Most people are familiar with the term “substance abuse,” but many have never heard of “polysubstance abuse.”
Until there’s a social consensus, it bears repeating that addiction is a complex and complicated disease of the brain. People develop the condition for a variety of different reasons, which makes plotting out an effective treatment approach a challenge for patients, physicians, therapists, and other addiction healthcare specialists.
That said, the treatment of addiction continues to make advances and be more effective for all kinds of patients, including those battling polysubstance abuse.
What is Polysubstance Abuse?
Though the diagnosis is generally misunderstood and not made that regularly, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), often referred to as the bible of psychiatry, Polysubstance Abuse occurs in people who use three or more drugs without showing a particular preference to any one of them.
The DSM-5 eliminates the diagnosis of polysubstance abuse dependence due to how little it was used and how much it was misunderstood. “With the new threshold for substance use disorders (two or more criteria), the category became irrelevant,” the manual states.
Still, polysubstance abuse is a unique form of dependency. This type of addiction is different from, for example, a person that’s both physically and psychologically dependent on the use of heroin to avoid withdrawal symptoms.
With polysubstance abuse (also known as Poly Drug Use or Poly-substance Dependence), an individual is more addicted to the mood and mind-altering consequences of substance abuse than, say, alcohol itself or other illicit drugs alone.
Poly Drug Use Can Be Psychological
Poly-drug use is usually more of a psychological misuse of drugs instead of a physical one that results from taking the same drug over and over because the body becomes dependent on it.
For many poly-drug users, their main goal is seeking the best drug synergism. A “drug synergy” is a combination of two or more drugs taken together that amplifies or increases the effects of each individual drug or substance so that the total effect is greater than each individual substance taken alone by itself. Poly addicts crave a good drug synergy and this is the high they are chasing each time they use.
It’s quite common for poly addicts to experiment with multiple substances to find their ideal synergism and when they find it, they often to use this combination whenever possible.
For some, the perfect synergy might be alcohol, marijuana, and LSD taken together to produce the perfect high. If they can’t find LSD, they might substitute psychedelic mushrooms instead.
It doesn’t really matter to them what drugs they are taking, as long as they get high. This is a major aspect that differentiates polysubstance abuse from traditional forms of a substance use disorder, where the person is addicted to something like alcohol and only craves that one specific substance.
What are Some of the Most Commonly Poly-Abused Drugs?
- Alcohol
- Marijuana
- Cocaine
- Methamphetamines
- Heroin
- Synthetic drug formulations, such as Spice/K2, bath salts, gravel
- Opioids or Prescription painkillers including OxyContin, Oxycodone, Vicodin
- Benzodiazepines, such as Xanax, Ativan, Klonopin
- Designer drugs like MDMA (Molly, Ecstasy)
- Amyl nitrate combinations like “poppers“
- Psychedelics like LSD or psilocybin mushrooms
Any combination of three or more of the above substances, excluding nicotine and caffeine from the mix, is considered polysubstance abuse.
Teenagers and young adults are often more inclined to poly drug use because it can be difficult for them to get a regular supply of drugs and they tend to experiment as they discover new things to get high from. They also are under much stress during their teen years and use drugs as a way to escape reality.
Why is Polysubstance Abuse Dangerous?
Polysubstance abuse isn’t like traditional addiction where a person becomes dependent on a specific type of drug, but it can still be dangerous for a number of reasons.
Here are 6 reasons why polysubstance dependence can be dangerous:
1. Risk of Overdose
For one thing, the risk of overdose is always an issue for any person taking multiple drugs, especially when experimenting with substances they aren’t familiar with, or that they use on a regular basis. Buying drugs on the street from a variety of places increases the risk of getting something that contains fentanyl without knowing how powerful it can be. Fentanyl mixed with heroin or street opioids has helped escalate the opioid epidemic.
2. Mental Health Issues
Many polyaddicts use drugs to numb the symptoms of an underlying mental health issue and they only want to get high to run away from their depression or other forms of mental illness. Using drugs, for this reason, will cause their mental health condition to become more problematic over time.
3. Health Complications
The human body has a difficult time when ingesting one type of drug, but taking three or more at the same time only complicates matters and can put undue stress on the heart and other organs, including the brain. Prolonged drug use of this kind can cause major health complications over time.
4. Medical Emergencies
If a person becomes sick or unconscious and medical help becomes necessary, it can be almost impossible for first responders or doctors to know how to treat the symptoms from multiple drugs, or even to know what drugs were ingested. Naloxone works well for opioids but is completely ineffective for cocaine or other drugs.
5. Relationship Problems
Work and family relationships suffer from any type of addiction, and polysubstance abuse is no different. When taking drugs to get high becomes a person’s daily motivation, they lose interest in everything else causing work, school, and family obligations to be completely derailed.
6. Treatment Can Be Difficult
It can be difficult to successfully treat a polysubstance abuser because they don’t adhere to the traditional criteria of a person dependent on one type of drug. They generally don’t want to get sober because they enjoy the high too much.
How is Polysubstance Dependence Treated?
The most effective method of care for people battling poly-drug abuse is an inpatient, residential treatment facility that incorporates detox, in the beginning, to comfortably and safely get patients through any withdrawal symptoms.
The next phase is an individualized treatment approach based on each patient’s distinct personality and personal struggles to get to the root cause of the drug use.
Motivational Enhancement Therapy (MET)
Motivational Enhancement Therapy (MET) is one of the most effective therapies for treating polysubstance abuse because the main goal is to get drug users to stop using.
MET is a non-confrontational form of counseling that addresses a person’s meaning or motivation for their drug use. It enhances and improves a person’s understanding of their actions and re-enforces the motivation for a change for the better.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) gives people the power to examine the underlying causes of their addictive behaviors. As each trigger is identified with the help of a counselor, patients learn over time to not just avoid these triggers but to confront them in a more positive, less socially and personally destructive way.
CBT is a powerful tool in developing and maintaining coping skills that can help prevent or lessen the number and length of relapses. Like cancer or diabetes, addiction is a chronic disease that sometimes comes out of remission. Relapses are not failures. They are a symptom and signs that the condition needs further treatment.
Relapse Prevention Therapy
Relapse Prevention Therapy helps users identify triggers that might cause them to use substances to get high, and teaches strategies and techniques for learning to cope with triggers and ways to avoid them. Because it can be very effective, Relapse Prevention is a necessary part of treatment for addiction for those in recovery to be successful and have a lasting life of sobriety.
As America continues to battle the onslaught of addiction to opioids and other substances, it’s critical that friends, family, colleagues, and anyone touched by someone else’s addiction, understand and speak out about the fact that this is a disease.
Driving those who are suffering from polysubstance abuse and dependence farther into the shadows only serves to worsen their symptoms and enforce the stigma surrounding drug and alcohol addiction.
For teens, it’s natural for them to experiment with many things as they mature into adulthood. Unfortunately, some experimentation can have dangerous consequences, especially when it involves trying a wide variety of drugs only to get high.
What starts out as simply partying with friends can turn into a full-blown dependence or addiction quicker than many realize. And with dangerous drugs like heroin laced with fentanyl widely available on the streets today, for too many people, there’s no way to rehab their way out.
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