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What Is Polysubstance Abuse?

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Polysubstance abuse is categorized by an addiction to the feeling of “being high” regardless of what substance is used. Those struggling with polysubstance use don’t have a specific preference for one particular drug. 

Polysubstance use is generally diagnosed when the individual is using three different substances. However, some definitions say it only requires two drugs to be used.

Polysubstance abuse can include the use of any type of drug. Alcohol tends to be a common one. Other substances that can be abused include but are not limited to:

  • Opiates
  • Inhalants
  • Cannabis
  • Amphetamines
  • Hallucinogens
  • Benzodiazepines

Most cases of polysubstance abuse involve alcohol and illegal drugs. However, prescription medications can also become a part of the problem. Prescription medications have the potential to become addictive, and eventually severely abused. 

How Can I Recognize Polysubstance Abuse?

You can recognize the presence of polysubstance use through a variety of symptoms that vary from individual to individual. Diagnosing polysubstance abuse can be tricky. 

In many cases, the individual may only be aware of one addiction, or none at all. Generally speaking, polysubstance use requires a minimum of three substances being abused. 

Besides, the individual must show at least three of the following signs within the last 12 months. Please note that there are many more signs and these are only a handful of symptoms to look out for: 

  • Loss of control: Using a higher amount of drugs and more often than originally intended.
  • Inability to quit: Several attempts to stop using drugs, with no successful outcome.
  • Unhealthy changes in lifestyle: An individual will stop participating in activities and interests that once brought them joy. Work, school, hobbies, and relationships become negatively affected.

It’s worth noting that it is possible to have more than one addiction, which is not the same as polysubstance abuse. For instance, an individual may have a cocaine addiction, as well as an alcohol addiction present. This is an example of multiple addictions rather than a polysubstance addiction.

Polysubstance abuse is specifically categorized by an addiction to the effects of substances. The particular substance is not an important component of the individual.

Self-Assessment: Am I Addicted?

Why is Mixing Drugs a Bad Idea?

There are numerous reasons as to why you should not mix drugs at all unless you are instructed to do so by your doctor. If you have taken any prescription medication, you have probably been warned about mixing your medicine with certain types of drugs and/or alcohol. 

Every drug, no matter what type it is, can interact with other substances and produce severe side effects. If you mix drugs recreationally, particularly drugs that you are using illicitly, the risk can be even greater.

Mixing drugs is a bad idea for many reasons. Some of these reasons include but are not limited to:

  • When drugs have similar mechanisms of action, the effects of both drugs are enhanced. This means that less of the drug is required to get the type of effects that you would normally get from the drug, including potentially dangerous side effects and the potential to overdose on the drug.
  • When drugs have opposing mechanisms of action and you mix them, they can negate the effects of one another, meaning that you would need to take more of the drugs to feel the effects. The drugs are still present in your body, and this means that you could risk overdosing on one or both of them by taking too much.
  • When different drugs are mixed in your body, they can produce potentially toxic substances (such as cocaine and alcohol, outlined below), which can lead to unpredictable side effects and organ damage.
  • Mixing different drugs can produce erratic results that can present as serious complications.
  • In some cases, combinations of drugs can be beneficial and are recommended to treat certain conditions. These combinations should only be taken under the supervision of your physician.

Mixing Alcohol and Other Drugs

Recreational drug users combine alcohol with other drugs at a higher rate than any other combination. This is because alcohol is legal and readily available to most people.

Alcohol is a CNS depressant, so it reduces the functioning of neurons in the brain.

The effects of combinations with alcohol will differ depending on the drug used.


Combining alcohol with other central nervous system depressants (like benzodiazepines, opioids, or other sedatives) enhances the effects of both drugs and increases the possibility that you may overdose on one of them.


If alcohol is combined with central nervous system stimulants like amphetamines or cocaine, each drug cancels out some of the effects of the other drug. This makes it very likely that you will take too much of one of them (most often the stimulant).

Other Prescription Drugs

When combined with antidepressant medications and other prescription medications that are typically not drugs of abuse, alcohol can reduce the medication’s effectiveness. The combination can also produce different side effects that can be very distressing.

Over the Counter Medications

Cold medicine and alcohol are another highly dangerous combination. Chronically combining alcohol with over-the-counter analgesics, such as acetaminophen (Tylenol), ibuprofen (Advil or Motrin), or naproxen (Aleve), can lead to an increased risk for liver damage, ulcers, and cardiovascular issues.


The chronic effects of combining alcohol and tobacco products can lead to numerous long-term health issues, especially increased risk for many different forms of cancer. This risk is significantly higher than the risk of getting cancer as a result of using either drug alone.

Combining alcohol with other central nervous system depressants (like benzodiazepines, opioids, or other sedatives) enhances the effects of both drugs and increases the possibility that you may overdose on one of them.

Whenever you drink alcohol, your liver gives priority to metabolizing the alcohol in your system overall other substances.

This means that other potentially toxic substances, like other drugs, are not metabolized until your liver has eliminated the alcohol from your system.

As a result, combining alcohol with other drugs places a significant burden on the liver and the rest of your system. Unless instructed to do so by your physician, you should never combine alcohol with any drug of abuse, prescription medication, or over-the-counter medication.

What are Other Dangerous CNS Depressant Combinations?

Other central nervous systems (CNS) depressant combinations are popular among abusers of this class of drugs. These include:

  • Combining benzodiazepines (Valium, Xanax, and others) and prescription opioids (Vicodin, OxyContin, codeine, and others).
  • Combining different benzodiazepines.
  • Combining different opioid medications or illicit opioids with other opioids. Heroin and fentanyl is a particularly dangerous combination that leads to numerous overdose deaths.
  • Using mild sedatives in conjunction with benzodiazepines or opioids.

Any of these combinations can lead to an enhancement of the effects of the drugs, resulting in potentially dangerous issues. The most serious risk is a severe or even fatal overdose on either drug.

What are Dangerous CNS Stimulant Combinations?

Stimulant drugs speed up the central nervous system. Combining stimulant medications can enhance their effects. This can result in potentially dangerous issues, such as dramatically increased blood pressure, cardiac issues, stroke, seizures, and psychosis.

The following stimulant medications are commonly abused and may be combined:

  • Methamphetamine (crystal meth or meth)
  • Cocaine in all its forms
  • Prescription drugs to treat ADHD like Adderall or Ritalin
  • Ecstasy (MDMA)
  • Over-the-counter diet medications
  • Antihistamines
  • Other amphetamines (like diet aids)

The same principles regarding enhanced effects and overdose apply to these combinations.

A Growing Issue: What are the Harmful Consequences of Combining Alcohol and Adderall?

There have been many research studies proving that there are harmful consequences and risks associated with abusing alcohol and Adderall together. 

Some of the many negative risks include:

  • Suffering from alcohol poisoning as a result of Adderall negating the intoxicating effects of alcohol. This can be potentially fatal.
  • Impairment in judgment and rational thinking.
  • Nausea.
  • Dehydration.
  • Cardiovascular problems.
  • Aggression.
  • Risky behavior, such as driving under the influence.
  • Stroke.

Dangers of Mixing Drugs Continued: What are the Risks of Combining Xanax and Cocaine?

Xanax and cocaine are other examples of a combination of drugs that individuals take. There are many adverse risks to taking Xanax and cocaine at the same time. Cocaine and Xanax have many opposing effects. 

Cocaine can stimulate feelings of euphoria, high energy, as well as paranoia and anxiety. Xanax typically decreases anxiety and energy, while increasing drowsiness, and possibly depression.

The similarities between cocaine and Xanax use are often irritability and restlessness. The comedown from cocaine can commonly lead to depression and exhaustion. The use of Xanax can intensify these effects.  

Combining cocaine and Xanax can also result in a dangerous accumulation of both drugs in the body. Consequently, this can lead to high levels of toxicity and overdose. An individual with excessive amounts of Xanax and cocaine built up in their system are at risk of:

  • Paranoia
  • Heart attack
  • Stroke
  • Dependence
  • Addiction
  • Overdose
  • Death

What are the Cognitive and Emotional Effects of Mixing Drugs?

The effects of combining different types of drugs also affect your ability to think, control emotions, or inhibit impulsive behaviors.

If you combine central nervous system depressants, you are more likely to have decreased reaction times, slow rates of thinking, be irrational, and have problems controlling your emotions, leading to emotional outbursts of anger, depression, and even aggression.

Combining stimulant medications often leads to feelings of invulnerability that can lead to significant problems with judgment. It can also result in psychotic-like states due to high levels of excitatory neurotransmitters like dopamine being released in your brain.

Combining drugs with opposite actions nearly always reduces your ability to make quick decisions, think clearly, and control your emotions and impulses. This can lead to numerous issues, including accidents, legal entanglements, and other serious problems.

Safely Using Drugs to Eliminate Cravings Under Medical Supervision and Care

In many cases, there are medicinal effects associated with mixing certain types of prescription medications or in using combinations of medications that you can get over the counter with prescription drugs. 

For instance, if you mix the opioid antagonist ReVia (naltrexone) with other opioid drugs, you may find that your cravings to use these drugs are reduced, and you use less of them. Using naltrexone to eliminate cravings and cut down on opioid abuse is a common practice.

Your physician may prescribe you different combinations of medications to treat different conditions. But in these cases, the physician is aware of the potential interactions that may occur and engage in a cost-benefit analysis based on their expertise to determine the treatment that can best address your situation. 

You should never combine medications or illicit drugs without consulting with your physician.

Don’t Let Polysubstance Abuse Take Away Another Second of Your Life: Seek Help Today!

There are thousands of potential interactions that can occur when you combine different types of drugs. People who abuse drugs will very often combine alcohol with their drug of choice, or they may seek to enhance or decrease the effects of one drug by combining it with another drug. 

This can be a dangerous practice. When you combine controlled substances with other drugs without consulting with your physician, you are taking your life into your own hands. 

Our dedicated addiction recovery team can guide you through the enrollment process and get you started with treatment immediately. If you have any questions, comments, or concerns, please don’t hesitate to find your location and reach out to us. We’re here for you the moment you make that first call!

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