A person who engages in polysubstance abuse consumes multiple psychoactive substances but may not prefer one over any other. People diagnosed with this disorder are actively abusing two or more substances, and often one of these is alcohol.
Regarding illicit drugs, cocaine and heroin are the most commonly abused in combination with multiple substances, but marijuana, prescription opioids, amphetamines, benzodiazepines, and hallucinogens are also frequently used.
Why Do People Abuse Multiple Substances?
Studies have shown that heavy use of one drug increases the likelihood of excessively using another. Indeed, many individuals who abuse multiple substances are looking desperately for a particular type of high and aren’t necessarily concerned about how they achieve it.
It’s important to note that all types of intoxicating substances work on the same regions of the brain and the same neurochemicals and induce feelings of pleasure and reward. Some people seeking instant “feel good” gratification will eventually devise multiple ways to achieve those feelings and begin to experiment with various substances.
In other words, intoxicating substances all have one thing in common—they serve as a reward to persons who use them, at least in the beginning. But often, regular substance abuse lead to what is known as tolerance—a condition best described as “repeated exposure = reduced response.”
When an individual is no longer to obtain a high using the usual method, they may turn to other substances to enhance or amplify the effects of the first. Or, they may use the substance(s) that cancel out specific side effects of the other, such as anti-anxiety medication, to relieve the comedown and withdrawal effects from a cocaine high.
One of the leading causes of overdoses in the U.S. is polysubstance drug intoxication. This condition occurs when an individual uses more than one substance in combination. This action can put a dangerous amount of stress on the central nervous system (CNS) as well as major organs.
Substances frequently used and abused together include alcohol, benzodiazepines, opioids, sedative-hypnotics, mood stabilizers, antipsychotics, and muscle relaxers. Ingested any combination of these substances can be extremely unpredictable and result in severe complications, including cardiac arrest, respiratory arrest, coma, and death.
Some people who abuse multiple substances are attempting to over self-medicate for an underlying mental or physical health condition such as anxiety, depression, or insomnia, instead of only seeking to get high.
The Tragic Case of Heath Ledger
In January of 2008, 28-year-old Australian actor and director Health Ledger was found unresponsive by his housekeeper in his apartment. Probably best known for his role as the Joker in The Dark Knight (2008), Ledger was experiencing insomnia at the time of his death and was using medication to help him sleep.
Subsequently, an autopsy and toxicological examination revealed that Ledger died due to acute intoxication by the combined effects of multiple opioids, benzodiazepines, and an antihistamine. Moreover, he had ingested two different opioids and three different benzos at varying doses. In his desire for sleep, he used a toxic cocktail of painkillers and anti-anxiety medications, which in this amount was largely unnecessary.
Who Is at Risk for Polysubstance Abuse?
Like all forms of drug use and addiction, polysubstance abuse can happen to nearly any individual, and many of the risk factors for substance abuse in general are the same as those for polysubstance dependence. There are potentially additional determinants, however, that could increase the risk of a polysubstance use disorder developing, including the following:
- Abusing or being dependent on alcohol
- Having been prescribed medication for depression, anxiety, or pain medication
- Being active in specific social environments, such as nightclubs, parties, raves, festivals, concerts, etc.
- Having attention-deficit hyperactive disorder or a similar condition, or exhibiting significant difficulty regulating emotions or impulses
Getting Treatment for Polysubstance Abuse
Because of the complicated nature of polysubstance abuse and possible compounded withdrawal symptoms, people seeking recovery may require an extended stay in detox that may be longer than others. Different substances contribute to different withdrawal symptoms, and the most severe may need priority over others.
Treatment should involve a comprehensive residential or outpatient program that includes behavioral therapies, counseling, peer group support, psychoeducation, art and music therapy, and holistic techniques such as mindfulness meditation to be the most effective. Just Believe Recovery offers these services and more using an intensive and integrated approach to treatment.