What is Lean? The Highly Addictive Codeine Drink

Codeine Cough Syrup used in Lean

What is Lean? 

Lean or Purple Drank is a drink made from a mixture of Codeine cough syrup, soda, and sometimes hard candy and/or alcohol. The Codeine cough syrup used is a prescription opioid medication which is typically prescribed for illnesses such as Strep Throat and severe colds or flus. The codeine acts as both a cough suppressant as well as pain relief for symptoms. Unfortunately abuse has become widespread and street prices for Codeine cough syrup can be as much as $200 per bottle. 

Codeine is an opioid, similar to Morphine. It is weaker but like all opioids, regular abuse leads to tolerance and addiction. Further concern lies in the fact that with Lean, the amount used in the drink can be up to  25x the recommended dose and thus can lead to overdose. Codeine cough syrup that also uses Promethazine, a strong antihistamine, can cause further issues. Promethazine is another central nervous system depressant. In combination with codeine, promethazine can slow breathing to the point of complete respiratory arrest. This is particularly troubling due to the high amounts of the syrups used in Lean drinks. 

Additional concerns come into play when alcohol is mixed into a Lean cocktail. Adding alcohol increases the change of respiratory depression. This can lead to organ damage, coma, or death due to the reduced oxygen flow to the brain. 


Other Names for Lean

  • Purple Drank
  • Sizzurp
  • Syrup
  • Dirty Sprite 
  • Purple Lean
  • Purple Tonic
  • Texas Tea
  • Memphis Mud
  • Drank

Lean in Pop Culture

Codeine cough syrup has been abused by people for years but in the past few decades Lean was popularized in pop culture through songs and interviews with musicians. It became particularly prominent in the hip hop community and is reported to be the reason for Lil Wayne’s ongoing hospitalizations for seizures. Bow Wow recently shared about nearly dying from Lean addiction and the late Mac Miller also spoke of his struggles with addiction to Lean in 2013. Even Justin Beiber has sung about the drug, leading to a dangerous growth in popularity and curiosity. 


Side Effects of Lean 

The name “Lean” comes from the tendency to lean or be off balance when the drink is consumed. Lean can produce the feeling of euphoria associated with opioids but it can also have very negative consequences, especially in the amounts used in Lean. These include: 

  • Nausea and vomiting
  • Hallucinations
  • Extreme sedation
  • Wheezing
  • Respiratory depression or trouble breathing
  • Loss of coordination
  • High body temperature
  • Severe constipation
  • Itchy skin
  • Seizures
  • Dizziness
  • Loss of consciousness 
  • Changes in heart rhythm
  • Night Terrors

Long-term Health Issues Associated with Lean 

  • Seizures
  • Irregular Heart Beat
  • Liver damage
  • Trouble breathing
  • Urinary Tract Infections
  • Weight gain
  • Tooth decay

Codeine Overdose Symptoms

Early treatment can save a life. If you or someone else experiences these signs or symptoms after consuming Codeine or any other opiate, call 911 immediately: 

  • Nausea or vomiting
  • Hallucinations
  • Blue fingernails and/or lips
  • Trouble breathing
  • Blurred vision
  • Confusion
  • Weak pulse
  • Low blood pressure
  • Seizures
  • Loss of consciousness

Withdrawal from Codeine

Like all opiates, addiction to codeine can lead to significant withdrawal symptoms when the user tries to quit. Codeine is considered a fast-acting opiate, so withdrawal symptoms can start as soon as 12 hours after last use. The symptoms can be severe enough to require medical intervention in the form of a professional detox center. Symptoms of Withdrawal include; 

  • Muscle aches
  • Sweating
  • Agitation
  • Watery Eyes
  • Runny nose 
  • Headaches
  • Insomnia 
  • Anxiety
  • Nausea
  • Vomiting
  • Abdominal Cramps 
  • Diarrhea
  • Dehydration
  • Fever

Withdrawal symptoms also carry the risk of complications. For example, lung infections caused by vomiting or severe dehydration caused by vomiting and diarrhea. Severe dehydration can lead to problems of its own such as seizures. 

Detoxing from codeine addiction is best done in a clinical environment where the patient can safely come off the drug with medical supervision. In a clinical setting, like Harmony Recovery Group’s centers, doctors can prescribe medication to support the patient through the detox and withdrawal process, reducing symptoms and cravings. Furthermore, trained professionals can put a plan in place that includes therapy, group support and tools to promote long-term recovery. 


Seeking Help

We hope this article has helped you better understand what Lean is and the risks associated with Codeine abuse. If you or a loved one are struggling with Lean, codeine or any substance addiction, please reach out. 

Call us today and find out how we can help. 



Snorting Adderall

A Person Snorting Adderall

Snorting Adderall – Stimulants like Adderall are subject to abuse. Some people may crush these drugs and snort them as a method of consuming a lot of Adderall very quickly. Snorting drugs also gets them into the bloodstream faster, so they bind to brain receptors more rapidly.

Adderall is a prescription amphetamine used to treat attention-deficit hyperactivity disorder and narcolepsy. Adderall is prescribed as a tablet intended for oral use, but when abused for recreational purposes, it can be crushed into a powder and the remaining product snorted into the nasal passage.

It is classified as a central nervous system (CNS) stimulant and is often abused due to its cocaine-like effects such as increased energy, attention, alertness, and euphoria. For Adderall abusers, intranasal use is sometimes preferred due to the especially intense, fast delivery to the brain. Here, Adderall works on neurotransmitters (chemical messengers) such as serotonin and dopamine.

Rapid absorption then results in a massive release of “feel good” chemicals that lead to excessive energy and euphoric-like effects. It is this action that essentially becomes the catalyst for the drug’s psychoactive and addictive nature.

Snorting Adderall: Tolerance, Dependency, and Addiction

Adderall, like all amphetamines, has a high potential for abuse, dependency, and overdose. Signs and symptoms of Adderall addiction include, but are not limited to the following:

  • Continued drug use despite undesirable physical and psychological effects
  • Loss of interest in activities and interests once considered enjoyable
  • The use of Adderall in dangerous or improper situations
  • Adverse changes or problems in other areas of life such as work, school, relationships, and financial status.
  • General malaise, lethargy, or sedation

When Adderall is abused on a continual basis, tolerance and dependency start to develop. Tolerance increases as the user’s brain becomes less sensitive to the drug’s presence and potential for impact. As a result, the user then requires increasing amounts of the drug to achieve the desired feelings to which he/she is used.

Over time, the person’s central nervous system is “hijacked” by Adderall, and is much less able to function normally without drug use. Subsequently, efforts to decrease drug use or to stop using altogether result in extremely uncomfortable and sometimes painful physical and emotional side effects, also known as withdrawal symptoms.

Symptoms of withdrawal can linger for several days after the user’s last dose, their severity affected by factors related to the user’s frequency and duration of use.

Snorting Adderall | Why It's So Dangerous | Recovery By The Sea

Symptoms of Adderall withdrawal may include but are not limited to the following:

  • Extreme fatigue
  • Sleep disturbances
  • Insomnia, followed by hypersomnia
  • Vivid drug-related dreams
  • Hunger
  • Memory impairment
  • Drug cravings
  • Anxiety
  • Depression

Because of the rapid delivery of an intranasal dose and its absorption into the mucous membrane, the risk of addiction and overdose may be significantly higher among those who snort Adderall. In addition to dependency and an increased risk of overdose, snorting Adderall can result in frequent infections and damage to the nasal septum and surrounding tissues.

Other possible side effects and dangers of snorting Adderall include:

  • Headache
  • Dry mouth
  • Nausea
  • Stomach aches
  • Digestive issues
  • Reduced appetite
  • Diarrhea
  • Constipation
  • Anxiety
  • Restlessness
  • Pounding or rapid heartbeat
  • Shortness of breath
  • Sleep disturbances
  • Excessive fatigue
  • Changes in libido

Snorting Adderall and Overdose

Snorting Adderall, especially when combined with other drugs or alcohol is exceptionally risky and life-threatening.

Symptoms of an Adderall overdose include, but are not limited to the following:

  • Aggression
  • Anxiety
  • Panic attacks
  • Depression
  • Blurry vision
  • Disorientation
  • Hallucinations
  • Rapid breathing
  • Uncontrollable shaking/tremors
  • Rapid heart rate
  • Fever
  • Upset stomach and diarrhea
  • Fatigue
  • Muscle aches and weakness
  • Fainting, loss of consciousness
  • Seizures
  • Cardiac arrest
  • Death

Getting Help – From Detox to Addiction Treatment and Beyond

Getting Help – From Detox to Addiction Treatment and Beyond

People who abuse prescription amphetamines often falsely believe that they are less dangerous than illicit drugs such as methamphetamine and minimize the severity of their addiction. Failure to seek help, however, can be life-threatening and receipt of treatment as soon as possible is critical to long-term sobriety.


Professionally-supervised treatment for Amphetamine use disorder starts with our detox program, a clinical process in the which the individual is monitored 24/7 and medication is rendered to reduce some symptoms of withdrawal.

Following discharge, patients are encouraged to seek admission to one of our addiction treatment programs, which include both inpatient and intensive outpatient (IOP) therapy formats.

Treatment for Adderall Addiction

Persons who choose to remain long-term in one of our treatment programs will receive the very best, state-of-the-art therapeutic services and support. We use a comprehensive approach to drug abuse and addiction that is intended to treat all aspects of a person’s mental and physical health and well-being.

Why Seek Our Help?

Adderall addiction is a dangerous, potentially fatal condition that requires treatment in the form of long-term therapy, counseling, and support. There is no cure for Adderall addiction, but those who seek treatment are given the opportunity to regain their lives and live in peace and sobriety.

Recovery By The Sea

Our addiction treatment center offers patients a secure, structured environment and professional healthcare staff who are trained to identify and treat the unique needs of each individual using an in-depth, custom approach to drug addiction treatment and recovery.

Call us or Contact us now to learn about our treatment options.

How Much Cocaine Does it Take to Overdose?

how much cocaine does it take to overdose | Recovery By The Sea

How Much Cocaine Does it Take to Overdose? – Cocaine is a powerful stimulant drug that has a limited medical use but is most often found illicitly. Someone who snorts, smokes or injects too much cocaine can experience an overdose, which can be life-threatening.

Cocaine doses typically range from 30 – 70 mg, but as users develop tolerance, they tend to use more and increase their doses above 1 g. The minimum dose of cocaine that is considered lethal is 1.2 g, but users with hypersensitivity to cocaine have suffered fatal overdoses from as little as 30 mg. In some rare cases of remarkably high tolerance, cocaine addicts have reported using 5 g of cocaine daily, which would prove fatal for most individuals.

The intensity of cocaine effects also largely depends on its method of administration. While many cocaine abusers snort it so that the drug is absorbed through the nasal cavity or smoked into the lungs, injection brings on the fastest high and therefore is the most dangerous method of use.

In addition to the amount used and the method of administration, whether cocaine use results in an overdose also depends on the drug’s purity and the user’s level of tolerance and overall health.

People who regularly abuse cocaine build a tolerance over time, which compels users to increase their dose in order to achieve the desired effect. Tolerance can also lead to binges, which can significantly increase the risk of an overdose.

Cocaine Overdose Symptoms

After a person uses too much cocaine, seizures or convulsions can begin within 2-3 minutes, and they can last up to a half an hour. The objective of emergency medical technicians is first to stop the seizures, then stabilize temperature, heart rate, and breathing. If the brain doesn’t receive enough oxygen, the person can slip into a coma. If a person experiencing a cocaine overdose does not receive medical attention in time, death may ensue.

Permanent effects of a survived overdose can include damage to the heart, liver, lungs, brain, kidneys, intestines, and reproductive organs.

Other symptoms that indicate a person may have used an excessive amount of cocaine include the following:

  • Chest pain
  • Extreme mood swings
  • Aggressive behavior
  • High levels of energy
  • Irritability
  • Restlessness
  • Insomnia
  • Anxiety
  • Panic attacks
  • Paranoia
  • Nausea
  • Vomiting
  • Abdominal pain
  • Excessive talkativeness
  • Increased heart rate
  • High blood pressure
  • Dizziness or fainting
  • Twitches or tremors

How Cocaine Overdose Affects The Body

Cocaine’s immediate physical harm and potentially life-threatening effects originate from the multitude of systems it affects throughout the body.

Impact on the Heart

A cocaine overdose has a tremendous impact on the heart. The user may suffer from severe chest pain or pressure as the coronary arteries that supply blood to the heart constrict. At this point, the heart is being deprived of both oxygen and blood and begins to work excessively hard – which can eventually result in a stroke or a heart attack.

Blood pressure and heart rate will also perilously spike during an overdose, which could also cause heart failure. Also, if the user already has high blood pressure or heart problems without the use of stimulants, the risk of experiencing a life-threatening heart attack or stroke is much greater. Additionally, arrhythmia (irregular heartbeat) can occur which can also result in death.

Impact on the Lungs

An overdose of cocaine overdose can also lead to acute bronchospasm as well as a number of other more severe lung conditions – such as pneumothorax (collapsed lung). Some users – especially those who injected cocaine – are also at increased risk of developing blood clots in the lungs.

Impact on the Brain and Central Nervous System

As noted, seizures and convulsions can occur during a cocaine overdose, as the brain is susceptible to toxic levels of the drug. Likewise, blood vessels in the brain can rupture, so the user may experience a fatal aneurysm or hemorrhagic stroke.

Also, the overdose process may lead to nerve cell “miscommunication” – an effect that can result in uncontrollable muscle movements such as shaking, jaw clenching, and teeth grinding.

An increase in muscular activity can lead to a dangerously elevated body temperature. The extremities may also feel shaky and weak, and, eventually, the exhausted muscles may seize up to a point where the user may not even be able to call for help.

Treatment for Cocaine Addiction

Cocaine addiction, if left untreated, can be a devastating and life-threatening disease. Fortunately, however, cocaine addiction is treatable. Persons abusing cocaine are highly encouraged to undergo long-term, comprehensive addiction treatment that includes evidence-based approaches such as behavioral therapy, psychoeducation, individual and family counseling, and group support.

You can restore sanity to your life and experience the happiness and wellness you deserve. Contact us now to find out how we can help you achieve sobriety and begin your journey to indefinite recovery!

What are Narcotic Drugs?

Narcotic Drugs | Recovery by the Sea

Narcotic drugs, also known as narcotic analgesics, opioids, or painkillers are used primarily for the treatment of moderate-severe acute (short-term) pain, such as that experienced following an injury or surgery. They are also sometimes used to relieve chronic pain, such as in the case of cancer or palliative care, and can also treat diarrhea and coughing.

Some narcotic drugs such as oxycodone and codeine are legal if they are obtained through a prescription. However, these drugs are commonly diverted for their pain-relieving, feel-good effects. They are also found in completely illicit versions on the black market (e.g. heroin and fentanyl.)

Regardless of their origin, all narcotics have a high potential for abuse, addiction, and overdose. For this reason, they are considered very dangerous when not administered as prescribed under the care of a physician. In a nutshell, narcotics are depressant drugs that dull pain but can also impair cognition and senses, cause sedation, and slow autonomic functions of the central nervous system to a life-threatening extent.

Although the word narcotic tends to have a negative connotation regarding the illegal drugs associated with it, it is also a standard term used in health care. From one to another, narcotic analgesics vary in their ingredients, strengths, dosages, and cost. Many are taken orally as tablets, capsules, or liquids, while others can be injected or administered as a transdermal patch.

List of Narcotic Drugs

The following is an extensive list of both prescription and legal narcotic drugs.


Opium is the raw, natural foundation for all narcotics. It is derived from the somniferum papaver poppy plant and contains several opiate alkaloids including morphine, codeine, and thebaine. These chemicals have pain-relieving properties and are also the basis for many modern drugs, including oxycodone (thebaine) and heroin (morphine.)

Opium is not as commonly abused in the United States as derived opiates and opioids due to its limited availability as a natural substance, although it is classified as a Schedule I drug per the Drug Enforcement Administration (DEA.) However, when it is encountered, it is usually found as a brownish powder and can be smoked, drank as a tea, taken in pill form, or injected.

Morphine (MS Contin, Kadian, and Arymo ER)

Morphine, as noted above, is an opiate derived directly from the opium poppy that is used as an analgesic for the treatment of both acute and chronic pain, and is also used as a sedative before surgical procedures. Morphine is considered to be one of the most effective pain relievers on the market and is available in oral solutions, tablets, suppositories, and injection preparations.

Is the U.S, morphine is not misused nearly as often as heroin and prescription opioids, but still has a high potential for addiction and is most often abused via injection by those dependent on opioids.


Codeine is used as an analgesic and cough suppressant, but for pain, is widely considered to be less effective than morphine. In the U.S., codeine is only available in generic form or in combination products, such as Tylenol with codeine.

Codeine is generally thought to be less addictive than many more potent narcotics – that said, however, it still has the potential for abuse, dependence, addiction, and overdose.


is heroin a stimulant

Heroin is an illicit, semi-synthetic opiate, and like opium is heroin is classified as a Schedule I controlled substance in the U.S., as it has no accepted medical use and a high potential for abuse and addiction.

It is commonly distributed as a brown-to-white powder or a less pure version known as “black tar heroin” which resembles a dark sticky tar-like substance.

Heroin can be snorted, smoked, or injected. Heroin creates a very intense and rapid rush of euphoria, but can also cause extreme sedation. Therefore, users often cycle between an awake and unconscious state, also known as being “on the nod.”

Overdose deaths due to heroin and its far more potent cousin fentanyl (see below) have increased dramatically since the turn of the century, and are involved in tens of thousands of deaths each year.

A heroin overdose is a medical emergency and is characterized by labored/difficult breathing, stupor, lethargy, confusion, clammy/cold skin, slow heart rate and blood pressure, a bluish tinge (cyanosis) to the nails and lips, and potentially, a complete loss of consciousness.

Oxycodone (OxyContin, Percocet)

Oxycodone is an effective painkiller for moderate to severe pain, but if used for longer than a few days or abused, however, can quickly result in drug tolerance and dependence. Oxycodone is generally dispensed in tablet form and may be combined with an over-the-counter analgesic, such as acetaminophen.

Oxycodone is a Schedule II controlled substance, meaning that it does have an approved medical use. However, it is also commonly abused – in fact, OxyContin (and other oxycodone products) contain a black-box warning concerning their high diversion (theft), abuse, dependence, addiction, and overdose potential.

Oxycodone pills/tablets can be crushed and the powder can be snorted, smoked, or injected. These methods increase the effects of oxycodone, but also increase the risk of addiction and overdose.

Hydrocodone (Vicodin, Norco, Lortab)

Prescription Drugs | Recovery By The Sea Addiction Treatment

Hydrocodone is an effective painkiller and the #1 prescribed and most often diverted and abused opioid drug. Prescribed in tablets, capsules, and syrups, hydrocodone medications can be swallowed, snorted, smoked, or injected.

The DEA has warned that hydrocodone is one of the top drugs found to be involved with prescription opioid overdose deaths, and it is considered to have a high potential for addiction. It is also frequently found in combination formulations with acetaminophen (Norco, Vicodin) which increases the risk of health complications when abused.

Hydromorphone (Dilaudid and Exalgo)

Another Schedule II narcotic derived from morphine, hydromorphone is dispensed in tablets, vials, suppositories, and injectables. The drug is frequently diverted via “doctor shopping” – e.g., forged prescriptions and sketchy prescribers – and through pharmacy and nursing home theft.

When abused, hydromorphone can be smoked, snorted, swallowed, and injected. It is very potent, highly addictive, and has a carries a significant potential for overdose when abused.

Meperidine (Demerol)

Demerol is a pain medication marketed as a table or syrup, and abuse often begins with a legitimate prescription for pain. A patient using Demerol for severe pain may become tolerant to prescribed doses and begin to escalate use (and evolve into abuse.)

Even when Demerol is used as directed with a prescription, a patient can become dependent on the drug and experience withdrawal symptoms when they attempt to quit – therefore, it can be challenging to stop using Demerol, resulting in misuse/abuse and addiction.

Methadone (Dolophine, Methadose)

Methadone is an opioid analgesic, although it is frequently prescribed for opioid dependence and detox as a replacement for faster-acting, more potent opioids such as heroin. It can be dispensed as a pill, wafer, or in liquid form, often administered through federally-regulated clinics.

Methadone is one of the longer-acting opioid agonists, as it remains active in the bloodstream for close to a full day. This means that it can be prescribed in lower doses and less often than other narcotics for the management of opioid withdrawal symptoms.

Buprenorphine (Subutex, Buprenex, Butrans, Probuphine and Suboxone, Zubsolv, and Bunavail)

Buprenorphine is a long-acting, partial opioid agonist drug approved by the Food and Drug Administration to treat opioid dependence, both on its own and included in buprenorphine/naloxone formulations such as Suboxone. However, it can still be abused and has a potential for dependence.

The inclusion of naloxone in combination with buprenorphine products acts as an abuse-deterrent. Moreover, naloxone is an antagonist drug – if buprenorphine combination products are altered for abuse, effects of the opioid agonist are blocked.

Tramadol (ConZip, Ultram, and Ryzolt)

Narcotic Drugs | Recovery by the Sea

Tramadol is a different kind of narcotic analgesic. It not only has opioid agonist effects but also blocks the reabsorption of norepinephrine and serotonin for additional painkilling properties.

Although Tramadol is considered to have a relatively low potential for abuse and addiction, it is still a controlled substance and those who are already dependent on opioids and chronic pain sufferers may be more likely to abuse it.

Fentanyl (Actiq, Fentora, Duragesic, Subsys, Abstral) and Carfentanil

Fentanyl is a very potent narcotic (up to 50 times more potent than heroin) prescribed for the treatment of chronic and severe pain in those who are tolerant to other opioids. As a prescription, is it often administered as a transdermal patch. In a hospital setting, it is also used for general anesthesia.

On the black market, fentanyl is not usually a product of drug diversion, however. Rather, it is illicitly made in Chinese labs and frequently cut into other drugs such as heroin to increase the potency of the product and maximize profits. It the last few years, it has been involved in an escalating number of overdose deaths, now numbering in the thousands each year.

Carfentanil is similar to fentanyl but 100 times more potent. It is not indicated for any medical use in humans, and in the U.S. is only used by large animal handlers for sedation. The drug can be lethal to adults in tiny doses of two milligrams or less and is extremely dangerous to even handle it, less alone consume it.

Treatment for Addiction to Narcotic Drugs

After detox, narcotic drug addiction is most effectively using a comprehensive, evidence-based approach that includes behavioral therapy, counseling, and group support. Our center offers these therapeutic services in inpatient, partial hospitalization, and outpatient formats.

Our professional medical and mental health staff specialize in addiction and can provide clients with the knowledge and tools they need to recover and enjoy long lasting sobriety and wellness. Recovery from addiction is a lifelong endeavor, but you don’t have to do it alone.

Dope Sick: What Does It Mean?

Dope Sick: What Does It Mean?

“Dope Sick” is a term that describes a pattern of symptoms related to withdrawal from opiates or opioids such as heroin or prescription painkillers. These symptoms occur when a person tries to quit using a drug abruptly or dramatically cut back.

Withdrawal complications from opiates and opioids are rarely fatal, but symptoms are highly uncomfortable and often lead to relapse or suicidal ideations. The severity and duration of symptoms are primarily dependent on individual factors, the intensity and frequency of drug use, and whether or not professional help is sought (medical detox) for the withdrawal process.

Dope sick withdrawal symptoms include, but is not limited to the following:

  • Depression and anxiety
  • Mood swings
  • Lethargy
  • Nausea and vomiting
  • Drug cravings
  • Excessive sweating
  • Insomnia and sleep disturbances
  • Muscle aches and pains
  • Watery eyes and runny nose
  • Diarrhea

How Long Does Dope Sickness Last?

Snorting Hydrocodone | Recovery By The Sea

Withdrawal symptoms typically begin within a few hours of the last use and tend to peak within 1-3 days. Effects begin to subside over the course of a week, but some symptoms may persist longer and take weeks to abate fully.

Treatment for Dope Sickness

Undergoing a medical detox is strongly recommended for anyone suffering from opioid withdrawals to avoid relapse and severe mental health issues. During detox, vital signs can be closely monitored and medications rendered to mitigate symptoms. Medication-assisted treatment usually includes opioid replacement therapy such as buprenorphine or suboxone to manage cravings and the worst effects of withdrawal.

Detox should be following by inpatient or intensive outpatient treatment for a period of not less than 30 days.

Benefits of professional detox following by addiction treatment include the following:

  • 24-hour medical supervision
  • Medication management for withdrawal symptoms as needed
  • Individual and group therapy
  • Individual and family counseling
  • Nutritional assessment and guidance
  • Holistic treatment options such as yoga, meditation, art therapy, and more

There is a wide range of treatment options available to help those who want to get clean, so seek one out and make a huge change in your life today.

Polysubstance Abuse

Polysubstance Abuse | Recovery By The Sea

A person who engages in polysubstance abuse illicitly consumes multiple psychoactive substances but does not necessarily prefer one over another. People who are diagnosed with polysubstance abuse or dependence are actively abusing two or more substances, and typically one of these is alcohol.

Among drugs, cocaine and heroin are the most commonly misused in combination with multiple substances, but opioids, marijuana, amphetamines, benzodiazepines, and hallucinogens are also frequently abused, as well.

Why Do People Abuse More Than One Substance?

Research has shown that excessive use of one drug increases the likelihood that the person will excessively use another. Indeed, many people who abuse multiple substances are looking desperately for a “high” and aren’t concerned about how they achieve it.

It’s important to remember, however, all types of psychoactive substances work on the same regions of the brain (in many cases, the same neurotransmitters) and induce feelings of reward. Some people who are seeking instant “feel good” gratification will eventually devise multiple routes to those feelings, and henceforth, experiment with various substances.

In other words, psychoactive substances all have one thing in common – they serve as a reward to those who use them, at least initially. But often, regular substance abuse results in what is known as tolerance – a state best described as “repeated exposure = reduced response.”

When a user is no longer to obtain a high via a usual method, he or she may turn to other substance(s) to enhance or amplify the effects of the first. Or, they may use a substance(s) that cancel out certain side effects of the other, such as anti-anxiety medication to minimize the come down from a cocaine high.

Combined Drug Intoxication

Polysubstance Abuse | Recovery By The SeaOne of the leading causes of drug overdose in the United States is combined drug intoxication. This condition occurs when a person uses more than one substance (often three or more) in conjunction, a decision that ultimately puts a dangerous amount of stress on the central nervous system (CNS) and major organs.

Substances frequently used together include alcohol, benzodiazepine (benzos), opioids, hypnotics (sedatives), mood stabilizers, antipsychotics and muscle relaxers. Consuming any combination of these substances can be highly unpredictable and lead to serious complications including coma, cardiac arrest, respiratory arrest, and death.

It’s also fair to say, however, that some people who abuse multiple substances (case in point, Health Ledger, see below) are trying to over self-medicate for an underlying mental or physical health condition as opposed to only seeking a high.

The Case of Heath Ledger

On January 22, 2008, 28-year-old Australian actor and director Health Ledger was found unresponsive by his housekeeper in his New York apartment.

Probably most well-known for his roles as The Joker in The Dark Knight (2008) and Ennis in Brokeback Mountain (2005), Ledger was suffering from insomnia at the time of his death and was taking medication to help him sleep.

Later, an autopsy and toxicological examination revealed that “Mr. Heath Ledger died as the result of acute intoxication by the combined effects of…”

  • oxycodone (i.e. OxyContin, an opioid analgesic)
  • hydrocodone (ie. Norco or Vicodin, an opioid analgesic containing acetaminophen)
  • diazepam (i.e. Valium, an anti-anxiety medication, benzo)
  • temazepam (ie. Restoril, an anti-anxiety medication, benzo)
  • alprazolam (i.e. Xanax, an anti-anxiety medication, benzo)
  • doxylamine (an antihistamine)

What do we notice in these findings? Ledger consumed two different opioids and three different benzos at varying strengths. In his desperation for sleep, he used a toxic amount of painkillers and anti-anxiety medications -most of which that should have been unnecessary.

Who is at Risk for Polysubstance Abuse?

Like addiction, polysubstance abuse can happen to nearly anyone, and many of the risk factors for unilateral substance abuse are the same as those for polysubstance dependency.

There are additional determinants, however, that could increase the chances that a polysubstance use disorder will develop. These include:

  • Abusing or being dependent on alcohol
  • Holding a prescription for anxiety, depression, or pain medication
  • Being active in certain social environments, such as parties, raves, festivals, concerts, etc.
  • Having attention-hyperactive deficit disorder (ADHD) or a similar condition, exhibiting significant difficulty managing emotional regulation or impulsive control

Polysubstance Abuse Treatment

Due to the complicated nature of polysubstance abuse and potentially intense withdrawal symptoms, people seeking recovery may require a more extended stay in detox than others. Different substances manifest different withdrawal symptoms, and the most severe may need priority over others.

Treatment for polysubstance use disorder is not necessarily special when compared to those who suffer from a single dependency, but it is a bit more involved in that the patient is battling more problems and unique long-term effects.

Polysubstance abusers may also find it particularly challenging to remain sober due to having an “everything but the kitchen sink” mentality toward obtaining a high.

Treatment, however, should still involve a comprehensive program that includes inpatient or intensive outpatient therapy, behavioral therapies, counseling, group support, and holistic practices such as meditation if desired.

To learn more about treatment center, or to get answers to any questions that you may have about any aspect of treatment, please feel free to contact us at your convenience. We look forward to helping you make the most informed decision for yourself or for a loved one.

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