Polysubstance dependence, a physical reliance on more than one drug, is commonly treated in addiction recovery centres across the UK.
Today, we’re going to discuss why polysubstance dependence is so common, how it can severely harm your health, and where you can go to successfully recover from this debilitating drug problem.
Our advice and support is always available via our helpline, on 0800 140 4690 (UK) or +44 345 222 3508 (international). If you’re ready to get help, we can get the ball rolling for you.
Polysubstance dependence is a term that describes reliance on more than one drug. The drugs are either used at the same time (simultaneously) or within a short timeframe (concurrently).
For example, someone may use cocaine during a night of drinking, or combine opioids with benzodiazepines.
On its own, this isn’t necessarily dependence; it may just be polysubstance use. However, it’s very common for people to become dependent on drugs when they engage in this behaviour, leading to polysubstance use disorder.
Polysubstance use is more common than monosubstance use. Research suggests just 22% of people in treatment for a substance use disorder in the US are using one drug, indicating addiction services are primarily treating polysubstance users (1).
Let’s look at specific examples.
Around 3 out of 4 cocaine users consume alcohol with cocaine, either simultaneously or concurrently. 6 in 10 use cannabis concurrently (2).
Evidently, simultaneous and concurrent polysubstance use is very common among drug users, despite the associated dangers, from increased risk of addiction to overdose.
There are many reasons for polysubstance abuse, and often, multiple reasons apply.
When someone becomes more tolerant to a particular substance, they need more of the same drug to feel the same effects.
Sometimes, they may choose to introduce another drug as a more convenient or more powerful way of combatting their tolerance.
It goes without saying that the issue will only crop up again when they further increase their tolerance. However, many drug users have tunnel vision on substances, and as long as they can experience the “high” they’re after, they are temporarily satisfied.
It’s common to use multiple drugs to enhance the effects. The brain and body tend to react more strongly to two or more substances, so we may feel more intense emotions and sensations through polysubstance use.
Sometimes, people use a second substance to counteract the side effects of the first drug. This can be a way to cope with negative effects, and prolong their drug use.
For example, someone may take a sedative after a stimulant to reduce a stimulant crash.
If a certain drug is difficult to access, drug users may introduce a second or third drug to ensure they always have a steady supply.
There isn’t always a logical reason for someone being a polysubstance user. They may be desperate to solve their physical or mental health problems, so they self-medicate with any drug they can access.
In addiction recovery services, common combinations are:
It’s important to note that these are dangerous drug combinations. Mixing drugs can enhance dangerous side effects, introduce new symptoms, and lead to severe health complications, such as breathing problems and overdose.
When someone is using multiple substances, they are at a much higher risk of addiction. Any changes to brain chemistry are intensified and accelerated, which can bring on dependence much faster.
Often, this leads to increased drug use, as users feel they need the substance in order to function.
There’s also a higher risk of overdose when multiple substances are involved. It’s trickier to determine how the drugs will affect the user, which can lead to accidental overdose.
Side effects of using drugs can be worsened when polysubstance use is present. This can increase the likelihood of:
Simultanenous polydrug use makes users more vulnerable to health risks, as it’s associated with more drug-related problems in general (3). However, concurrent polydrug use can also pose a serious threat to the user’s health.
Treating polysubstance dependence is uniquely challenging for several reasons:
There may be different triggers for each substance, making trigger identification much more complex.
With different withdrawal symptoms attached to each drug, patients may face a more challenging detox process, and they may potentially need more supervision and intervention because of this.
When just one substance is involved, the treatment plan is more straightforward. Medical professionals can determine whether the problem is a dependence or addiction, and based on this, they can advise the most effective next steps.
With polysubstance dependence, there are more layers involved. A patient may be physically addicted to one drug, but psychologically addicted to another, which requires different treatments.
Below, we outline treatment options for polysubstance dependency:
If one or more of the drugs are physically addictive, patients can have a drug detox, either as an inpatient or an outpatient.
Detoxing shouldn’t be the only step in addiction recovery. It doesn’t tackle psychological causes, and even if the patient isn’t yet psychologically dependent on drugs, it’s important to prevent relapse by offering mental health support.
Rehabilitation comes in many forms, but the most common is a residential rehabilitation setting, where patients recover in a supportive environment, with therapies, counselling, and other psychological interventions.
It’s possible to pursue polysubstance addiction treatment without being an inpatient. It works by attending appointments throughout the day, with your home remaining your main base.
Polysubstance addiction treatment is very responsive to therapy. Whilst therapy doesn’t solve the issue, it helps patients to explore their triggers, and learn how to manage them healthily.
It’s more effective to have several types of addiction therapy, especially when treating multiple drug addictions. Some common examples are:
These are a combination of traditional and holistic therapies. It isn’t a case of one being superior to another, but instead, each one has unique advantages for patients.
Often, it’s best for patients to explore multiple types of therapy before deciding which models they respond best to.
To maximise a patient’s chances of lifetime sobriety, support should continue after the main stages of polysubstance dependence treatment.
A tried-and-tested way to do this is to provide patients with an aftercare plan, which is generally implemented for one year after rehab.
However, if the patient didn’t get the traditional rehab experience, it’s still possible for them to access ongoing care, such as:
Even those who have attended rehab are advised to implement as many of these as possible, as it’s crucial to receive support that extends far beyond just one year.
If you have a friend who’s dealing with polysubstance dependence, you can certainly get some advice for dealing with this.
If you contact Rehab 4 Addiction on 0800 140 4690 (UK) or +44 345 222 3508 (international), we can point you in the right direction for guidance.
Some general tips are:
If your friend isn’t open to getting professional help, you may want to continue to support them and hope they change their mind. It’s important to take care of yourself in this period, as witnessing someone battling addiction can be a huge strain on your mental health.
Another possibility is to stage an intervention. This is for people who are in desperate need of professional support, but are either in denial, or are against addiction treatment for any reason.
Interventions can be controversial, so it’s best to speak to an addiction specialist at Rehab 4 Addiction before making any decisions. A poorly-executed intervention could actually delay your friend from getting help.
We have brilliant connections with treatment services all over the UK, known for high-quality polysubstance addiction treatment, and we can help you to enrol in as little as one day.
To secure your place with a trusted addiction treatment service, or simply explore your options, give Rehab 4 Addiction a call on 0800 140 4690 (UK) or +44 345 222 3508 (international).
Below, we answer some common questions around this important topic:
No, polysubstance use refers to the use of more than one drug, either simultaneously or concurrently.
On the other hand, polysubstance dependence is when someone has become dependent on more than one drug.
It’s very common for alcohol to be part of a polysubstance dependence for various reasons.
Alcohol is an extremely common drug, with many people not even recognising it as a dangerous substance in the same way as illicit drugs. This means the average person is already drinking alcohol, and they become a polysubstance user when they add another drug to this.
Another reason is that alcohol is effective at enhancing the effects of drugs, so people commonly use it for a more powerful drug-taking experience.
It’s impossible to use multiple drugs without risking addiction. Any drug use comes with this risk, but polysubstance use heightens the risk significantly.
If you have been using multiple drugs for a long time and you still haven’t developed an addiction, keep in mind that it does not mean you won’t ever become addicted. People can develop addictions after many years of drug use.
Yes, younger age groups are more likely to take multiple drugs. Evidence shows this behaviour increases between early adolescence and early adulthood (4).
However, it is likely to continue into later adulthood, and it’s also common for adults to start this behaviour for the first time, even when it was absent from their adolescence.
[1] https://pubmed.ncbi.nlm.nih.gov/37438998/
[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC7450360/
[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC1761923/
[4] https://www.frontiersin.org/journals/behavioral-neuroscience/articles/10.3389/fnbeh.2021.797473/full
Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field. His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline. You can connect with Boris online at LinkedIn or X.com.
