Polysubstance Abuse

Man about to inject an illicit drug with a shot of liquor on the table

While abusing substances on their own is very risky, combining substances is even more dangerous and can be deadly. Polysubstance use often includes prescription and/or illicit substances as well as alcohol. Those using multiple substances are at high risk for negative drug reactions and overdose.

What is Polysubstance Abuse?

Polysubstance abuse is characterized by the misuse and abuse of more than one drug at the same time, and includes an addiction to intoxication, rather than to specific substances. Although polysubstance abuse is a serious condition, the reasons that it develops are not clear. There may be biological risk factors for polysubstance use, as well as psychological conditions that can increase the risk of addiction. Social or cultural norms can also be associated with polysubstance abuse.

Signs and Symptoms of Polysubstance Abuse

There is some evidence that polydrug use may be more common in certain subcultures, like people who attend raves or festivals, compared with people with specific substance use disorders. However, there are various risk factors associated with polysubstance abuse, including youth, unemployment and childhood trauma.

The signs and symptoms of polysubstance abuse may look different than single drug use. This is because multiple drugs can interact with each other to have a different effect. These can include:

  • Drug seeking behavior
  • Aggression
  • Self-harm
  • Aggravation if they are unable to access one or more kinds of drugs
  • Risk taking behavior

The criteria for a diagnosis of polysubstance abuse or addiction usually includes an addiction to being in an altered or intoxicated state, without a clear preference for type of substance.

Types of Polysubstance Abuse

Type of polysubstance abuse may vary depending on the group of people, age, or other psychiatric conditions. For example, research has shown that around 8% of 10th graders used multiple substances, usually including marijuana, alcohol and prescription medications in the past year.

In the United States, there has also been an increase in combining prescription medications and alcohol. However, there are no clear subtypes of polysubstance abuse, and people who use multiple substances may combine stimulants, benzos, opioids, alcohol or other substances at different times.

Dangers of Polysubstance Abuse

A key danger of mixing drugs is that multiple substances can have an additive effect on the central nervous system. This means that the impact of each drug compounds on top of the others, and it can be too much for the body to handle. Mixing prescription or illicit drugs can include consequences to physical and mental health.

Physical Dangers

The physical dangers of combining various drugs can include difficulty breathing, non-responsiveness and overdose. Drugs can act on the central nervous system and the combined effects can disrupt functions required to live. These side effects can also have a permanent impact on physical health.

Psychological Dangers

Combining drugs can increase the risk for drug abuse and addiction. In addition, if a person is self-medicating for a psychiatric condition by taking multiple substances, their symptoms may worsen. Mixing some drugs may also produce psychological problems like hallucinating or other psychotic symptoms. Polysubstance abuse can make existing mental health problems worse, or introduce new symptoms altogether.

Treatments for Polysubstance Abuse

There are many treatments available for polysubstance abuse. The most suitable type of treatment or drug treatment center can depend on the types of substances used and the severity of illness.

Treatment for drug abuse will often include medical detox as a starting point to clear drugs out of the system. This can be followed by inpatient or outpatient treatment, and patients usually attend long-term therapy or meetings to support their recovery. Different approaches or combinations will work for different people.


Prescription medications are sometimes used to help treat polysubstance abuse. This may not always be appropriate, particularly if someone has been abusing prescription medications. However, opioid replacement therapy, often referred to as methadone treatment may be a useful treatment strategy. This can help reduce cravings and minimize withdrawal symptoms and risks.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) for substance use disorders can be an effective way to address underlying thoughts, beliefs and experiences related to substance abuse. CBT involves identifying thoughts and behaviors, re-evaluating and changing thought and behavior patterns. CBT is conducted with a psychiatrist over a number of sessions, and involves implementing new strategies in real-world situations.

Asking for help for for polysubstance abuse is an important first step in recovery. There are many treatments available that can be tailored to meet your needs. Contact The Recovery Village Ridgefield today to discuss treatment options available.

Ogbu, Uzor C et al. “Polysubstance abuse: alcohol, opioids and benzodiazepines require coordinated engagement by society, patients, and physicians.” The western journal of emergency medicine, 2015. Accessed August 31, 2019.

Connor, Jason P. “Polysubstance use: Diagnostic challenges, patterns of use and health.” Current Opinion in Psychiatry, July 2014. Accessed August 31, 2019.

Conway, Kevin P et al. “Prevalence and patterns of polysubstance use in a nationally representative sample of 10th graders in the United States.” The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2013. Accessed August 31, 2019.

Martinotti G, Carli V, Tedeschi D, et al. “Mono- and polysubstance dependent subjects differ on social factors, childhood trauma, personality, suicidal behaviour, and comorbid Axis I diagnoses.” Addictive behaviors, 2009. Accessed August 31, 2019.

Borschmann R, Winstock AR. “Polysubstance use, mental health and high-risk behaviours: Results from the 2012 Global Drug Survey.” Drug Alcohol Rev. July 2015. Accessed August 31, 2019.

Schulden, Jeffrey D et al. “Substance abuse in the United States: findings from recent epidemiologic studies.” Current psychiatry reports, October 2009. Accessed August 31, 2019.

Food and Drug Administration. “FDA Drug Safety Communication: FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines; requires its strongest warning.” September 2017. Accessed August 31, 2019.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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