Polysubstance Use: Definition and Dangers of Mixing Drugs

Polysubstance use is a common but dangerous practice.1 The simultaneous use of more than one addictive substance may promote the development of a polysubstance use disorder and influence the course of treatment.2

This page will cover what polysubstance use is, commonly mixed drugs, the dangers of mixing drugs, and treatment options.
What Is Polysubstance Use?

Polysubstance use is the use of more than one substance at the same time or within a short period of time.1

Using two or more drugs together may be intentional or unintentional. Some people intentionally mix drugs to:1,3

  • Enhance the effects or “high” they experience.
  • Reduce the effects of another drug.
  • Experience the effects that stem from the combination of substances.
  • Avoid withdrawal symptoms.
  • Escape from real life circumstances, traumas, or problems.

Polydrug use can also be unintentional. Street drugs are sometimes mixed or cut with other substances by drug dealers. Fentanyl is frequently mixed with drugs like heroin and cocaine because it produces a more intense high at a cheaper cost. People may take these drugs without realizing what they are consuming.4

Regardless of whether polysubstance use is intentional or unintentional, it is a dangerous practice that could lead to deadly results.1

Examples of Polysubstance Use

Many people who regularly combine more than one substance at a time struggle with two or more different substance use disorders—a situation referred to as polysubstance use disorder.

For example, nearly 60% of people with a cocaine use disorder also have an alcohol use disorder and around 35% of people with a heroin use disorder also have a prescription opioid use disorder.3

Polysubstance use can involve mixing any combination of drugs together. Common polydrug combinations include:1

  • Combining alcohol with other drugs or prescription medications, like benzodiazepines, opioids, and stimulants.
  • Mixing opioids with sedating drugs like benzodiazepines.
  • Mixing stimulants such as cocaine with opioids like heroin.
  • Mixing different stimulants, such as cocaine and Adderall.
  • Mixing prescription medications, such as taking Xanax with OxyContin.

Mixing Stimulants & Depressants

Central nervous system stimulants and depressants are two types of drugs that are often mixed together. Stimulants include substances like cocaine, methamphetamine, and prescription medications like Adderall, Ritalin, and Concerta. They are sometimes referred to as “uppers” because they can result in extended wakefulness and exhilaration.5

Depressants include substances like alcohol and benzodiazepines. They may be referred to as “downers” because they have effects like relaxation and drowsiness.1,6

Taking stimulants and depressants at the same time can cause one drug to mask certain effects of another drug. As each of the drugs may appear to have less of an effect, it could lead the person to take more of one or both. This can result in unpredictable or potentially dangerous effects and increases the risk of an overdose.1,2

People who misuse stimulants may also take depressants like benzodiazepines to help avoid certain side effects of these drugs. For example, when stimulants like cocaine are taken in large amounts, benzodiazepines may be taken in an attempt to relieve unwanted side effects like irritability and agitation.1,2,7

Dangers of Mixing Drugs or Substances

The specific dangers of mixing drugs depend on the types of drugs mixed together. However, polysubstance use can be risky because mixing drugs can:1,2

  • Lead to unpredictable effects.
  • Make the effects of the drugs more intense.
  • Increase the likelihood of polysubstance addiction development.
  • Cause an increased risk of overdose or drug toxicity and other dangerous results.

Other adverse effects of specific drug combos include:3

  • Heart issues (e.g., MDMA and cocaine; alcohol and methamphetamine).
  • Respiratory arrest (e.g., opioids and benzodiazepines; alcohol and sedatives).
  • Panic, anxiety, or psychotic symptoms (e.g., stimulant combinations).
  • Oversedation, loss of consciousness, and coma (e.g., sedating or depressant substance combos)
  • Increased risk of overdose toxicity.

Polysubstance Overdose Risks

Polysubstance use is associated with an increased risk of drug overdose. When a person takes more than one drug at the same time, the effects can be difficult to predict and, in some instances, life threatening.1,2,3  In 2021, around 106,000 Americans died from a drug overdose and many of these fatal overdoses involved polydrug use—specifically, those involving opioids.8

Possible signs of an opioid overdose include:9

  • Loss of consciousness.
  • Small or pinpoint pupils.
  • Slowed or otherwise difficult breathing.
  • Cold and clammy skin.
  • Changes in a person’s skin and nail color.

Naloxone is a medication that reverses the effects of an opioid overdose. It is available as a nasal spray or an injection. It will only work to reverse an opioid overdose, but it is not harmful, and should be administered even if you are unsure what the person took.9

Opioids like fentanyl are increasingly involved in a variety of drug overdoses, so administering naloxone in any overdose situation may be recommended.9

Naloxone is available in all 50 states. In some states, you can even get naloxone from a pharmacy without a prescription. There are also several community-based programs that provide naloxone.9 You can learn more about getting naloxone by visiting Get Naloxone Now.

Treatment Options for Polydrug Addiction

Polydrug addiction treatment may be relatively more complex than addiction treatment for one substance alone. However, effective recovery is possible with a comprehensive and potentially multi-pronged, evidence-based approach to address concurrent substance use disorders.3

People who are coming off multiple drugs often require medical detox. This is because when you are withdrawing from more than one substance, your withdrawal symptoms and timelines may vary. Some withdrawal symptoms can be life threatening.3

A medical detox program can identify your specific needs and develop a treatment plan tailored to you. This can help promote a more comfortable and safer withdrawal from a combination of substances.3

Once detox is complete, people recovering from polysubstance use disorder will benefit from additional, more comprehensive treatment. While detox focuses on helping support you through the withdrawal process, addiction treatment gives you the tools you need to maintain your recovery.3

Polysubstance Addiction Treatment at Desert Hope

Desert Hope Treatment Center offers several types of addiction treatment at both its outpatient facility and its inpatient rehab facility in Las Vegas. The medical detox program at Desert Hope provides a safe and comfortable withdrawal experience.

The first step in the detox process at Desert Hope is an evaluation by the treatment team, followed by stabilization. During this phase of detox, medical staff will closely monitor withdrawal symptoms and provide medications, if necessary, to relieve symptoms and reduce the risk of medical complications.

Once detox is complete, our treatment team can assist you in transitioning to another level of treatment. Our inpatient drug treatment program allows you to temporarily stay in our facility while attending daily therapy and groups. We offer amenities like a fitness center, mindfulness spaces, and biofeedback chairs.

We also offer intensive outpatient and partial hospitalization programs. These programs allow you to participate in treatment at our facility several days a week. People who participate in our outpatient programs may live at home or at Resolutions—Desert Hope’s nearby sober living facility.

Please remember, polysubstance use is treatable. Reach out today for the help you deserve. Our compassionate team is here for you.

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