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
One 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.