Polysubstance use refers to the deliberate or unintentional combining of substances. This may also be referred to as combined drug intoxication or multiple drug intake. With polysubstance use, a person takes two or more drugs simultaneously or within a short period of each other. Combined drug intoxication can occur with alcohol, drugs, and prescription medications.

This article discusses the signs, symptoms, and dangers of polysubstance use, as well as how to find treatment options.

Causes

Substance use is a significant public health crisis. To complicate matters, many individuals use multiple substances.

A study looking at the prevalence and patterns of substances identified factors that increase the risk of polysubstance issues, including:

  • Age (younger people have a higher risk)
  • Lower levels of education
  • Unemployment
  • Being White
  • Living with a disability
  • Anxiety
  • Depression and other mood disorders
  • Severe tobacco or alcohol use

Genetics, family history of substance use, stress, trauma, and accessibility of drugs are other factors that can contribute to polysubstance use.

Signs

Signs that someone may be struggling with multiple substance abuse include but are not limited to: 

How Common Is Polysubstance Abuse?

According to research, mixing drugs is not uncommon and appears to be the norm. For example, one study noted that in people who use opioids, almost all of the participants used opioid or non-opioid substances together. Research also shows that people who use tobacco, alcohol, cannabis, prescription opioids, cocaine, and heroin are more likely to struggle with polysubstance abuse.

  • Mood swingsChanges in behavior Intoxication Overdose Falling behind or neglecting personal and professional responsibilitiesDifficulty maintaining relationshipsLegal and financial trouble Health problemsEngaging in drug-seeking behavior

Symptoms

A person dealing with polysubstance use may notice the following symptoms:

  • Cravings and urges to use
  • Thinking about and planning to use
  • Difficulty controlling substance use
  • Tolerance or needing to mix or use greater amounts of substances to achieve desired effects
  • Symptoms of withdrawal after stopping use
  • Anxiety, depression, or isolation
  • Personal and relational consequences (trouble at home, work, school, or in relationships)

Dangers of Polysubstance Use

A person may mix drugs to enhance the effect of a single drug, to feel the effects of the drugs together, or to decrease the effects of a substance. Combining substances can have serious consequences.

Health Problems

Drugs and alcohol harm the body. Using multiple drugs puts a person at risk of developing or worsening health issues. The resulting health problems can be short or long-term.

Mixing substances can cause damage to vital organs like the brain and liver, and can lead to health complications such as:

  • Stroke
  • Heart attack
  • Brain injury
  • Seizures

Worsening Mental Disorders

In some cases, substance use can lead to mental health symptoms. In other cases, an individual may self-medicate or use drugs to manage their symptoms.

Either way, taking drugs or combining them can aggravate mental health symptoms and make them worse. This includes using substances on top of prescription medications for mental health conditions.

Relapse

Relapse prevention is a vital part of treatment and recovery. Polysubstance use can make it difficult for someone to be consistent with treatment. It can also lead to relapse. Relapse is serious and, depending on the situation, can increase the risk of health problems and overdose.

Overdose

The risk of overdosing is higher when using multiple substances, especially when one of them is an opioid. Depending on the type of drug, the effect on the body can vary.

When drugs are taken together, the effects can be intensified. For instance, taking more than one depressant drug can increase the risk of overdose or death. According to the CDC, almost half of overdose deaths in the United States in 2019 were related to polysubstance use.

Treatment

Because polysubstance abuse involves using multiple drugs, the first step in treatment is detoxification. Healthcare providers often supervise this process to manage and alleviate withdrawal symptoms. Withdrawal can be intense and physically taxing.

Help Is Available

Mental health symptoms and polysubstance use can exacerbate each other by causing or worsening problems. If you or a loved one are struggling with mental health symptoms or substance use, you can contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

In the event of an overdose or medical emergency, call 911 immediately.

Some symptoms of withdrawal include:

  • Mood changes
  • Sweating
  • Tremors
  • Nausea or vomiting
  • Pain
  • Fatigue
  • Irritability
  • Hallucinations
  • Seizures

After detox, a patient may begin treatment at a residential or intensive outpatient facility.

A mental health professional will conduct an evaluation to get a sense of the patient’s mental health and substance use history. This information can also help a healthcare provider and patient determine the best approach to treatment. For instance, it’s imperative to identify whether substance use disorders will be treated concurrently, independently, and what other professionals may be part of the care team. 

Intensive and outpatient environments allow people to explore their thoughts, feelings, and behaviors related to using, learn coping and problem-solving skills, and develop a relapse prevention plan.

Some types of therapy that can help include:

  • Cognitive behavioral therapy (CBT)
  • Motivational interviewing
  • Family therapy
  • Group therapy
  • Self-help and peer support groups

In addition to detox and therapy, healthcare providers may integrate medications into a treatment plan to manage mental health or medical conditions, as well as reduce cravings or urges to use.

Treatment varies from patient to patient. Working closely with a treatment team will determine the best approach.

Summary

Polysubstance abuse is the intentional or unintentional mixing of substances. While people combine drugs for many reasons, consuming multiple drugs is dangerous. Individuals who use multiple substances have a higher risk of developing health problems, experiencing a decline in mental health, and overdose or death. Substance use treatment can help people reduce and stop their behavior.

A Word From Verywell

If you are struggling with substance or polysubstance use, you’re not alone. The first step to seeking help and making change is being honest with yourself about your behavior. Polysubstance use can impact your mind, body, relationships, and other aspects of your life. Though recovery can be challenging, it is possible with social and professional support.

Frequently Asked Questions

  • What is polysubstance abuse?
  • Polysubstance use involves the purposeful or unintentional mixing of drugs, alcohol, or prescription medications. Despite serious consequences, a person may continue to use and combine drugs. Polysubstance use can be especially harmful and increase the risk of mental and physical health issues and overdose or death.
  • What is a “drug cocktail?”
  • A drug cocktail is a combination of drugs used to achieve a high or specific effect. Because drugs interact with each other in the body, it’s essential to be aware of what you are taking. Combining drugs (stimulants, depressants, hallucinogens, etc.) can have serious health consequences.
  • Can you recover from polysubstance abuse?
  • Recovery is possible. There are various treatment options available for people struggling with polysubstance use. Treatment recommendations may vary and depend on the severity of use. Detoxification, inpatient, intensive outpatient, and aftercare are options a healthcare provider may suggest. Additionally, people may find community by going to self-help or peer support groups.

Polysubstance use involves the purposeful or unintentional mixing of drugs, alcohol, or prescription medications. Despite serious consequences, a person may continue to use and combine drugs. Polysubstance use can be especially harmful and increase the risk of mental and physical health issues and overdose or death.

A drug cocktail is a combination of drugs used to achieve a high or specific effect. Because drugs interact with each other in the body, it’s essential to be aware of what you are taking. Combining drugs (stimulants, depressants, hallucinogens, etc.) can have serious health consequences.

Recovery is possible. There are various treatment options available for people struggling with polysubstance use. Treatment recommendations may vary and depend on the severity of use. Detoxification, inpatient, intensive outpatient, and aftercare are options a healthcare provider may suggest. Additionally, people may find community by going to self-help or peer support groups.