What is Polysubstance Abuse?

Polysubstance use is the use of two or more drugs simultaneously or within a short timeframe. A person can become addicted to the heightened effects of combined drugs when polysubstance abuse occurs.

Combining drugs is unsafe because it can cause unpredictable and more potent results. We will explore what polysubstance abuse is and how you can seek treatment for someone with polysubstance abuse disorder.

What is Polysubstance Abuse

Types of Polysubstance Use

Polysubstance abuse can either occur intentionally or unintentionally.

Intentional polysubstance use happens when someone combines two or more drugs to either strengthen the impact of the first drug or mix their effects for a unique experience.

Intentional polysubstance use also occurs when patients receive multiple prescriptions from their doctors. Each drug may treat a specific health condition, or the second drug counteracts the first drug’s side effects. These drugs can have negative consequences if you use them beyond what your doctor prescribed or combine them with other drugs.

Unintentional polysubstance abuse occurs when someone uses drugs without realizing they are mixed with other substances. For example, sometimes drug dealers will mix fentanyl in the drug to increase its potency while cutting their costs in drug production.1

All types of polysubstance use are dangerous and associated with health risks.2

Signs and Symptoms of Polysubstance Abuse and Addiction

Polysubstance abuse is when a person uses multiple legal substances different from their intended use. Here are several examples of polysubstance abuse.

  • Using illegal substances
  • Taking prescribed medications different than their doctor prescribed
  • Using another person’s medications
  • Increasing their dosage of prescription medications

When a person abuses drugs regularly, they are at risk of addiction. The following are common signs of polysubstance addiction.3

  • You have a greater tolerance to drugs and need more to achieve the same effects.
  • You take prescription drugs more than you need them.
  • When you don’t take the drugs, you feel withdrawal symptoms, such as headaches, fevers, seizures, nausea, and depression.
  • You continue to use the drugs even when they negatively impact your family, social, work, and school lives.
  • You often think about the drugs and plan for getting more.
  • You lose interest in activities you used to enjoy and have trouble performing daily tasks.
  • You do dangerous activities while under the influence of the drug.
  • Your health begins to change, such as new sleeping patterns, gained or lost weight, and bloodshot eyes.
  • You try to hide your drug use.

You might be able to identify polysubstance abuse in a loved one if they exhibit several of the following signs.

  • Increased lethargy, irritability, confusion, and agitation
  • Changes in their personality, behavior, friends, and routine
  • Less attention to their hygiene
  • Bloodshot eyes and bloody noses
  • Shakes, tremors, and slurred speech
  • Unexplained financial problems or regular need for more money without an explanation

Risk Factors for Polysubstance Abuse

Your risk of polysubstance abuse increases if you are already addicted or abusing drugs. You are also at greater risk if you have a mental health issue such as depression, attention deficit disorder, or post-traumatic stress disorder.3

However, these risk factors do not mean someone will develop an addiction. With proper support and awareness, individuals can safeguard themselves against polysubstance abuse. If you notice signs and symptoms in yourself or a loved one, early treatment will help decrease the severity of your withdrawal.

Common Combinations for Polysubstance Abuse

Over 250 lives are lost every day in America due to drugs, and about half of them involve the use of multiple drugs. We will look at some of the most common combinations of drugs and their risks.4

Using Multiple Stimulants

Stimulants increase your heart rate and blood pressure. When you combine them, they increase their effects which may elevate your rates to a dangerous high, potentially resulting in brain injury, liver damage, heart attack, or stroke.

Some examples of stimulants include:

  • Ecstasy
  • MDMA
  • Cocaine
  • Methamphetamines
  • Amphetamines

Some signs of polysubstance overdose with stimulants include:

  • Fast breathing and pulse
  • High body temperature
  • Nausea and vomiting
  • Chest pains
  • Tremors and seizures

Using Multiple Depressants

Depressants decrease your breathing and heart rate. Combining them also increases their effects, which can result in brain damage, organ damage, and death.

Some examples of depressants include:

  • Opioids like heroin, morphine, oxycodone, hydrocodone, and fentanyl
  • Benzodiazepines

Some signs of polysubstance overdose with depressants include:

  • Slow breathing
  • Weak pulse
  • Confusion
  • Unconsciousness or fainting

Mixing Stimulants and Depressants

When you combine stimulants and depressants, your results are far more unpredictable. You might even have a more difficult time seeing side effects as the drugs can mask the effects of each other. Nevertheless, they are equally, if not more, dangerous than taking each drug on its own.

Combining Drugs with Alcohol

Alcohol is a depressant and the most common type of substance involved in use disorder.5 Many people use alcohol along with other drugs, like using cocaine with alcohol.

Combining drugs with alcohol increases your risk of overdose and can result in severe brain damage, heart damage, and organ damage.

Combining Drugs with Nicotine

Nicotine is also one of the most used addictive substances. According to previous studies, when you use it along with other drugs, you are more likely to increase your use of both. For example, one study showed that 80-90% of those with an alcohol use disorder also smoke cigarettes.6

Combining Prescription Medications

Prescription medications still put you at risk for overdose if you don’t take them as directed by your doctor. You should never combine them with other prescriptions without your doctor’s approval or combine them with illegal and street drugs. Always let your doctor know all the drugs you currently take so they can adjust your prescription accordingly to prevent any of the previously discussed side effects.

If you or a loved one is experiencing signs or symptoms of a polysubstance overdose, call 911 immediately.

How to Treat Polysubstance Abuse

Treatment is possible and effective if you invest yourself in addressing both the use of substances and any underlying causes such as mental health problems, stress, negative influences, and triggers. Treatment begins after you detox your body from the substances, then you can receive care and support to help you achieve long-term freedom.

Each person’s treatment journey will differ depending on the substances they use, length of abuse, cause of substance use, and investment in the treatment.7

Step 1: Detox

Your first step is to detox from the substances you use. During this stage, you will clear your body from all the drugs while trained professionals help you manage your withdrawal symptoms by keeping you comfortable and monitoring you for any adverse or life-threatening reactions to withdrawal. Monitoring for polysubstance abuse is critical as your symptoms tend to be more unpredictable than people who are detoxing from a single drug.

During detoxification, medical professionals may use medications to ease the symptoms. Your medications will vary depending on your withdrawal symptoms and the types of drugs you use.

Step 2: Treatment

Patients can choose from inpatient and outpatient polysubstance abuse treatment. During their treatment, medical professionals can also address any underlying conditions and health issues contributing to their addiction.

Inpatient treatment allows patients to stay at a facility for 24/7 monitoring during their treatment process. It is ideal for those with more extreme cases of addiction as they have consistent support during their treatment. Most patients with polysubstance abuse disorder should consider inpatient care as their treatment is more complex than those with only one drug in their system.

Outpatient care allows a patient to stay at home and continue some of their routine such as attending school or working. They will then return to a facility for regular treatment and support. This type of care can take longer to treat because you aren’t fully immersed in a program. It also puts you at greater risk of coming across triggers that increase your chances of using drugs again. However, it is ideal for those with responsibilities they cannot leave for an extended period.

Step 3: Aftercare and Ongoing Support

Once you receive treatment, you can receive aftercare and support, which helps you remain sober for long-term success. Some examples of ongoing support include:

  • Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) groups
  • Sober living homes
  • Step-down care
  • Support groups

Get Addiction Help Today

Are you or a loved one is showing signs of polysubstance abuse or addiction?

Our treatment facility in Palm Springs, California is here to support you every step of the way until you achieve long-term recovery.

Call us today to learn more about our treatment facility and how we can help you achieve a more fulfilling life through recovery.

Frequently Asked Questions about Polysubstance Abuse

What is polysubstance abuse?

Polysubstance abuse is the misuse of two or more substances. It can be intentional, such as combining prescription medications or illicit drugs, or unintentional, like when you take a drug that was mixed with a second drug.

Is alcohol counted in polysubstance use?

Alcohol is counted in a polysubstance abuse diagnosis. Any substance that is addictive can contribute to polysubstance abuse and should never be combined.

What qualifies as substance abuse?

Substance abuse is using drugs outside of their intended use in the case of prescription medications or using any illegal substances. When someone regularly abuses drugs, they are at risk of drug addiction.

How is polysubstance abuse treated?

Treatment for polysubstance abuse is similar to regular drug abuse treatment. You will go through stages of detox, treatment, and aftercare. However, the use of multiple substances results in more unpredictable symptoms and requires increased monitoring and involved treatment.


1. United States Drug Enforcement Administration. (n.a.). Facts about Fentanyl. DEA. https://www.dea.gov/resources/facts-about-fentanyl

2. Connor JP, Gullo MJ, White A, Kelly AB. (2014, July 27). Polysubstance use: diagnostic challenges, patterns of use and health. Curr Opin Psychiatry. https://pubmed.ncbi.nlm.nih.gov/24852056/

3. NIH Library of Medicine. (2020, May 10). Substance Use Disorder. MedlinePlus. https://medlineplus.gov/ency/article/001522.htm

4. Centers for Disease Control and Prevention. (2021, July 19). Polysubstance Use Facts. Stop Overdose. https://www.cdc.gov/stopoverdose/polysubstance-use/index.html

5. National Institutes of Health. (n.a.). Alcohol. National Institute on Drug Abuse. https://www.drugabuse.gov/drug-topics/alcohol

6. Kohut SJ. (2018, March 1). Interactions between nicotine and drugs of abuse: a review of preclinical findings. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602608/

7. NIDA. (2019, January 17). Treatment Approaches for Drug Addiction DrugFacts. https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction


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