Most people are familiar with substance use disorders, where an individual is addicted to a particular substance, such as alcohol or prescription opioids. Many people are also aware that substance addictions can occur simultaneously with mental health disorders like depression or anxiety. Yet, many people are not as familiar with polysubstance abuse, also called polysubstance use disorder, which is when someone uses more than one substance simultaneously.
What Is Polysubstance Abuse?
Polysubstance abuse is using two or more substances simultaneously or within a short period of each other. Just like substance use disorders, people who practice polysubstance abuse eventually develop substance dependence and addiction.
Furthermore, some people will intentionally use multiple substances either to enhance their effects or in the belief to mitigate negative effects. On the other hand, polysubstance abuse can also be unintentional when the person has no idea they are using multiple substances. For example, they believe they are using pure heroin, but it was mixed with fentanyl.
In many cases, people with polysubstance use disorder generally have a primary preference for one substance but do not have a preference over other substances. For example, a person may have a preference for alcohol and will combine it with cocaine, Molly, or another easily obtainable substance.
How Common Is Polysubstance Abuse?
Polysubstance abuse is quite common as people intentionally and unintentionally use multiple substances. A study conducted in 2018 about the prevalence of polysubstance use reported the following:
- 13.8% of participants reported multiple substance use
- 7.4% reported they frequently used two substances
- 6.4% reported they regularly used three or more substances
- 63.6% reported alcohol and multiple substance use
- 73.8% reported marijuana and multiple substance use
- 87.5% reported prescription opioid and multiple substance use
- 90.2% reported cocaine and multiple substance use
- 93.8% report heroin and multiple substance use
What Are the Causes of Polysubstance Abuse?
The precise cause of polysubstance abuse is not fully understood. However, research suggests it is related to the effects experienced when combining two or more substances. Specifically, substance use triggers the release of neurotransmitters in the brain, such as dopamine and serotonin, which can make people feel relaxed, calm, happy, and even euphoric.
The brain remembers these feelings and sensations as positive behaviors, reinforcing continued polysubstance use. Other factors that can encourage polysubstance use include:
- Attempting to achieve the desired effect of another substance that is not available
- Attempting to enhance the effects of the primary substance
- Attempting to balance or counteract the effects of the primary substance
- Mixing substances to alleviate withdrawal symptoms
- Using multiple substances to enhance or prolong a substance “high”
- Attempting to cut back on one substance by mixing it with another
- Having an existing substance use disorder
- Having a family history of substance use disorders, polysubstance use disorders, or mental health disorders
- Having unresolved trauma
- Having easy access to substances
- Being exposed to substances at an early age
- Having experienced neglect, trauma, or abuse as a child
Signs and Symptoms
The signs and symptoms of polysubstance use disorders will vary depending on which substances are being used together. The signs and symptoms are also affected by the frequency of use, duration of use, and amount used.
Physical Signs
The physical signs of regular polysubstance use can result in the following:
- Increased tolerance: Needing to use higher amounts of the substances to achieve the desired effects
- Withdrawal symptoms: When the substances wear off, withdrawal symptoms like nausea, vomiting, headaches, and diarrhea occur.
- Changes in weight: Some substances cause noticeable weight loss, while others can cause weight gain
- Changes in eating patterns: Some substances stimulate the appetite while others suppress it
- Increased risk-taking: People under the influence can engage in risky behaviors, like unprotected sex with multiple partners or driving a car
- Increased risk of overdose: As tolerance continues to increase, the risk of overdose also decreases
- Health problems: Various substances can cause different types of health problems, such as liver damage, seizures, and increased risk of cancer, heart attack, and stroke.
Psychological Signs
The initial psychological signs could include the following:
- Euphoria
- Happiness
- Overly excited
- Overly energetic
- Relaxed
- Calmness
- Talkative
- Reduced social inhibitions
However, once the substances begin to wear off, people can experience these psychological withdrawal symptoms:
- Mood swings
- Anxiety
- Depression
- Anger/hostility
- Agitation
- Irritability
- Sleep disturbances
- Difficulties concentrating and focusing
Social and Emotional Signs
The social and emotional signs of polysubstance use disorders could include:
- Withdrawing from friends and family
- Attempting to hide one’s substance use
- Neglecting personal responsibilities in favor of polysubstance use
- Inability to control or cut back on polysubstance use
- Relationship problems
- Associating with other polysubstance users
- Difficulties maintaining employment
- Neglecting personal hygiene
- No longer finding pleasure in hobbies and activities previously enjoyed
- The development of a co-occurring mental health disorder, such as anxiety or depression
- Need to use multiple substances just to function
Dangers of Polysubstance Use
The two primary dangers of polysubstance use are the increased risk of accidental overdose and death. Other potential dangers include:
- Heart attack
- Heart failure
- Stroke
- Organ damage
- Respiratory failure
- Development of mental health disorders
- Impaired cognitive functioning
Treatment Options for Polysubstance Abuse
Treating polysubstance use disorders involves using a combination of evidence-based and holistic therapies and medication-assisted treatment as part of a comprehensive addiction treatment program, which could include:
- Detox: Detox is the first step to overcoming polysubstance use addiction. It requires ridding the body of the substances while under medical supervision. Detox incorporates various therapies and medications, where appropriate, to help manage withdrawal symptoms.
- Residential treatment: For severe polysubstance abuse, residential treatment may be recommended after completing detox. This level of care provides intensive and structured treatment with 24/7 support. It is also recommended for people without a strong support system outside treatment.
- PHP: A partial hospitalization program provides the same intensive and structured treatment as residential treatment. However, participants are allowed to return home in the evenings.
- IOP: An intensive outpatient program is a step down from a PHP. It provides intensive treatment and therapy sessions for several hours daily. Participants have more flexibility to maintain personal commitments outside treatment.
- Outpatient treatment: Outpatient treatment is the lowest level of care and provides continued support, therapy, and treatment as people fully integrate back into their normal daily routines. In addition, treatment sessions are generally held several times weekly.
Contact Renewal Health Group to Start Treatment Today
Are you ready to take control of your polysubstance abuse addiction? Renewal Health Group offers comprehensive polysubstance addiction treatment tailored to your specific needs in California. Our caring and support team of addiction professionals works with you to help you overcome addiction, develop effective coping skills, and reduce the risk of relapse. Contact us today to start your recovery journey to a brighter, substance-free future.
Published: 3/10/2025
