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People often hear about someone who has an “addictive personality”. For some, it’s not about the substance being abused that causes an addiction; their addiction stems from the “high” that they get from abusing various substances and not just one particular substance. This is what is known as polysubstance abuse. 

10 Minutes Read | Published Sep 25 2023 | Updated Feb 23 2024 Expert Verified
Emma Collins
Written by
Ashley Bayliss
Reviewed by
Emma Collins
Written by
Ashley Bayliss
Reviewed by

Polysubstance Abuse Symptoms and How the Complex Problem is Treated

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In this article, we will explore the definition of polysubstance abuse disorder, the signs of polysubstance addiction, and how one can overcome it.

Defining Polysubstance Abuse

According to the DSM-IV – the previous standard guide for identifying mental disorders in the United States – any person who frequently abuses three or more substances at the same time with no preference to which substance they abuse can be considered to be have polysubstance abuse disorder. However, there is some confusion as to what exactly constitutes polysubstance dependence; a person can be addicted to three different substances – not including nicotine and caffeine – but not have a polysubstance abuse.

According to the DSM-IV, polysubstance dependence is only the diagnosis when there is indiscriminate use of the three or more drugs being abused. This means that none of the substances are taken over another, and the addict is more interested in the “high” in general than the type of high from a particular drug.

However, since then, the DSM-V has classified all types of addictions and substance dependence under one term: substance use disorder. Polysubstance addiction is still considered to be a disorder that requires specialized treatment in order to deal with.

Identifying Polysubstance Addiction: What Are the Signs?

An addiction to multiple substances is often difficult to identify because many addicts don’t always report all of the substances that they are abusing. One drug addiction may be identified through common signs but another may slip by because it shares similar signs.

According to the DSM-IV, if three or more substances are being abused and they have three or more of the following signs in a year’s time, then they have a substance use disorder involving multiple drugs:

  • Self-harm which manifests through their continued use of the drug despite what it’s doing them.
  • It has started to interfere with other activities such as hobbies, social outings, and their occupation or schooling.
  • Increasingly more time is spent on everything related to substance abuse, such as getting a hold of drugs or alcohol, recovering from their abuse, and being “high” or intoxicated.
  • They have lost the ability to stop abusing the substances, and every attempt to stop or slow down has been met with failure.
  • They have lost control over the amount of the substance they take, and how much they take in one sitting.
  • They experience withdrawal symptoms associated with each of the substances when they haven’t had any recently.
  • The amount they used to take is no longer enough, and due to this tolerance, they have to take higher amounts.

Behavioral Signs

Behaviorally, there are signs that can indicate that there is substance abuse present. These changes often come on suddenly or over short period. Some of the signs include the following:

  • Criminal behavior such as stealing
  • Changes in their priorities
  • New friends and social circles
  • Depression
  • Lethargy
  • Anger, aggression, and irritability
  • Personality and attitude changes
  • Secretive behavior
  • Social isolation

Polysubstance Abuse Treatment

The following section explores how treatment for an addiction to multiple substances is handled at a rehab center equipped to treat such conditions, and what challenges there are to treating it. Of course, each person is different when it comes to treatment, and a thorough assessment and continued assessments throughout treatment is essential for effective treatment.

Challenges Polysubstance Abuse Treatment

One of the challenges to polysubstance abuse treatment is identifying that the individual doesn’t have a problem with just one substance, but to the “high” that they can get from any substance. Relapse prevention plan strategies such as staying away from certain places in fear that it will cause triggers won’t necessarily prevent them from wanting to have another substance in a different setting.

Moreover, drugs and alcohol affect the brain, and almost all drugs eventually affect or stimulate the dopamine system in the brain. When just one substance is abused, the source of the problem and the damage it caused is clear – albeit wide-spread – but in a polysubstance case, the sources of the damage and problems in the brain are compounded by the different substances that are all affecting the same systems. In a sense, it’s taking several problems in the brain and then multiplying it with the effects of each of the drugs. Damage and psychological problems are often extensive and can take longer to properly treat.

Medical Detox

Due to the variety of substances that the person has abused, their detoxification will of course be affected. By itself, certain detoxes such as cocaine withdrawal may be fairly harmless apart from the deep depression that may cause suicidal behavior, but when these symptoms are combined with two or more other substances, the consequences due to the bodily changes can be severe; what was once harmless becomes possibly life-threatening.

A medical detox is therefore of the utmost importance when it comes to stopping a polysubstance addiction.

Therapy and Counseling

A crucial part of recovery for this type of substance abuse is counseling and therapy. Some of the therapy and counseling methods include:

  • Contingency management – A method of using low-cast rewards to promote change.
  • Motivational interviewing – Using motivation and the patient’s willingness to change.
  • Multidimensional family therapy – Aimed at treating adolescents with substance use disorder in a family-orientated approach.
  • Cognitive-behavioral therapy – This method helps addicts to avoid, recognize, and cope with situations that trigger substance abuse.

Through therapeutic methods, an addict can learn to change their behavior and thinking so that substance abuse no longer holds the answer to their problems. Therapy is essential in order to tackle the real issues that caused their abuse in the first place.

Aftercare Services and Long-Term Abstinence

Once the initial stages of treatment have been dealt with, long-term maintenance then becomes the next step. Due to the relapsing nature of the mental disorder, it’s important to follow a relapse prevention plan after leaving rehab.

Aftercare services such as support group meetings, 12-step programs, sober living homes, and halfway houses can help a recovering person stay clean long after they’ve finished with their intensive rehab program.

If you or a loved one is struggling with addiction, get help right away. Make a phone call that will connect you to a professional drug treatment center. The call you make may save your life or the life of someone you love. Call us today at (800) 429-7690.


bullet National Library of Medicine
"DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale"
Retrieved on October 26, 2018
bullet DSM-5 Update
Retrieved on October 26, 2018
bullet National lnstitute on Drug Abuse
Retrieved on October 26, 2018

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