Polysubstance Addiction: Definition, Causes, Signs, Effects, And Treatment Methods.

Polysubstance addiction is a form of substance use disorder where people combine various forms of drug intake. Polysubstance abuse includes the usage of at least two or more forms of stimulants, depressants, and other drugs.

The causes of polysubstance addiction include self-medication, peer pressure, enhancing effects, environmental factors, psychological factors, genetic predisposition, and mental health issues.

The signs and symptoms of polysubstance abuse include a change in behavior or personality, neglect of responsibilities, losing interest, irritability, secretive behavior, visible intoxication, stealing money to buy drugs, lying for prescriptions, and social withdrawal.

Common effects of polysubstance abuse include breathing problems, increased body temperature, nausea, chest pain, seizures, weak pulse, slow breathing, confusion, change in brain chemistry, death, enhanced sensory perception, mood swings, overdose, heart problems, liver issues, brain injuries, and internal bleeding.

The treatment methods for polysubstance addiction include detoxification, cognitive behavioral therapies, medication, long-term rehabilitation programs (in-patient/ out-patient), support groups, and aftercare.

What is Polysubstance Addiction?

Polysubstance addiction refers to the continuous use of multiple drugs at the same time. Numerous drugs are often consumed simultaneously to control the dosage of a particular drug. Polysubstance addiction is either intentional or unintentional, as per the CDC. Intentional misuse of substances happens when multiple drugs are taken together to regulate or enhance the effect of a drug. However, unintentional polysubstance abuse occurs as a result of taking drugs mixed with other substances with no prior knowledge of them.

How common is Polysubstance addiction?

Polysubstance abuse is very common because the study titled “National Epidemiologic Survey on Alcohol and Related Conditions (2001-2002)” revealed that almost 5.6% of adults in the US took both alcohol and drugs in that year. Nicotine and alcohol intake is most common during combined use with drugs and stimulants.

What are the causes of Polysubstance addiction?

The 7 causes of polysubstance addiction include self-medication, peer pressure, enhancing effects, environmental factors, psychological factors, genetic predisposition, and mental health issues.

The causes of polysubstance addiction are listed below:

• Self-medication: Self-medication is the identification and selection of medicines by individuals themselves to treat conditions they know about. Self-medication leads to the mixing up of medications and eventually substance misuse. Self-medication is a common cause of irrational and excessive use of drugs according to a study published on Social and Administrative Aspects of Pharmacy in Low- and Middle-Income Countries (2018) by Mukhtar Ansari. Unsupervised intake leads to severe consequences of substance misuse.

• Peer Pressure: Peer pressure is the impact an individual has on their behavior and activities based on their social interactions. Adolescents' engagement with activities related to substance abuse is highly connected with peer pressure, as discussed in a study on “Family Process and Peer Influences on Substance Use by Adolescents”. The onset of drug addiction here leads to the involvement of multiple substances, resulting in polysubstance addiction.

• Enhancing effects: Enhancing effects refer to the increased sensation of drug toxicity in the body. Drugs in varying forms often affect the same brain receptors, thus leading to a prolonged euphoric state. The use of cocaine with alcohol intake leads to an enhanced and prolonged euphoric state according to a study by E. Jane Marshall on Multiple substance use (2006). The increased sedative effect is a common cause of polysubstance addiction.

• Environmental factors: Environment factors include the situations a person regularly experiences within their surroundings. Family dynamics, social behaviors, and media exposure are some of the main environmental factors leading to substance misuse. Societal behaviors are highly linked to the onset of drug addiction, according to a study on “The Genetic and Environmental Bases of Addiction”, by Reid. This is a major cause for individuals leaning towards polysubstance addiction.

• Psychological factors: Psychological factors include mental and emotional triggers like stress, traumas, or illness. People suffering from psychological issues like stress, PTSD, anxiety, and depression often lean towards substance abuse as a source of relief, according to research on the Interplay of Psychosocial Factors and the Long-Term Course of Adolescents with a Substance Use Disorder. The need for relief leads to the desire to take multiple drugs together for enhancement and becomes a leading cause of polysubstance abuse.

• Genetic factors: Genetic makeup is the inherited traits passed on through the family bloodline. People with a history of drug abuse within the close family are more likely to be addicted to drugs. Genetic factors like a person's metabolic ability have a greater influence on managing drug dosage through multiple substance misuse, according to a study on Genes matter in addiction.

• Mental health issues: Mental health issues include diseases like depression, anxiety, bipolar disorder, etc. that disrupt an individual's daily life. People suffering from mental health disorders are likely to cope with the condition with the usage of multiple drugs, as per SAMHSA.

What are the signs and symptoms of polysubstance abuse?

The 9 signs and symptoms of polysubstance abuse include a change in behavior or personality, neglect of responsibilities, losing interest, irritability, secretive behavior, visible intoxication, stealing money to buy drugs, lying for prescriptions, and social withdrawal.

The common signs and symptoms of polysubstance abuse are listed below:

• Change in behavior and personality: Polysubstance abuse leads to a significant change in behavior. People withdraw from social gatherings, start being secretive, or look for ways to collect more money for drugs.

• Neglect of responsibilities: Individuals engaged in polysubstance addiction are usually neglectful of their responsibilities. They tend to forget or ignore the activities they were supposed to be taking care of.

• Losing interest: Losing interest in the things and activities that once intrigued the affected person is a common sign of substance abuse. Polysubstance addiction causes a person to give up various aspects of life.

• Irritability: Polysubstance addiction leads to mood swings and constant irritable behavior. The withdrawal situation often leads to a heightened irritable mood that impacts a person's routine activities.

• Secretive behavior: Polysubstance addiction makes people secretive as they want to avoid others knowing about this activity. They find ways to engage in substance abuse in a way that no one knows about.

• Visible intoxication: Polysubstance abuse intoxication is often visible in physical appearance. Red eyes, puffy face, and shaky hands are common indicators of polysubstance addiction.

• Stealing money to buy drugs: Drug addiction can lead to financial instability. As a result, people suffering from polysubstance addiction find other means of gathering money to fulfill their needs. Stealing becomes common in this scenario.

• Lying for prescriptions: Common drugs like opioids and stimulants are often provided for treatment upon an expert’s prescription. People with polysubstance addiction usually lie to access the drugs through prescriptions.

• Social withdrawal: People suffering from polysubstance abuse usually tend to stay away from social interactions. They are more comfortable confined in a personal space. Social withdrawal is often due to fear of judgment or being caught.

What are the common drug combinations and their effects? 

The common drug combinations include mixing stimulants, mixing depressants, mixing stimulants and depressants, and mixing alcohol with other drugs.

These are the common drug combinations and the impact they have:

Mixing stimulants:

Mixing stimulants like cocaine, crystal meth, and nicotine can have serious effects on the brain and body. Here are some effects of mixing stimulants:

• Breathing Problems: Stimulants are known to lower breathing rates. Mixing multiple stimulants together enhances the effects and leads to higher risks of increased breathing problems.

• Increased body temperatures: Combining stimulants like ecstasy, cocaine, and opiates is likely to increase body temperature to a concerning level. Mixing stimulants leaves the body in a thirsty and burning state, as per a study in “Handbook of Clinical Neurology”.

• Nausea: Polysubstance misuse is known to have impaired digestive tract effects. Mixing stimulants amplifies the associated risks and leads to increased nausea.

• Chest pain: Cardiovascular disease risk increases with the intake of drugs. Mixing stimulants enhances the risk and chest pain becomes a common symptom. The use of fentanyl and heroin together leads to a higher risk of cardiovascular diseases, as per a study in the “American Journal of Emergency Medicine”.

• Stroke: Drugs instantly increase blood pressure in the body. Mixed stimulant intake like amphetamines and cocaine leads to a higher risk of stroke due to increased blood pressure levels in the body.

Mixing depressants

Mixing multiple depressants like benzodiazepines, opioids, and alcohol has serious effects on health as listed below:

• Weak pulse: Mixing depressants like alcohol and benzodiazepines is known to lower heart activity. Combining such drugs often leads to a higher risk of overdose as a result.

• Slow breathing: Taking multiple depressants results in a lower breathing rate. Mixing depressants like alcohol and opioids slows breathing and increases the risk of cardiac arrest.

• Confusion: Drugs are known to slow down brain activity. Depressants affect the central nervous system and reduce common brain activity. Combining depressants enhances the effect and leaves the person in a state of confusion.

• Change in brain chemistry: Depressants are known to alter the neurotransmitter levels in the brain. Taking multiple depressants at the same time increases the alteration and disturbs brain chemistry.

• Death: Depressants have side effects and this is why the dosage must always be monitored. Increased dosages of multiple depressants have the potential to be fatal.

Mixing stimulants and depressants

Mixing multiple stimulants and depressants like heroin, opioids, alcohol, and benzodiazepines has serious effects including:

• Enhanced sensory perception: Mixing depressants and stimulants like marijuana and cocaine leads to an enhanced sensory perception.

• Mood swings: Depressants and stimulants are known to be mood-altering drugs and their mixed usage can enhance effect. Mixing depressants like alcohol with stimulants like methamphetamine leads to a higher chance of altered and disturbed mood.

• Overdose: Mixing stimulants like heroin, and fentanyl with depressants like Xanax, and alcohol leads to a higher risk of overdose. Overdose has the potential to be fatal hence the mixing of depressants with stimulants is severely risky.

Mixing alcohol with other drugs

Mixing alcohol with other drugs can cause serious effects like heart problems, liver issues, organ damage, brain injuries, and internal bleeding.

• Heart problems: Drugs like cocaine instantly increase blood pressure whereas alcohol intake increases the risk of hypertension. Mixing these together leads to a higher risk of serious health problems.

• Liver issues: Chronic alcohol use along with other drugs leads to a serious risk of liver failure. The combination of alcohol and drugs puts pressure on the liver and kidney leading to a chance of developing a peptic ulcer, according to a study “Managing medicines in alcohol-associated liver disease: a practical review” by Amy L. Johnson.

• Brain injuries: Alcohol and drugs are toxins for the body that change the brain chemistry and lead to chances of brain injuries.

• Internal bleeding: Mixing alcohol with drugs puts you at risk of internal bleeding. Combining these together increases the risk of gastrointestinal inflammation leading to internal bleeding.

How is Polysubstance misuse dangerous?

Polysubstance misuse leads to dangerous consequences including overdose, health issues, and severe side effects. Here are some of the common dangerous consequences associated with polysubstance misuse:

• Overdose leading to SUD (Substance use disorder): Overdose refers to the excessive usage of drugs to the point that it becomes fatal. Substance use disorder is an illness known for irregular patterns of substance intake. Polysubstance abuse often leads to overdose and substance use disorder.

• Increase severity of side effects: Drug addiction has several side effects like health issues, dependency, and fatal disease. Polysubstance abuse causes an increase in the potential and extent of such side effects.

• Acute health problems: Polysubstance addiction increases the risk of acute health problems like seizures, lung diseases, cardiac arrest, and mental health issues. Health issues like these make it difficult to keep up with regular activities.

• Co-occurring mental health issues: SUD often emerges with other mental health issues like depression, anxiety, ADHA, schizophrenia, and personality disorders The side effects of substance abuse can lead to a disturbed mental state.

What are the withdrawal symptoms of polysubstance addiction? 

The withdrawal symptoms of polysubstance addiction are insomnia, fatigue, depression, and intense cravings. Polysubstance addiction withdrawal refers to the physical, emotional, and mental state a person experiences after cutting down or eradicating the substance usage.

The 4 polysubstance withdrawal symptoms are listed below:

• Insomnia: Insomnia or disturbed sleeping pattern is a common symptom experienced after withdrawing from drugs. People find it hard to adjust to this new change and hence, become unable to sleep properly. Fixing sleep patterns by following a sleeping schedule, drinking warm milk before sleeping, starting yoga or meditation, lowering screentime, and increasing physical activity helps in managing the insomniac effect.

• Fatigue: Fatigue is a significant part of recovery from polysubstance withdrawal. The body feels tired when there is no drug intake to numb the emotions and needs. The best way to manage this is to improve dietary intake and exercise regularly. A maintained lifestyle can eliminate these symptoms.

• Depression: Depressive thoughts are often ignored by the use of drugs. Polysubstance misuse helps to numb these thoughts. After withdrawal, depression becomes a common symptom as these thoughts become inevitable. Seeking professional help from a mental health expert helps to minimize the effects of depressive episodes after withdrawal.

• Intense cravings: Withdrawing from multiple drugs simultaneously can leave the body feeling weaker. Conclusively, it requires a direct or alternative fulfilling source, leading to intense cravings. Healthy dietary choices and regular exercise are linked to lowering the extent of these cravings.

What are the treatment methods for Polysubstance Addiction?

The 6 treatment methods for polysubstance addiction include detoxification, cognitive behavioral therapies, medication, long-term rehabilitation programs (in-patient/ out-patient), support groups, and aftercare.

The treatment methods for polysubstance addiction are listed below.

Detoxification

Detoxification refers to the medicated interventions that help the body get rid of drug intoxicants. Detox helps to address the withdrawal symptoms and health issues related to polysubstance addiction. The duration of this treatment form varies on the extent of addiction. Detox is often completed within a week but it can take up to a few weeks based on increased severity.

Cognitive behavioral therapies 

Cognitive behavioral therapy is a form of therapeutic intervention where a therapist helps relieve the symptoms. Mental health experts hold sessions with the patients and address the root causes of addiction. The sessions can last up to several weeks or months, based on the severity of the condition.

Medication

Medications like naltrexone and methadone help get rid of polysubstance abuse. The selection, dosage, and duration of medication are strictly regulated by a medical expert. Drug replacement medications like nicotine replacements are often prescribed with other medications to curb the situation. Medications can take up to 2 to 3 weeks before effects start appearing.

Long-term rehabilitation programs (in-patient/ out-patient) 

Rehabilitation programs are designed to distract individuals from substance abuse. They are redirected towards other daily life activities and hobbies with medications and special care. Rehabilitation can be in a specific facility or personalized for the patient at their home. Rehabilitation takes 2 to 3 months before recovery happens.

Support groups

Support groups involve people suffering from similar conditions talking about it under an expert’s supervision. People with polysubstance addiction benefit from support groups as they find hope in recovering after talking about it. The effectiveness of these sessions varies based on the person’s condition.

Aftercare

Aftercare is an essential part of polysubstance addiction treatment. Patients are at a great risk of falling back into the same pit even after full recovery. Aftercare like a few therapist sessions and medical check-ups helps to keep the recovery in check.

What are the complications of Polysubstance Abuse?

Polysubstance abuse complications include various physical, emotional, and mental health issues. Drug addiction leads to fatal health conditions in various ways. Immune systems get highly affected, increasing the risk of excessive diseases. Mental health conditions are often linked with polysubstance abuse. Depressive episodes and other mental disorders become common during substance misuse. Heart health becomes severely at risk as a result of polysubstance misuse. Stroke and cardiac arrest are common risk factors associated with it. In order to address the complications, it’s important to treat the root cause i.e. polysubstance addiction.

What are the most common polysubstance abuse drugs?

The common polysubstance abuse drugs are alcohol, marijuana, opioids, methamphetamine, etc. Polysubstance abuse happens either by mixing the same type of drugs like depressants or by taking different types of drugs together like stimulants and depressants. The consequences of polysubstance abuse are based on the type of drug combinations used.

Are alcohol and marijuana frequently combined together in polysubstance use?

Yes, alcohol and marijuana are frequently combined together in polysubstance use. Alcohol is present in drinks in the form of ethanol. However, marijuana is the dried leaves of a cannabis plant. Both of these drug forms have sedative and addictive risk factors. Alcohol addiction is associated with drinking while marijuana is associated with the inhalation of smoke.

Do users of heroin-benzodiazepine mixes show similar dependency patterns?

Yes, users of heroin-benzodiazepine mixes show similar dependency patterns. Benzodiazepine is a form of a medicinal drug that slows down brain activity, Heroine, on the other hand, is a drug made from the opium poppy plant that gives euphoric effects. Both of these drugs are known for sedation and lowered breathing rates. The mix of heroin and benzodiazepine increases the risk of overdose.

Is opioid abuse more common than methamphetamine in polysubstance use?

Yes, opioid abuse is more common than methamphetamine in polysubstance use. Opioid includes mainly painkillers and narcotics. Opioid affects the opioid receptors in the brain, blocking any form of pain signals coming to the brain. Methamphetamine is a powerful drug that affects the central nervous system. Meth is often prescribed during ADHD treatment, but it remains a recreational drug and leads to severe methamphetamine addiction.