Polysubstance abuse is a particularly dangerous form of drug use. What is polysubstance use, why is it so risky, and what happens if a person can’t stop?

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What Is Polysubstance Abuse?

Polysubstance abuse refers to misusing multiple drugs, either simultaneously or within a short period of time.

A common example of this behavior is drinking alcohol while also using cannabis (marijuana).

Two common reasons why people intentionally engage in polysubstance use are to intensify the drugs’ effects or to offset certain effects:

• Intensifying: The example cited above (combining alcohol and marijuana) would fall into the “intensification” category. Alone, either alcohol or marijuana can cause effects such as elevated mood, diminished stress, and lowered inhibitions. Someone who uses both drugs at the same time may be hoping to achieve these effects sooner or experience them more deeply.
  
• Offsetting: One example of intentional polysubstance abuse for the purpose of offsetting some effects is using prescription pills or other opioids in addition to using cocaine. Like alcohol, opioids also slow the functioning of the central nervous system. This causes effects such as drowsiness and diminished responsiveness. To reduce the intensity of these effects, a person may also use cocaine or another stimulant.

As we will discuss in greater detail later in today’s post, intentional polysubstance abuse is never a good idea, regardless of which drugs a person is using or why they are combining them

In addition to the intentional reasons for polysubstance abuse, some people may ingest two or more drugs without even realizing what they’re doing. 

For example, due to the relative ease of synthesizing, storing, and transporting fentanyl, many illicit drug manufacturers have been adding this powerful opioid to other drugs as a way to boost their effects (and increase their profits). However, the people who buy and use these drugs are often not aware that they also contain fentanyl.

According to a November 2023 report in the journal Drug and Alcohol Dependence, an analysis of 718 samples of methamphetamine and cocaine revealed that 12.5% of the meth samples and 14.8% of the cocaine samples also contained fentanyl.

Regardless of why polysubstance abuse happens, using multiple drugs at the same time can expose you to considerable harm.

Which Drugs Do People Usually Combine?

There is no limit to what types of drugs (or how many drugs) a person may use at the same time, but some combinations occur more often than others. Common examples of polysubstance abuse include:

• Alcohol and marijuana
• Alcohol and cocaine
• Alcohol and opioids
• Alcohol and benzodiazepines
• Cocaine and opioids
• Opioids and benzodiazepines
• Stimulants and benzodiazepines

What Are the Dangers of Polysubstance Abuse?

The many dangers of polysubstance abuse include magnified symptoms, risk of addiction, and threat of overdose.

Magnified Symptoms

Any type of recreational substance use can cause unexpected effects. In cases of polysubstance abuse, the risk of something unwanted occurring can increase considerably.

One of the more serious dangers involves magnified symptoms. 

For example, both alcohol and opioids cause drowsiness, impaired coordination, slowed reaction times, and diminished cognition. If a person has both substances in their system at the same time, these types of effects can become much more pronounced. 

In addition to the threat of overdose, these magnified symptoms can raise a person’s risk for physical injuries due to slips, falls, and automobile accidents. They can also make a person more susceptible to being victimized by others due to their drug-induced vulnerability.

Risk of Addiction

The continued use of virtually any mind-altering drug can put a person in danger of developing a substance use disorder (addiction). As highlighted by a June 2020 review article in the journal Frontiers in Neuroscience, polysubstance abuse can amplify this danger:

• Experts estimate that more than one in 10 people who meet the criteria for a diagnosis of a substance use disorder (11.3% of this population) are addicted to both alcohol and another drug.
• Alcohol abuse doubles a persons risk of becoming addicted to heroin.
• Cannabis use triples the risk of heroin addiction, while people who use cocaine are 15 times more likely to develop an addiction to heroin.
• Among people who receive professional care for an addiction, those with histories of polysubstance use are less likely to remain in treatment and more likely to relapse. 

Threat of Overdose

Fentanyl has been accurately identified as a prime contributor to the nation’s ongoing overdose epidemic, but polysubstance abuse has also played a role.

According to data provided by the National Institute on Drug Use (NIDA):

• In 2023, the U.S. recorded 105,007 drug overdose deaths. 
• About 41,000 overdose deaths that year – or around 39% of the total – involved fentanyl along with cocaine or another psychostimulant (such as amphetamine or methamphetamine).
• About 7,600 overdose deaths involved fentanyl and benzodiazepines
• About 7,000 overdose deaths involved fentanyl and prescription painkillers
• About 3,100 overdose deaths involved fentanyl and heroin
• About 2,800 overdose deaths involved fentanyl and antidepressants

Signs of overdose can vary depending on which drugs a person has been using, but common indicators include:

• Profound confusion or disorientation
• Abnormal heart rate
• Slow, shallow, or labored breathing
• Loss of consciousness and inability to be awakened
• Making gurgling or snoring sounds
• Skin that is cool and clammy to the touch
• Blue or purple coloring of skin near lips and fingertips

If a person has overdosed on fentanyl or another opioid, administering Narcan may be able to reverse the overdose effects. But Narcan does not have an impact on the effects of other drugs. 

This is another reason why polysubstance abuse can be particularly dangerous. If a person has both opioids and non-opioids in their system, even if they are revived with Narcan, they may still be at risk of significant damage from the other drugs.

This is why it is so important to call 911 when you are with a person who overdoses, even if you have Narcan and it appears to work. Anyone who overdoses on any substance or substances must be evaluated by a qualified professional to ensure that aren’t still in danger.

Find Treatment for Polysubstance Abuse in Atlanta

Compulsive polysubstance abuse can lead to devastating outcomes. But when a person gets appropriate help from a reputable addiction treatment provider, they can safely rid their bodies of these dangerous substances and learn to live a much healthier life in recovery.

To learn more about polysubstance abuse treatment in Atlanta, or to schedule a free assessment at Buckhead Behavioral Health, please visit our Admissions page or call us today.