underlying substance use disorders.

Group Sessions

Group therapy is one of the key elements of a polysubstance use disorder, as it allows patients to meet others with similar struggles. These therapies provide patients with a platform to share their stories and challenges, seek peer advice, and form meaningful connections that support each other for a lifetime.

Family-Focused Therapy

Family members and loved ones are crucial in supporting and helping a person through recovery. Hence, many rehabs providing polysubstance abuse treatment regularly conduct group sessions where they teach everyone how to set realistic boundaries and improve positive communications while instilling conflict resolution strategies.

12 Step Programs

The 12-Step program introduced by Alcoholics Anonymous remains a cornerstone in addiction treatment. The program includes various chronologically ordered benchmarks that guide people with polysubstance use disorder toward recovery.

Holistic Therapies

Many rehabs routinely incorporate different types of holistic therapies in their treatment programs. These include various experiential activities and relaxation techniques, such as acupuncture, massage, yoga, meditation, art therapy, and mindfulness.

With the right guidance and support from a treatment program, overcoming a polysubstance use disorder is possible.


What do you mean by a drug cocktail?

A drug cocktail combines different types of drugs to achieve a certain effect or high. The drugs added to a cocktail can interact with each other in the body and amplify each other’s effects, leading to a more powerful impact. A common example of a drug cocktail is mixing any drugs, such as depressants, hallucinogens, or stimulants, with alcohol. Remember that as tempting as a drug cocktail seems, it can be extremely dangerous for the body and bring on serious consequences.

What causes people to acquire polysubstance dependence?

Substance use has remained a significant public health crisis for decades. More recently, things have gotten more complicated as many people, especially young adults, have started resorting to polysubstance use by mixing different drugs. Researchers have been studying this phenomenon for years and have concluded that various factors may contribute to an individual’s risk of polysubstance use. These risk factors and causes may include the following:

  • Age (younger individuals are more likely to abuse more than one substance together)
  • White race
  • Unemployment
  • Low levels of education
  • Co-existing depression, anxiety, or other types of mood disorders
  • Living with a disability
  • Age (younger people have a higher risk)

Other factors contributing to polysubstance dependence include a family history of substance use disorders, genetics, past traumas, high-stress levels, and easy accessibility to drugs.

Is the risk of polysubstance abuse based on gender?

Polysubstance abuse hits males more than females, especially those who begin abusing substances at an early age.

Is it possible to recover from polysubstance abuse?

Recovery from polysubstance abuse is completely possible. While it may be difficult and seem impossible initially, many people have overcome multiple addictions with help and support. The best way to seek recovery if you are abusing various drugs at the same time is by joining a supportive and high-quality rehabilitation center. Treatment recommendations for this issue can vary depending on factors like the severity of use and the type of substances you use. In general, a healthcare provider may incorporate multi-level care, including detoxification, inpatient treatment, and aftercare services, to ensure that you reach your recovery goals. Additionally, you may get access to self-help measures and peer support groups to maintain long-term sobriety.

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