An Overview of Polydrug Use: Risks, Common Combinations, Treatment

When it comes to substance use, overdoses and addiction, drug users often mix two or more drugs to get a desired effect, such as:

Unfortunately, most of these drugs should not go together, leading to dangerous and even life-threatening side effects.

What is Polydrug Use?

Polydrug use or polysubstance use describes combining two or more drugs together in a short period of time (whether intentionally or unintentionally) that can enhance each drug’s effect or even become dangerous. Intentional polydrug use occurs when a drug user takes a specific substance to increase or decrease the effects of another substance, or they like the effects of the drugs combined. Unintentional polydrug use describes taking a drug that has been cut with other substances, such as fentanyl, without their knowledge. Unfortunately, this causes many overdose issues or even death: nearly half of fatal overdoses involve a combination of two or more drugs, according to CDC.gov.

Common Drug Combinations

Many types of drugs are combined, but these are some of the most prevalent combinations:

Stimulants and Depressants

These are often used together to balance the effects. For example, some individuals might combine cocaine (a stimulant) with alcohol (a depressant) to manage the intense high from cocaine with the calming effects of drinking alcohol.

Alcohol and Benzodiazepines

Both are depressants, and the combination of alcohol and benzos can enhance relaxation and sedation, but it also significantly increases the risk of overdose and respiratory depression.

Opioids and Stimulants

Known as "speedballing," this combination involves using heroin or prescription opioids with cocaine or methamphetamine. This combination is highly dangerous due to the opposing effects on the central nervous system.

Marijuana and Alcohol

This is a very common combination among drug users. The mix can impair cognitive and motor functions more than either substance alone.

MDMA (Ecstasy) and Alcohol

MDMA is a stimulant with hallucinogenic properties, and combined with the use of alcohol, it can increase the risk of dehydration and hyperthermia, as well as reduce inhibitions, leading to risky behaviors.

Cocaine and Heroin

Similar to speedballing, this combination is used to balance the stimulating effects of cocaine with the depressant effects of heroin, but it carries a high risk of overdose.

Marijuana and Stimulants

Some individuals use cannabis to mitigate the anxiety or jitteriness that can accompany stimulant use, such as with amphetamines or cocaine.

Dangers and Risks of Polydrug Use

It’s impossible to predict how drugs will interact with each combination. From potential overdose to physical and mental impacts, these are the main risks of polydrug use:

Increased Overdose Risk

When two or more drugs are combined with or without the person’s knowledge, the chance of overdosing significantly increases: in 2018, nearly 63% of opioid overdose deaths in the United States also involved methamphetamine, cocaine or benzodiazepines. Fentanyl has also been a driving force for overdose deaths when combined with other opioids (often, unknowingly).

Unpredictable Reactions

When mixing drugs, the reactions are unpredictable, even if you’ve done it before. Combining drugs, whether they’re prescription drugs or illicit drugs, can put stress on your heart, impact your breathing and even become fatal. That’s why, at the very least, it’s important to talk to your doctor before mixing any prescription drugs.

Physical Health Impacts

There are dozens of concerning negative physical reactions from polydrug use. For example, combining benzodiazepines with opioids can lead to a decreased breathing rate, and an increased risk of overdose. Mixing depressants with stimulants, such as methamphetamine and alcohol, puts a strain on the heart and can cause respiratory infections, bronchitis, dehydration, overeating and kidney failure.

Mental Health Impacts

Mixing drugs is not only dangerous for your physical health, but it significantly impacts your mental health, too. Certain drug combinations can increase the risk of anxiety, psychosis, confusion and panic attacks. Another risk is a condition called serotonin syndrome, which is an often fatal effect of too much serotonin in the brain from taking too many stimulants.

How Polydrug Use Impacts the Addiction Recovery Process

When you’re a polydrug user, the recovery process becomes even more difficult. With regular exposure to more than one drug, your likelihood of becoming addicted to those drugs increases, creating more negative physical and mental health side effects. Polydrug use multiplies the rewarding effects of drugs on the brain — so increased use with each drug satisfies the brain’s reward system, making the addiction even stronger.

This Australian report found that multiple drugs were found in more than half (59%) of unintentional drug overdoses.

Plus, the risk of relapse may be greater for those with polydrug addiction. In fact, studies show that the chance of heroin or opioid relapse tends to be higher than other drugs.

In order to address the addiction, treatment for polydrug abuse must be thorough and well-rounded, addressing both the physical drug addiction and the mental health reasons behind the desire for the drug. Dual diagnosis rehab (rehab with multiple approaches) will most likely be recommended.

Understanding the Treatment Approaches for Polydrug Use

When drug users are addicted to multiple substances or are struggling with multiple disorders, a more thorough and careful approach to treatment is recommended. Effective treatment approaches include:

Before seeking treatment, it’s important to consult a doctor or addiction recovery specialist to select the best treatment route for you.

Prevention and Education

Substance use is a serious issue, especially when combining substances, and the best form of treatment is preventative education. Have regular conversations with your loved ones about the risks, statistics and dangers of mixing drugs, specifically with alcohol, opioids and what may be hidden in a drug supply (such as fentanyl).

If you suspect your loved one is addicted to multiple substances, early intervention is key — enlist the help of addiction specialists and experts early on so the road to recovery will be easier (and more effective).

How Caron Can Help With Polydrug Treatment

At Caron, we provide evidence-based inpatient treatment programs in our beautiful Pennsylvania and Florida facilities, with a 95.5% rate of recovery 30 rate days after treatment. View our locations and learn how to become a Caron patient today.