We often think of addiction in singular terms, with someone being purely an “alcoholic,” “cocaine addict,” or “heroin addict,” but the truth is that addiction often is not so cut-and-dry. In fact, addiction can and often does center around more than one substance.

The term “polysubstance abuse,” also known as “polydrug” or “multidrug” abuse, can have a few different definitions. In general, it refers to the abuse of two or more drugs for therapeutic or recreational purposes. (Sometimes definitions of the term will specify that it actually refers to the use of three or more substances simultaneously.) An individual might use any combination of substances, including alcohol, nicotine, marijuana, cocaine, methamphetamine, heroin, prescription opioids, benzos, prescription amphetamines, hallucinogens, or inhalants. Often, however, alcohol is abused simultaneously with other substances.

How does it start?

As with any form of substance addiction, the development of polysubstance abuse is highly complex; there is little documented evidence that explains just what exactly causes polysubstance abuse. Often it involves underlying, coexisting psychological issues such depression, PTSD, and anxiety. An individual might move from a single-substance addiction to polysubstance addiction in order to fill voids not relieved by (or no longer relieved by) a single substance. An individual might move to a second substance after building tolerance to the first substance, becoming bored with the effects of that first substance. A person might use a second or third substance in order to compound the effects of other substances, or a person might prefer different substances at different times or in different situations. Alternatively, a person might turn to other substances simply because there are other cheaper, more easily accessible substances available.

What are the associated dangers?

As with single substance abuse and addiction, someone who abuses multiple substances can quickly develop tolerance to the abused substances, requiring more and more of those substances in order to experience the same effects. That person can quickly lose control of when he or she uses substances, allowing the addiction to take priority over many other areas in life. Those who abuse multiple substances are also going to experience withdrawal symptoms upon ceasing use of any of those substances. Detox for polysubstance abuse must be approached especially carefully since there are multiple drugs involved.

Polysubstance abuse is especially dangerous because you have multiple substances working within the body. Each substance will have its own effects on various systems within the body, and those substances may very well compound the effects of one another, bringing about additional, often unexpected effects on the body. People who abuse multiple substances also tend to exhibit higher levels of general psychological distress, as well as increased symptoms of depression and anxiety. In fact, alcohol users who exhibit concurrent illicit drug use are more likely to have generalized anxiety or a major depressive disorder.

Polysubstance abuse requires a more complex and tailored approach than single-substance abuse, but it can be overcome.