Polysubstance use, also known as polydrug use, is a common and dangerous behavior involving the use of multiple substances together. Misusing substances in this way can easily lead to polysubstance use disorder, a complex condition requiring specialized addiction treatment protocols.
The unpredictable and often severe effects of combining drugs, either intentionally or unintentionally, increase the risks of dependency, overdose, and other complications. Empowered Recovery Center in Atlanta offers personalized care plans to support people on the path to long-term recovery and wellness.
What Is Polysubstance Use?
Polysubstance use is the act of using more than one substance at the same time or within a short period of time. This combining of drugs is dangerous—the effects it can have on the user’s body are often unpredictable, and in some cases, life-threatening.1
Polysubstance use can occur intentionally or unintentionally. Intentional polysubstance use occurs when a person combines drugs to increase or decrease the effects of these drugs, or wants to experience certain effects that are only felt through the combining of drugs.
Unintentional polysubstance use occurs when a person takes a drug that has been mixed or “cut” with other substances without their knowledge.1 Taking heroin or another illicit substance that has been cut with fentanyl is an example of unintentional polysubstance use.
Whether intentional or unintentional, polysubstance use can lead to polysubstance use disorder, wherein repeatedly using more than one drug leads to a pattern of use that interferes with the user’s health and ability to function. Polysubstance use disorder, also known as polysubstance addiction, is a treatable mental health disorder.2
Effects & Dangers of Polysubstance Use
Polysubstance use can lead to an array of mental and physical health complications.
The dangers of polysubstance use include:4
- Increased heart rate
- Increased blood pressure
- Liver damage
- Heart attack or stroke
- Respiratory depression
- Brain damage
- Overdose
- Coma
- Death
Polysubstance use has also been associated with higher rates of suicide attempts, arrests and incarceration, and more severe medical and psychiatric comorbidities, that is, the simultaneous presence of two or more serious medical conditions.3
Polysubstance Overdose Symptoms
Overdose is a very real risk of polysubstance use. The effects of combining drugs are often unpredictable, tricking the user into thinking the drugs are not having as much effect as they actually are.2,4 In 2022, nearly half of drug overdose deaths in the U.S. involved multiple drugs.5
The general symptoms of polysubstance overdose include:6,10
- Quickened or troubled breathing
- Confusion
- Increased body temperature
- Nausea or vomiting
- Chest pain
- Seizures or tremors
- Weak pulse
- Passing out
- Gurgling or snoring sounds.
- Slow breathing or no breathing.
- Small pupils.
- Discolored fingernails or lips.
If you think that someone is experiencing a polysubstance overdose, seek medical care immediately. Lay the person on their side to prevent choking and try to keep them awake in order to keep them breathing. Call 911 or your local emergency number, and be prepared to give information about the kind and amount of substances that were taken.
Substances Commonly Misused Together
Due to unpredictable interactions and stronger side effects, polysubstance use increases the risks associated with substances that can be dangerous all by themselves. Substances that are commonly misused together include:
Alcohol and cocaine. These two substances are often combined to prolong the pleasurable effects of cocaine while countering the depressant effects of alcohol. One of the big risks of this combination is that the body metabolizes both substances into cocaethylene, a toxic compound that increases the risk of heart attack and liver damage.6
Cocaine and opioids. Commonly known as a “speedball,” mixing cocaine with an opioid like heroin provides an intense burst of energy followed by a period of euphoric calm. Cocaine and opioids counteract each other’s effects, masking the severity of polysubstance abuse symptoms like respiratory depression or irregular heart rate and increasing the likelihood of overdose.7
Alcohol and stimulants. Mixing alcohol with stimulant drugs like MDMA or Adderall allows users to maintain energy and alertness while drinking. However, stimulants can mask alcohol’s depressant effects, leading to overconsumption and possible alcohol poisoning, which can damage the brain, heart, and other organs.4
Prescription drugs and other substances. Common combinations in this category include benzodiazepines like Xanax with alcohol, benzos with opioids, and prescription stimulants like ADHD medication with illicit drugs. Such combinations can lead to dangerous drug interactions, including increased sedation, respiratory depression, or irregular heartbeat.8
Fentanyl in illicit drug supplies. Fentanyl is a synthetic opioid that has been found to be many times more potent than morphine. Many illicit drug dealers mix fentanyl into other substances like heroin, cocaine, methamphetamine, and MDMA because it is a cheap way to enhance a drug’s potency. Since fentanyl is so potent, users can inadvertently take a much stronger dose than their bodies can manage, increasing the risk of overdose.9
Mixing Stimulants & Depressants
One of the more common misconceptions around polysubstance use is that, by mixing stimulants and depressants, one can strike a safe balance, since stimulants are “uppers” and depressants are “downers.”
The fact is, the results that come from combining stimulants like cocaine, MDMA, amphetamines, or methamphetamine with depressants like alcohol, opioids, or heroin are wildly unpredictable. Mixing stimulants and depressants can modify or even mask the effects of one or more drugs. This can lead to increased drug use, which can lead to overdose.1
Treating Polysubstance Use Disorder
Treatment of polysubstance use is more complicated than treating a single substance use disorder and thus requires additional planning and coordination of care. For instance, detox, which is the first step in the recovery process, often requires increased medical supervision to safely manage the wider range of withdrawal symptoms that polysubstance use disorder presents.3
While polysubstance use disorder is treated in various settings, the first step of the recovery process should be detox. This process, which can take between three and seven days, allows the patient’s body to be entirely free of toxic substances.
Once detox is completed, the patient will undertake one or more addiction treatment programs, which are designed to help them develop coping skills and avoid relapse.
Many addiction treatment programs offer dual diagnosis treatment, a therapeutic approach that addresses both the addiction and any co-occurring mental health disorders such as depression or anxiety. Some programs offer addiction therapies along with Medication-Assisted Treatment (MAT), which utilizes prescription medications to address uncomfortable withdrawal symptoms and reduce cravings.
Finding the right polysubstance use disorder treatment depends on the patient’s health history, the substances to which they are addicted, and the length of their addiction. Empowered Recovery Center in Atlanta can provide such personalized treatment plans.
Polysubstance Addiction Treatment in Atlanta
At our drug and alcohol rehab in Atlanta, we strive to empower clients with the life skills they need to effect positive change in their lives. Our polysubstance addiction treatment can help you every step of the way in your recovery journey.
We offer a number of rehab programs to suit your needs, including partial hospitalization programs (PHP), intensive outpatient programs (IOP), and outpatient rehab. Our programs also include one year of free recovery coaching to provide extended support once you’ve completed your program.
We accept several insurance plans. We can also work with out-of-network insurance plans to get you the help you need. Our admissions team can verify your benefits, either over the phone or online, so that you’ve got the details of paying for rehab, including using insurance to pay for rehab. If you’re ready to learn more about our comprehensive treatment programs, call us today or fill out our contact form to take that first step toward a better life.
References
- U.S. Centers for Disease Control and Prevention. (n.d.). Polysubstance Use Facts. U.S. Centers for Disease Control and Prevention. Retrieved January 21, 2025, from https://www.cdc.gov/stop-overdose/caring/polysubstance-use.html
- Cleveland Clinic. (2024). Polysubstance Use Disorder. Cleveland Clinic’s Health Library. Retrieved January 20, 2025, from https://my.clevelandclinic.org/health/diseases/polysubstance-abuse
- Agency for Healthcare Research and Quality. (n.d.). The Role of Primary Care and Integrated Behavioral Health in Polysubstance Use. U.S. Department of Health & Human Services. Retrieved January 20, 2025, from https://integrationacademy.ahrq.gov/products/topic-briefs/polysubstance-use
- U.S. Centers for Disease Control and Prevention. (n.d.). Polysubstance Use Facts. U.S. Department of Health and Human Services. Retrieved January 20, 2025, from https://www.cdc.gov/stop-overdose/media/images/polysubstance-use/pdf/Polysubstance-Use-Fact-Sheet_508.pdf
- U.S. Centers for Disease Control and Prevention. (n.d.). Fatal Drug Overdose Data. U.S. Centers for Disease Control and Prevention. Retrieved January 20, 2025, from https://www.cdc.gov/overdose-prevention/data-research/facts-stats/sudors-dashboard-fatal-overdose-data.html
- U.S. National Library of Medicine. (2002). Effects of concurrent use of alcohol and cocaine. National Institutes of Health. Retrieved January 21, 2025, from https://pubmed.ncbi.nlm.nih.gov/12133112/
- Florida Alcohol and Drug Abuse Association and Florida Behavioral Health Association. (2020). “Speed-Balling”: Mixing Stimulants and Opioids. Florida Alcohol and Drug Abuse Association and Florida Behavioral Health Association. Retrieved January 20, 2025, from https://www.mncourts.gov/mncourtsgov/media/High-Profile-Cases/27-CR-20-12646/Exhibit1708282020.pdf
- National Institute on Drug Abuse. (2011). Is it safe to use prescription drugs in combination with other medications? National Institutes of Health. Retrieved January 19, 2025, from https://nida.nih.gov/publications/research-reports/misuse-prescription-drugs/it-safe-to-use-prescription-drugs-in-combination-other-medications
- National Institute on Drug Abuse. (2021). Fentanyl Drug Facts. National Institutes of Health. Retrieved January 20, 2025, from https://nida.nih.gov/publications/drugfacts/fentanyl#ref
- California Department of Public Health. (n.d.). Signs of overdose. Retrieved February 17, 2025, from https://www.cdph.ca.gov/Programs/CCDPHP/sapb/Pages/Signs-of-overdose.aspx
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