It is not just abuse of prescription painkillers, synthetic drugs, heroin, and marijuana that is responsible for the spike in substance use disorders, accidents under the influence, and overdose.
According to NPR, polydrug abuse, or the use and abuse of drugs in combination, is very often the issue facing people in need of treatment and a significant driving force behind overdoses in many cases.
In Massachusetts during the first half of 2014, for example, most of the deaths caused by overdose were due to the use of either heroin or a prescription painkiller used in combination with alcohol or another illicit substance. An analysis done by the Harvard T.H. Chan School of Public Health reported that, in Massachusetts:
- Heroin played a role in 39 percent of overdose deaths.
- Fentanyl was used in 37 percent of overdoses.
- Cocaine use was detected in 23 percent of overdose deaths.
- Alcohol use played a role in 19 percent of deaths caused by overdose.
- Benzodiazepines were cited in 13 percent of overdoses.
What is driving polydrug abuse, and how can we stop the problem from taking more lives in the future?
The analysis revealed that fentanyl was very often a culprit in multi-drug overdose deaths, especially when it was combined with heroin or opiate prescription drugs. In some cases, it is a problem caused by recreational use, and in other cases, it is an issue triggered by a patient having prescriptions for drugs that do not work well together. For example, a prescription for methadone either for chronic pain management or treatment for painkiller detox in combination with a benzodiazepine prescribed for anxiety can too easily be fatal since both drugs can suppress breathing.
The results of the analysis have led doctors to carefully consider the medications they prescribe in combination to patients. Dr. Jim O’Connell is the president of the Boston Health Care for the Homeless Program. He says that he often will ask clients which medications are being used recreationally on the street and purposefully tries to avoid prescribing those drugs.
Says Dr. O’Connell: “We, as doctors, don’t really have a good sense of what we should be prescribing, what we shouldn’t. It’s really the combination of other drugs that is going to be the battle down the line.”
Emergency Medical Care
Not only do certain combinations of substances create a synergistic effect in the user that can easily be overwhelming, but an overdose caused by multiple substances is not necessarily easy to treat. Doctors may not be able to determine which drug is causing the overdose and address the issue in time. For example, the drug naloxone can be effective in arresting the effects of an opiate overdose triggered by heroin or prescription painkiller abuse but will not necessarily be helpful if the person abused both an opiate drug and a sedative like Ativan or Xanax. Multiple causes can make it more difficult to stabilize people in overdose and save their lives.
Reaching out for Treatment
For those who struggle with polydrug abuse or addiction, the good news is that treatment can be extremely effective just as it is for those who are living with a dependence upon a single substance. It’s important that the many issues driving use of all substances are all addressed during treatment. Comprehensive care should include:
- Full evaluation at the onset of treatment
- Personalized care plan based on the results of the evaluation, the client’s past history in addiction and treatment attempts, and the client’s goals for the future in recovery
- Detox and medical care as needed until the client is stable in recovery
- Traditional therapies like one-on-one therapy and group therapy
- Alternative therapies (e.g., dance therapy, art therapy, outdoor and adventure therapy, etc.) according to the needs and interests of the client
- Holistic treatments to reduce overall stress levels and increase focus on health and wellness (e.g., nutritional therapy, working with a life coach, yoga, etc.)
- Flexibility in terms of how long the client may stay in treatment
- Treatment for co-occurring mental health issues that may exacerbate drug use and addiction (e.g., depression, anxiety, eating disorders, etc.)
- Long-term support and aftercare once treatment is complete
How Families Can Help
If someone you love is struggling with polydrug abuse, you can help the person move closer to getting treatment that will empower a life of balance and stability in recovery. Treatment is key, and if drug use has long been a problem, it is unlikely that your loved one will be able to simply stop all drug use without professional help. In fact, the inability to stop drinking or using drugs despite attempting to do so is a diagnostic criterion for an addiction disorder.
Unfortunately, it is also indicative of addiction that the person struggling with the problem will be in denial. That is, your loved one may not be willing to discuss or even consider the option of treatment. This is not an insurmountable issue, however. Millions of families help loved ones who are resistant to treatment to get help by staging interventions and learning how to remove support of the addiction and increase support for positive change.