What is Polysubstance Abuse? Why Is It Dangerous?

Cause and signs of polysubstance abuse.

Polysubstance Abuse

Table of Contents

Polysubstance abuse is common among various individuals within and outside the United States. The significant purpose of this abuse is to alter the effects of multiple drugs. It may involve the combination of various substances, including heroin, cocaine, and cough syrups.

The dangers of the condition are evident, especially among young adults. According to the Journal Polished in the National Library of Medicine,1 the increase in individuals admitted to residential programs for the condition suggests a need to pay attention to psychiatric and physical rehabilitation.

What is Polysubstance Abuse?

Polysubstance abuse, also called polydrug abuse, occurs when an individual uses multiple drugs and develops polysubstance dependence. It is a term that generally describes the consumption of more than one substance at a time. According to the DSM-5 criteria, polydrug abuse also falls under the umbrella of a substance abuse challenge.  

An individual experiencing polydrug abuse may combine one or more prescription drugs, street drugs, or both to modify the effects of each drug. Alcohol is highly common in polydrug abuse.  

Most individuals with the condition typically combine various substances, including prescription medications with alcohol as a primary inclusion. Consistent intake of these substances at once may result in polysubstance dependence and adverse side effects. 

Various substances are used in polydrug abuse. Major examples include opioids like heroin or prescription pain medications alongside benzodiazepines for greater sedative effects. Other substances that individuals may use for polydrug abuse also include psychedelics and alcohol.   

Dangers of Polysubstance Abuse

Various dangers may occur due to polydrug abuse, depending on the specific drug combination. In most cases, it results in acute health problems like reduced metabolism and increased blood concentration of the substance. Individuals who abuse multiple substances at once may experience various chronic conditions like hepatitis C or myocardial infarction.

The combination of multiple drugs may also result in polysubstance dependence and increased severity of side effects. Note that the effects may be synonymous with that of each drug combined. Some of the significant side effects of the abuse or addiction include vomiting, body pain, balance problems, nausea, and change in heart rate.  

Common Combinations

A high percentage of individuals combine alcohol with various drug types, including prescription or illicit drugs, to reach a “stronger” high. According to the National Institute on Drug Abuse, the simultaneous use of alcohol and prescription medications may cause alcohol poisoning, blackouts, and loss of life. Alcohol gets mixed with prescription opiates like the extended-release form of oxycodone.

Apart from the combination of alcohol with opiates, it gets combined with stimulants and anti-anxiety drugs. Mixing alcohol and any substance may result in negative drug interactions that affect the individual’s overall health due to polysubstance dependence. Here are other common combinations to note:  

Cocaine and Alcohol

Cocaine and alcohol are common mixtures among certain individuals. When an individual who takes in cocaine drinks alcohol, it may significantly increase cocaine in the body system. The combination of alcohol and cocaine may result in the production of cocaethylene, which is a psychoactive metabolite.

Cocaethylene stays in the body for a long period and may cause increased blood pressure, which results in cardiovascular challenges. Individuals also tend to drink more alcohol because cocaine tends to reduce its effects on the body. Both cocaine and alcohol tend to mask their effects, which may result in overdose and potential complications.   

Opioids and Benzodiazepines

Both opioids and benzodiazepines as polydrugs tend to sedate and suppress breathing. Hence, combining both medications may increase the risk of complications in the respiratory organs. According to a report,2 there was an estimate of one million emergency department visits between 2005 and 2011 that involved a mixture of opioids and benzodiazepines, or alcohol.

Prescription and Illegal Drugs

Prescription medications are typically only safe when an individual uses them, according to the licensed doctor’s advice. When these drugs combine with illegal substances, they may result in various negative health conditions. According to NIDA,3 prescription medications, including those for cough and cold, are usually combined with substances like marijuana or alcohol-producing series of side effects.

Psychedelics and Other Drugs

Experts also refer to psychedelics as hallucinogens. These drugs are responsible for causing a change in mood, perception, or overall cognitive processes. High intake or addiction to psychedelics and other substances may result in polysubstance dependence, causing hallucination and other side effects.   

Causes of Polysubstance Abuse

Individuals may experience polysubstance abuse disorder due to a wide range of causes. The contributing factors may be biological, psychological, and socio-cultural. For better comprehension, here is a breakdown of each potential cause of polydrug abuse:

  1. Biological: Some biological factors may increase the risk of polydrug abuse. Examples of such factors include genes, development stage, and gender. Generally, scientists estimate that epigenetics4
     plays a role in 40% to 60of an individual’s risk of substance abuse, which may directly or indirectly influence polydrug abuse. 
  2. Psychological: Polysubstance abuse disorder may occur due to certain psychological factors like an underlying mental illness. It could result from stress, anxiety, or depression. Individuals may turn to polydrug abuse to deal with certain psychological trauma. 
  3. Socio-cultural: Various socio-cultural factors cause polydrug abuse. Some examples of such factors include the sense of community, allure of rebelling, or lifestyle appeal. Sense of community involves a feeling of belonging due to common use by a certain group of individuals. The allure of rebelling is mostly common among young adults.  

Signs of Polysubstance Abuse

Signs of polydrug abuse are usually severe when left without treatment. Most of the signs are visible and may require immediate medical attention. Here are the significant ones to note: 

  • ToleranceThis sign describes a state where an individual experiences the need to keep using a higher quantity of multiple substances to achieve a certain “high.” For instance, an individual who takes the combination of cocaine and alcohol may develop tolerance to those substances for the long term. When this sign occurs, it may signify polysubstance abuse disorder. 
  • Loss of control: Loss of control is typically a short-term or long-term experience where an individual feels the inability to manage their behavior.  This condition may relate to impairments in a certain area of the brain responsible for executing certain tasks, including self-control and autonomy. 
  • Withdrawal: Severe symptoms may occur when an individual attempts to stop the intake of these substances. Possible symptoms that may occur include a change in mood, vomiting, nausea, irritability, fatigue, change in appetite, and restlessness. 
  • Inability: A valid sign of polydrug abuse is the inability to perform certain daily activities. The individual may reduce the time for social or recreational activities. Inability also includes challenges at work or school due to lack of focus and memory retention. 

Comorbidity of Mental Disorders

When comorbidity occurs, it signifies that an individual may be experiencing two or more mental health conditions. For example, an individual experiencing polysubstance abuse disorder may also have other mental health challenges. For better comprehension, here is more detail about the comorbidity of mental disorders based on two common conditions:   


Depression is prevalent in individuals experiencing polydrug abuse and other mental conditions. According to research on the comorbidity of depression, it was evident that over one-third of all patients with a DSM-III-R diagnosis of major depressive disorder (MDD) showed comorbidity of alcohol or drug dependence.5

Eating Disorder

An eating disorder is classified as a mental disorder involving abnormal eating habits that affect an individual’s mental and physical health. If an individual with a polydrug abuse diagnosis also has an underlying eating disorder, it is categorized as comorbidity. According to research, the severity and symptoms of an eating disorder prove to affect comorbidity.6

Treatment for Polysubstance Abuse

There are essential treatment programs that a licensed mental health professional may undergo for proper treatment of polydrug abuse. Most of these treatment procedures are also applied in treating various substance use disorders. Here are the significant treatments to polysubstance abuse disorder: 

  1. Detox: This treatment procedure involves the removal of substances from the body. Detox is typically either inpatient or outpatient and requires the supervision of mental health professional. This process is important to manage potential withdrawal symptoms. 
  2. CognitiveBehavioral Therapy (CBT): CBT aims to ensure an individual develops a coping strategy. It focuses on ensuring individuals find a link between their thoughts, feelings, and actions. CBT may take place in or outside the therapist’s office. 
  3. Comprehensive Addiction Treatment: This procedure involves the evaluation and assessment of the individual’s overall condition. After an analysis by the licensed mental health expert, a suitable treatment plan gets created to solve previously identified problems causing polydrug abuse. 
  4. 12-Step Program: This program by Alcoholics Anonymous involves a 12-Step plan to overcome substance abuse or addiction, including for polydrug cases. All the 12-Steps are outlined in the initial Big Book by AA.7
  5. Relapse Prevention Therapy: This therapy is a type of CBT that helps individuals handle relapses by anticipating potential triggers that provoke them. Relapse Prevention Therapy (RPT) aims to teach individuals to see relapse from the right perspective. 


Polysubstance abuse typically occurs both in young and older adults. It may result in various severe medical conditions. It’s imperative to consult a medical doctor for immediate support, especially during withdrawal.   


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/
  2. https://www.samhsa.gov/data/sites/default/files/DAWN-SR192-BenzoCombos-2014/DAWN-SR192-BenzoCombos-2014.htm
  3. https://www.drugabuse.gov/publications/drugfacts/over-counter-medicines
  4. https://pubmed.ncbi.nlm.nih.gov/19295534/
  5. https://pubmed.ncbi.nlm.nih.gov/8864145/
  6. https://pubmed.ncbi.nlm.nih.gov/17606234/
  7. https://www.aa.org/assets/en_US/smf-121_en.pdf

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