The Slippery Slope of Polysubstance Abuse

The slippery slope of polysubstance abuse

Polysubstance abuse, or the abuse of one more than one drug at a time, sometimes starts innocently enough: The individual taking certain prescription medicines who doesn’t realize he shouldn’t be drinking while taking his meds. The person struggling with anxiety who takes a prescription sedative but then uses her son’s ADHD meds to supply a little boost of energy from time to time. The individual who is involved in a severe car accident and left with chronic pain … and subsequently a growing painkiller addiction.

Eventually though, the use of multiple drugs becomes something he or she depends on as well. Maybe the highs weren’t high enough anymore due to a growing tolerance. Or maybe the usual drugs weren’t available so the struggling individual substitutes whatever is on hand. Unlike drug or alcohol dependence in which the addict uses the same substance repeatedly over time, polysubstance abuse occurs when the individual craves the “high” or altered state using more than one particular substance. Often, he or she doesn’t necessarily care what the drugs are so long as they have the sought-after effect.

Technically speaking

In the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association outlines a list of symptoms for “substance dependence.” Three or more of the following must be exhibited over a 12-month period to meet the criteria for “substance dependence”:

• Increasing tolerance
• Withdrawal (either upon substance cessation or using to avoid withdrawal)
• Loss of control (e.g., shifting from weekend use to everyday use)
• Inability to stop using despite the desire to do so
• Increase in amount of time spent getting the drugs, using them, being under the influence, and recovering from use
• Interference with activities that don’t involve drug use
• Harm to self (using in spite of other ailments that are caused by or worsened by drug use)

Treatment for polysubstance abuse

Treating the individual who has been abusing multiple drugs at once is in some senses not altogether different from treating someone who has only one drug of choice: It requires a willingness to change and motivation to undergo treatment, abstinence, and a strong support system. However, depending on the number and types of substances someone has been using, treatment can be made infinitely more complicated as drug interactions and physiological dependence often require skilled medical intervention.
For this reason, treatment for those who struggle with polysubstance abuse often starts with inpatient treatment, where medical professionals can monitor vital signs and assist with supportive medications such as those that help combat severe nausea, anxiety, or tremors sometimes experienced during the withdrawal period.

Treatments commonly used during recovery include:

• Inpatient rehabilitation/detoxification
• Supportive medications to reduce withdrawal effects
• Outpatient therapy
• Individual and/or group counseling
• Cognitive behavioral therapy (CBT)
• Twelve-step programs
• Sober living residences

After the initial detoxification comes the difficult work of collaborating with mental health professionals to identify circumstances and feelings that trigger relapses. Just as those who abuse one drug or alcohol are more likely than the general population to have a co-occurring mental health disorder, those who abuse multiple substances also tend to have co-occurring mental health struggles. Addressing and determining a treatment plan for these mental health issues is an integral step in getting someone back on the path toward long-term sobriety.
The silver lining is that it’s never too late to take the first step toward sobriety. And while the best way to avoid polysubstance dependence is to refrain from using any types of drugs or alcohol, there are a number of other paths toward rediscovering a sober lifestyle. To learn more about a holistic approach to helping a loved one find their way back to a healthier life, contact Choice House today.

Admissions: Jordan Hamilton – 720-577-4422 or

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