What is Polysubstance Abuse?

Garrett Stanford

August 15, 2020

When most people think of substance use disorders, they picture a person who has a debilitating dependence on one particular substance. Individuals in addiction treatment often refer to their “substance of choice.” Polysubstance abuse refers to the practice taking three or more drugs on a regular basis. Individuals who engage in polysubstance abuse can suffer from drug dependence on one or more of these substances, but it is also common for them to use them indiscriminately and have no strong attachment to any of them. Polysubstance abuse is becoming increasingly prevalent among young adults. In a survey of highschool and college-aged young adults, among those who used drugs and alcohol, 40% engaged in drug abuse using more than one substance and 4% reported regularly using three or more substances. That same study found that polysubstance abuse is on the rise particularly among young people.

Why do People use Multiple Illicit Drugs?

People combine substances for a variety of reasons. The use of multiple substances is commonly associated with partying culture. Social pressures can cause people to feel that they must say “yes” to every substance offered to them. It is also common for people to combine drugs as a way of enhancing the effects of a drug they are already taking. For example, combining a stimulant, such as amphetamine, with an opioid is often perceived as offering an improved “high” than either substance alone. Many individuals who suffer from drug dependence also use other substances to mitigate some of the negative side effects that they normally experience on the main drug. For instance, marijuana or alcohol may be used to calm a person down when they are experiencing withdrawal symptoms after they stop taking a prescription drug. People who engage in polysubstance abuse may use multiple substances indiscriminately in the pursuit of greater highs, or they may “play doctor” to try to achieve precise effects and treat the negative effects of their substance abuse habits. Unfortunately, taking additional substances to deal with the negative consequences of addiction is likely to ultimately exacerbate the problems.

Signs of Polysubstance Dependence

Individuals engaging in polysubstance abuse may begin taking the drugs in a carefree manner, but they may ultimately find their freedom curtailed even more so than other drug users. This is because they develop tolerance and dependence on a wide variety of substances. While people who are addicted to one substance alone may struggle to obtain enough of their substance of choice to avoid going into withdrawal, the problem is amplified when a drug user must seek out multiple substances to avoid withdrawal symptoms. Some common signs of polysubstance dependence and abuse include:

Spending a lot of time and resources obtaining substances
Repeated failed attempts to quit using more than one drug
Substance abuse makes it difficult for a person to function in their daily activities
Continued abuse of multiple substances despite a recognition of the harms
Lack of attention to hygiene or changes in appearance
Mood or behavioral problems
Strong indiscriminate cravings for mood-altering substances

Long-Term Effects of Polysubstance Addiction

Over time, polysubstance abuse, like all forms of substance abuse, leads to debilitating dependence and addiction. Individuals who suffer from addictions to multiple substances come to prioritize their drug-seeking and drug-taking activities over their other commitments in life. As a result, people’s relationships tend to suffer. They may find themselves spending more time alone or in the company of “lower companions” who enable their substance abuse. Over time, individuals may suffer problems at work or at school. Substance abuse can directly lead to legal problems when the substances used are illicit, but it can also lead to criminal consequences when inebriation causes disinhibited and dangerous behavior. As financial, interpersonal, and legal problems build up, individuals with polysubstance addictions may find their lives unraveling.

Substance use disorders can make people feel helpless as well, especially after repeated attempts to control their substance use end in failure. Feelings of hopelessness and lack of autonomy can cause people to develop mental illness, especially when they also face the devastating life consequences of their addiction. In fact, among drug dependent individuals, 81% suffer from at least one comorbid mental health condition.

The greatest risk, however, is drug overdose. While many common recreational drugs pose an overdose risk, combining substances leads to drug interactions that significantly increase the risk. According to the World Health Organization, drug interactions are a leading cause of death worldwide. Dangerous combinations include:

Alcohol and prescriptions drugs
Alcohol and opioids
Benzodiazepines and opioids
Opioids and stimulants

Effective Treatment Programs for Polysubstance Addiction

Individuals who suffer from drug or alcohol addiction cannot manage their condition without outside help. For those who regularly use three or more substances, the need for professional help is even more dire. Most people with polysubstance addiction cannot stop using the drugs on their own. Drug addiction treatment centers are an essential resource for anyone hoping to get sober and piece their lives back together. Outpatient addiction treatment programs are recommended for polysubstance abusers. These programs enable people to withdraw from drugs in a safe and supportive environment. Individuals in outpatient programs work daily to develop the coping skills and tools they need to avoid relapse and hold onto their newfound sobriety. Moreover, outpatient programs allow individuals in recovery to rebuild their lives from the ground up. Most people turn to addictive drugs because something is wrong, whether they suffer from an untreated mental health disorder or mere loneliness. At an outpatient addiction treatment program, polysubstance users in recovery gain access to a strong sober social support system, take steps toward their goals, and emerge free, happy, and ready to face the future drug-free.

Garrett Stanford brings years of experience working with individuals and families struggling with substance abuse and behavioral health issues. He began working in the nonprofit treatment sector for 2 years before transitioning into the private sector. Garrett has been involved in treatment since 2010, with 10+ years of experience ranging from operations, administration, admissions and addiction research.

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