Looking Beyond Opioid Addiction
—How Polysubstance Abuse is Becoming the Norm

Girl is worry, addiction problem
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Anyone who has witnessed drug addiction or experienced it first-hand knows how horrible this condition is. It’s a daily crisis, a harsh, toxic, and debilitating punishment of the mind, body, and soul.

Sadly, addiction is getting worse in America. There are a few metrics that point to this, one being the fact that a majority of addicts are now addicted to more than one substance.

Defining the Crisis—What Does Polysubstance Abuse Entail?

Polysubstance abuse involves taking more than a single drug, either because the preferred drug can not be found, to reduce the side effects of the primary drug, or to enhance or modify the effects of the primary drug. Often multiple drugs are taken at once simply to amplify the overall effect of being high.

As one can imagine, the risks entailed with polysubstance abuse are considerable. Just using one drug on its own is extremely dangerous, life-threatening even. But adding a second substance into the mix increases the risk to a point even more significant than the sum of its parts. That’s because different drugs react differently when consumed together.

Benzodiazepines, courtesy of the DEA

For example, misusing alcohol comes with a range of adverse side effects. Misusing prescription drugs, such as benzodiazepines, also comes with a list of adverse side effects. However, when one misuses alcohol and prescription drugs together, the two substances react off of each other, creating severe risk for the individual and opening the door to a range of harmful side effects.

Another example is someone who uses opioids and methamphetamines together. Both are very harmful and highly toxic to the user. Both have the potential to cause death. But opiates are a depressant, and methamphetamine is a stimulant. Combining the two has the potential to set off chain reactions in the human body, highly unpredictable reactions that may have entirely unforeseen consequences. On a chemical and molecular level, one has to remember that these substances are not meant to co-mingle together.

Statistics—What is the Scope of Polysubstance Abuse?

Sadly, the scope of polysubstance abuse is much more severe than was initially believed. Researchers King, Nicolaidis, Korthuis, Priest, and Englander of the Oregon Health & Science University examined this problem in great detail.

The researchers studied hundreds of addicted patients who had been admitted to hospitals for in-hospital addiction intervention. Out of 486 addicts interviewed, about 70 percent of them were addicted to more than one substance. The most common drugs of choice were alcohol, cocaine, amphetamines, and opiates. Any one of those substances can wreak untold havoc on a person’s life. Being addicted to more than one makes the condition far worse.

The researchers also found that polysubstance abuse makes treatment more challenging. While about 40 percent of the patients surveyed were able to abstain from one substance-of-choice due to their stay, very few of them could abstain from all the substances they were addicted to.

When an addict is hooked on more than one substance, he will require special care and help to get off of all drugs of choice. That’s why it’s so critical that medical experts, family members, public officials, and policymakers begin focusing on the American addiction crisis as a crisis of multiple addictions, not just “the opiate problem,” or “the methamphetamine problem,” etc.

  “Methamphetamine use in many parts of the U.S., including Oregon, is prominent right now. If people are using stimulants and opioids—and we only talk about their opioid use—there are independent harms from stimulant use combined with opioids. People may be using methamphetamines for different reasons than they use opioids...”

The senior author of the study, Honora Englander, M.D., and associate professor of medicine in the OHSU School of Medicine, provided some valuable commentary on the findings. “Methamphetamine use in many parts of the U.S., including Oregon, is prominent right now. If people are using stimulants and opioids—and we only talk about their opioid use—there are independent harms from stimulant use combined with opioids. People may be using methamphetamines for different reasons than they use opioids. Understanding the complexity of people’s substance use patterns is really important to honoring their experience and developing systems that support their needs.

Professional help
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Addiction Treatment - The Importance of Seeking Help for a Drug Problem

When someone is addicted to drugs and alcohol, a characteristic of that addiction is that they will not be able to cease their drug use on their own. That is one of the key, defining factors of addiction.

When someone cannot cease using drugs or alcohol independently, they will need to seek professional help. And when they are addicted to more than one substance, the stakes are that much higher, the risks that much more significant.

An addiction to two or more substances creates cumulative risk, a greater chance of an overdose, a severe risk for death, accidents, or other crises and pitfalls. If you or someone you care about is addicted to multiple substances, please seek help from a qualified drug and alcohol rehab center today. Only with professional assistance and the level of care that a residential drug treatment center can offer can someone addicted to multiple substances have a hope for coming down off of all such substances safely. Only with the help of a rehab center can a recovering addict find lasting and permanent freedom from his or her past addiction to those drugs.

If you or someone you love is suffering from an addiction to one substance or several, Narconon offers a helping hand and a guiding path out of the morass that is drug addiction. Please contact our office today to take the first step to getting help.


Reviewed by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.