polysubstance abuse)

Polysubstance Abuse

Polysubstance abuse is simply a fancy word for abusing more than one substance at the same time. In fact, the word polysubstance applies to any substances being used together, whether it be two, three, or five, and isn’t exclusive to illegally obtained drugs. Someone prescribed medication by their primary doctor or physiatrist, and abuses alcohol on a regular basis actually falls under this term. 

That said, you can see how easily dependence, abuse, and addiction can occur and a person can fall into a cycle of polysubstance abuse. There are many combinations used together that can lead to more dangerous outcomes. Some of the most common are alcohol, cocaine, opiates, and even medications designed to treat depression, ADHD or anxiety.

Alcohol and Polysubstance Abuse

Alcohol is the one substance that is the most commonly involved when polysubstance abuse comes up. In fact, alcohol is the most commonly abused chemical to date. This is most definitely due to its availability to the public of a certain age. 

In addition, alcohol can be obtained by individuals in the United States by those as young as 21, and in some areas, can be purchased at grocery stores and gas stations 24 hours a day. However, responsibly enjoying one cocktail doesn’t seem like abuse and many disregard the labels on their medications that have dangerous interactions. This is when one single cocktail can become lethal and lead to the body not being able to tolerate the mixture. 

Stepping aside from accidental substance toxicity for a second, let’s consider those who consciously decide to use one or more substances with one another having the intention of reaching a level of intoxication that is more intense. When examining drug and alcohol abuse, studies have found that tolerance leads to having to ingest more or have more drinks, to achieve the desired feeling. Without a doubt, this practice can become costly and time-consuming. Because of how easy it is to become desensitized to the chemical consumption of alcohol, oftentimes people reach out to other substances to reinforce or accelerate the effects of casual drinking. 

Benzodiazepines: What They Are and Why They Are Common In Polysubstance Abuse

When visiting a doctor to discuss symptoms or if they are diagnosed with anxiety disorders, patients are typically prescribed some sort of medication within the benzodiazepine family. Since the mid 20th century, this class of drug has been prescribed more freely, thanks to advancements made in the pharmaceutical industry. In fact, when used properly, benzodiazepines have effectively helped more than 90% of people suffering from mild to moderate anxiety. Treating disorders such as insomnia and panic disorders, as well as more physical ailments, like muscle spasms or convulsive seizure movements, is important to the quality of life an individual needs care for. 

Benzodiazepines work by stimulating the receptor areas of the brain and make the neurotransmitter, known as GABA, more available. GABA plays a big part in how the brain registers pleasant feelings like a reward by its interaction with dopamine. An increase of dopamine leads to the much sought out feeling of a “high”, or euphoric sensations, that many people find pleasurable initially.

However, benzodiazepines (most commonly known as “benzos”), are highly addictive and do come with the risk of tolerance, resistance and even abuse after a period of use. The initial euphoria, though it is not what these medications are prescribed for, tends to be the feeling that many people associate with the effectiveness of the commonly abused substance. After using the medication for a period of time, the pleasure able side effects usually dissipate, leaving behind only the management part of an illness. Though the dosage is still working to alleviate the initial disorder, the misconception of being “without the high”, a lot of people report to their physician that they are becoming tolerant to their current dosage. Doctors in good faith, knowing that some tolerance is expected, tend to increase or alter the medication to prolong good care. 

When a person has been denied the increase of the medication or has already been prescribed the maximum amount, it is very common to enlist the assistance of another substance, off label, to enhance the benefits of the once helpful drug. This is when the dangers of polysubstance abuse become a serious problem. 

Polysubstance Abuse: Alcohol and Benzos

As a depressant, benzos, like alcohol, inhibit motor skills and induce the properties of intoxication when taken in large doses. Symptoms such as slurred speech and decreased reaction to any stimulus are noted as a side effect. Just like someone under the influence of alcohol, delusions, paranoia, drowsiness, inhibited motor functions and mood changes are common when benzodiazepines are taken over the recommended dosage or abused to achieve a sense of euphoria. 

When these behaviors are being exhibited by an individual, they may be completely unaware of their actions. This allows for poor decision making. Because of memory loss and confusion, the likelihood of polysubstance abuse and overdose rates increase dramatically to a dangerous degree. Since both alcohol and benzos are depressants, the respiratory system has unnecessary stress placed upon it and can cause respiratory failure or damage, most of which can be permanent. Regardless, the duration of use, these two substances together can, and have proven to be fatal.

Polysubstance Abuse: Depressants and Stimulants

On the opposite side of the spectrum, when using substances such as alcohol or benzos that both have depressant qualities, oftentimes in overdose cases there will be the presence of a stimulant. For example, a person who finds themselves feeling the negative effects as alcohol, such as drowsiness or confusion, may be enticed to use cocaine, crack or ADHD medication to seem more alert. At this point, there are many dangerous outcomes, including poor judgment. 

Since cocaine is a stimulant, a person that has been drinking alcohol may find that by snorting the substance it will allow them to ingest more alcohol without feeling the crash from their overindulgence. Often, in overdose-related cases, a person will drink two or three times their limit completely unknowingly. The body must then compensate by fighting off all toxins at once, and this can result in alcohol poisoning or even heart attack from abusing cocaine. 

In the middle to late 1980s cocaine became an epidemic sweeping over many of our United States. Since that time, usage and availability has only become greater, allowing for more people at younger ages to be faced with an encounter involving peer pressure or optional abuse. Because of this, and because of the availability of alcohol throughout the young adult community, teens are getting a head start on experimentation. The exposure to the deadly mix overpowers law enforcement efforts to control and regulate distribution accordingly, allowing for increased rates of polysubstance abuse. 

Polysubstance Abuse: Cocaine and Heroin

One of the most devastating combinations of polysubstance abuse includes the use of cocaine and heroin. Being responsible for lethal outcomes, this practice is sometimes referred to as “speedballing.” This method of intoxication is injected and is popular due to the increased timespan of euphoria. 

Cocaine and heroin can do plenty of damage to an individual when used separately. New age drug and alcohol abuse treatment centers are finding that speedballing is more common than ever before. Since cocaine is a stimulant and therefore blocks the dopamine reuptake receptors in the brain, the reward center of the brain remains active longer. Thanks to the dopamine neurotransmitter being blocked from being properly excreted, it enhances the “feel-good” feeling and is reported that using these drugs together makes the risk more worthy of taking. 

Another chemical in the brain norepinephrine increases while under the influence of cocaine. Norepinephrine is responsible for increased arousal and also provides you with alertness. This sensation works against the drowsy feeling caused by heroin tricking you into thinking that the drugs are counteracting each other. Considering the misconception, it is fairly easy to understand how easy it is to abuse. This can potentially lead to a deadly overdose. 

Speedballing is a very dangerous type of drug use seen in polysubstance abuse treatment. It is very important to seek out help for you or others of any signs of overdose are being shown. 

Some Signs to Look Out For During an Overdose Include:

  • Shallow breath
  • Suddenly limp arms or legs
  • Flushing or redness of the skin
  • Fingernails or toenails becoming more blue or red
  • Abdominal discomfort or pain
  • Loss of coordination
  • Loss of consciousness

During an overdose, there is no time to waste. Please seek emergency medical attention immediately. Life depends on it. 

Polysubstance Abuse and Chemical Reactions

Polysubstance abuse is particularly lethal because of the mix of two or more substances at the same time lead to the creation of new chemicals. In chemistry, we learn that when you mix certain materials, the result is just that, a chemical reaction. In regards to alcohol and crack cocaine being mixed inside of the body, there is a very real identifiable compound created. 

This new substance actually causes the body to have to work significantly harder to break down. Considering that either one of those substances abused alone can result in death, “cocaethylene”, becomes a very dangerous compound that increases the likelihood of overdose and death from this polysubstance abuse. 

Cocaethylene forms when both ethanol and cocaine are consumed in high amounts inside the body. Cocaethylene is a metabolite that is broken down by a person’s biome much more slowly than alcohol or crack cocaine would be on their own. The excess time an individual needs to metabolize, or break down the new chemical compound can be the difference between life and death. 

The problem with this is that during intoxication the primary warning sign of being under the influence of both alcohol and cocaine at the same time results in euphoria, and can oftentimes be mistaken as a desired outcome. With the feeling of being high, overindulgence often continues leading to a build-up in the muscles and organ tissues, taking a harmful toll on the cardiovascular system. Heart rate increases and heart muscle damage are stressing the organ, which can lead to sudden death and heart attack. 

Polysubstance Abuse Has No Boundaries

There are hundreds of drugs in the world, both illegal and legally prescribed. Any number of combinations can be created, and the vast majority lead to dependency, abuse, overdose, and even death. Some other substances that are found to be commonly used together are included below:

  • Alcohol and Xanax
  • Alcohol and MDMA
  • Heroin and Methamphetamines
  • Cocaine and Opiates
  • Alcohol and Methamphetamines
  • Opioids and Benzodiazepines 
  • Steroids and Cocaine
  • Heroin and Methadone
  • Methamphetamines and Suboxone

Keep in mind, this list exists to only give examples. Polysubstance abuse comes in many different sequences and consists of many different chemicals used together. 

Polysubstance Abuse Treatment Is Complex

Treating polysubstance abuse can be more difficult than just drug abuse treatment alone. There are different treatments for different types of addictions, for the dependency of different chemicals. Because of this, sometimes treating each substance being abused separately can be the best option. Other times, one addiction must be treated before the other, and some simultaneously. The lines become blurred, making polysubstance abuse one of the most complex and delicate addictions to treat.

Polysubstance Abuse And Dependence Is Unreported

Some taking part in a drug and/or alcohol abuse treatment program designed for rehabilitation, under report substance usage or consider legally obtained substances irrelevant. Drug and alcohol abuse treatment resource centers, provide information to create a specialized path toward rehabilitation. This obstructs the recovery progress by not addressing all of the needs of the individual.

An example of this hindering recovery is the treatment of cocaine abuse and the under-reporting of alcohol dependency. Alcoholism that is underlying is, therefore, going undiagnosed and untreated. It is important to be upfront with any and all substance abuse when seeking out effective treatment. 

Another instance often observed would be when someone is seeking help for heroin dependency, fails to report being treated for ADHD by means of Adderall or other amphetamines. Though this medication may very well be prescribed by a physician, the misuse of both of these substances together is polysubstance abuse. Post-rehab, the need for methamphetamine may still be relevant for attention disorders, and then has a very real potential to contribute to relapse. 

Psychological Disorders, Substance Dependency, And Polysubstance Abuse

Dual-Diagnosis (Co-Occurrence) comes into the picture when suffering from a psychological disorder and substance abuse happens at the same time. Though it is important to recognize that drug and alcohol abuse is also a mental illness. The circumstances for care are very different from behavioral and mental illnesses and are equally important. 

When coming up with a plan to treat an individual that needs help with more than one disorder, substance abuse treatment centers keep in mind that one illness may worsen or even contribute to another in a negative way. In a lot of cases, having or treating chemical dependency can cause distress that may worsen a person’s ability to cope with their mental illness. 

Polysubstance Abuse And Mental Illness: It Can Be Managed

A priority of substance abuse treatment centers is to restore your quality of life. To give you the means to develop your abilities and to find gratification from education, or to be effective at work or household responsibilities. It becomes more challenging when there is a decline in mental health playing against drug and/or alcohol abuse recovery and rehabilitation. This is not caused to give up, because you are not alone, you are not the first, and you will not be the last. With dedication, honesty, and forgiveness of oneself, there is a road to recovery developed uniquely for you. 

In fact, according to the Journal of the American Medical Association, there are more people than ever who face their own journey, taking the first steps to their wellbeing. It has been found that: 

  • About half of those that suffer from drug or alcohol dependency is plagued with a serious mental illness.
  • Of those that seek help for alcoholism, over 35% of them have been diagnosed with a psychological disorder. 
  • Mental illness presents in 53% of those that have drug addictions. 
  • With individuals that are being primarily treated for psychological or behavioral disorders, over 28% have admitted to having abused drugs or alcohol. 

Polysubstance abuse and dual-diagnosis (co-occurrence) are oftentimes presented together. The challenge, however, is to identify if one had anything to do with the other, or if treating one will affect the other. The good news is, there exists a substance abuse program that will work for you. 

Denial Of Polysubstance Abuse And Self Identification

Identifying polysubstance abuse can be difficult to admit, and the result is complete denial. Substance abuse treatment resource centers know how difficult is it so admit there may be a problem when relief can sometimes be obtained by self-medication and drug and/or alcohol abuse. Often times, denying that you have an abuse problem and need the assistance of others is the only thing standing in the way of the help you deserve. 

Coming to terms with the need for substance abuse treatment can seem embarrassing or humiliating. It can feel as though you have lost all control and that is one of the hardest things to admit. Please be assured, there is nothing to be ashamed of when it comes to bettering your life for you, and for those around you. Remember, getting far enough to read this, has already contributed to your recovery.

Take a second, sit quietly to reflect, and ask yourself a few questions: 

  • Do you often resort to consuming alcohol or doing drugs to cope with pain? Emotional or Physical?
  • Do you often seek drugs or alcohol to face fears or boost confidence? In social or professional situations?
  • Have you ever turned to substance abuse to forget hurtful or embarrassing moments from your past? What about emotional abuse or trauma?
  • Is there a feeling of motivation or the need for excess focus that inspired you to seek out dangerous substances?
  • Does your mood depend on whether you are high or sober?
  • Have you ever been diagnosed or treated for mental health and felt like it just wasn’t working? Feelings of hopelessness?
  • Do you feel better or worse when you are intoxicated? How do you feel when you are sober?
  • Has anyone in your family been diagnosed with mental illness? Alcoholism? Drug Abuse?
  • Have you ever sought out and received treatment for a mental health problem?
  • Have you ever looked for help for a drug or alcohol addiction?
  • Did you receive rehabilitation treatment for substance abuse disorder and relapse? Was this due to suffering from another mental illness? 
  • Has treatment for mental illness failed you in the past? Was it due to drug or alcohol dependency?

Regardless of your responses, having to resort to self-medication, using one or more dangerous and potentially deadly substances is not the solution. Polysubstance abuse does not treat addiction or mental illness, instead, it puts a blanket over it that will only be uncovered later. Receiving the help and care you need from polysubstance abuse will lead to a full and greater sense of wellbeing under the care of trained medical professionals that understand where you are, and where you could be. 

Polysubstance Abuse: Getting Help At Coastal Detox

Education, awareness, patience, and hope are all you need to break free of the restraints of drug and/or alcohol abuse. Our substance abuse treatment resource center at Coastal Detox, promises to take exceptional care to treat each individual with the utmost respect and to cultivate a successful path to wellbeing. Let’s beat substance abuse together. To learn more contact us here at Coastal Detox or you can call us at  (877) 978-3125.

Content Reviewed by Jacklyn Steward

Jacklyn StewardJacklyn is a Licensed Mental Health Counselor (LMHC) and an EMDR trained trauma therapy specialist with over 6 years of experience in the field of addiction. She has a Masters Degree in Mental Health and Substance Abuse Counseling from Nova Southeastern University.