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Polysubstance Abuse

Polysubstance dependence (the use of several drugs) is the description of the behavioral pattern demonstrated by a drug user who has been abusing a minimum of three psychoactive substances within a twelve-month period. Usually, no one drug outweighs the others, and the user abuses all substances with equal enthusiasm. A person with polysubstance dependence is psychologically addicted to being mentally altered and intoxicated, but because no single drug is preferred, the person might not develop symptoms of physical addiction (tolerance or physical withdrawal) to any of the substances abused.

Polysubstance Dependence VS. Polydrug Use

Where polysubstance dependence refers to the use of three or more drugs within a year, the term “polydrug use” refers to the use of two or more psychoactive substances in combination with each other to achieve a particular effect. Often, one substance is used as a primary substance, with additional drugs to compensate for the side effects of the primary drug. This heightens the experience, making the high more enjoyable with the effects of drug synergy. Because more than one drug is being administered, long term use of combined substances often results in polysubstance addiction.

Drug Synergy

In understanding the dynamics of polysubstance dependence, it is crucial to note that polydrug use often comes with more risk than simply using a single drug, due to increased side effects and drug synergy. The strengthening effect of one drug on another is formidable, and drugs such as alcohol, nicotine and antidepressants need to be considered when used in conjunction with psychoactive substances. Pharmacological pairings of psychoactive substances are of great concern. For example, the combination of alcohol and cocaine increases cardiovascular toxicity; alcohol or depressant drugs, when taken with opiates, lead to increased risk of a drug overdose; and opiates or cocaine taken with MDMA (ecstasy) or amphetamine also result in high toxicity, overdose, or death. Aggression and violent outbursts are common when benzodiazapines, such as Flunitrazepam or Xanax, are combined with alcohol.

A Popular Drug Combination

The term “Speedball” commonly refers to the dangerous intravenous use of heroin combined with cocaine together in the same syringe. The cocaine stimulates the body of the user, while at the same time the heroin depresses it. Thn produces an intense rush of euphoria with a high that combines the effects of both the drugs and excludes the negative effects, such as sedation and anxiety. The effects of cocaine fade more quickly than heroin. This extremely dangerous combination results in fatal respiratory depression when the effects of cocaine disappear and the full effects of heroin are felt.


Combined Drug Intoxication

Combined Drug Intoxication, (aka Multiple Drug Intake or lethal polydrug/polypharmacy intoxication), is a common cause of death. Although sometimes reported as a simple “drug overdose”, it is distinctly indicative of the simultaneous use of multiple drugs, whether they be prescription, over-the-counter, or recreational drugs, or some combination thereof. Combined Drug Intoxication occurs when numerous drugs are combined, including mixtures of over-the-counter drugs, prescription drugs (obtained legally or illegally), various herbal mixtures, and common home remedies. Drinking alcohol in combination with other drugs is the most common cause of Combined Drug Intoxication. In July 2008, the Associated Press and CNN reported a medical study demonstrating that over two decades, from 1983 to 2004, deaths as a result of Combined Drug Intoxication have soared. Combined Drug Intoxication has also become a particularly dangerous risk for older polysubstance users.

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