The Crisis of Poly-Drug Use

Service alcohol with pills.

When people think of drug and alcohol addiction, they generally think of a heroin addict or a cocaine addict or a pill addict or an alcoholic. They associate just one type of drug or substance with the individual, as though the individual is addicted to x drug and nothing else.

But that’s not actually how most addictions work. Most people who use addictive substances are using more than one kind of substance. Speaking from my experience of having worked with hundreds of addicts, I’ve found that it’s more likely for an addict to struggle with more than one addiction than it is for an addict to be using just one substance.

Defining Poly-Drug Use

What is poly-drug use? The term is a simple one. Poly-drug use means using more than one mind-altering substance. Such could apply to individuals who consume multiple drugs at the same time, or it could also refer to individuals who bounce back and forth between two or more addictive substances.

The opiate addict who has been using painkillers for months or years may also use heroin from time to time when he desires a slightly different type of high or when money/availability is tight for getting hold of painkillers. Someone who uses marijuana will often drink alcohol while high to maximize the depressant effects of marijuana. An individual who uses stimulant drugs such as cocaine, methamphetamine, or stimulant pharmaceuticals is likely to jump back and forth between different drugs, depending on which is available/affordable at the time.

That is poly-drug use. It is dangerous, and it is under-discussed and under-addressed mostly due to a lack of awareness that most addicts simply use more than one type of drug.

The Cumulative Danger in Poly-Drug Addiction

Multiple drug abuse.

As one can imagine, using multiple drugs at once bodes poorly for those who walk down this path. So let’s look at this further. If someone is using one drug, that creates a clear and present danger to that person. They take their lives into their own hands every time they use. Furthermore, they develop all kinds of complex physical and psychological dependencies to the drug which are challenging to break away from.

But what happens when an individual is using two drugs, instead of one? Now we’re looking at a person who has two dependencies, two substances that he relies on, two substances that cause no end of trouble and stress. His problem is suddenly multiplied and his life is that much more at risk. Helping him break free from addiction becomes that much more difficult.

Case in Point—A Look at Massachusetts Poly-Drug Deaths

To get an idea of the danger in poly-drug use, let’s look at a real example of what happens when people use more than one drug at once.

According to a news article in U.S. News from May 30th, 2019, most opioid drug deaths in Massachusetts involve other drugs which were present at the time of death. The evidence comes from the collection and examination of toxicology reports.

This research was done by the Boston Medical Center’s Grayken Center for Addiction. The research project analyzed all opioid deaths in the state, from January 2014 to December 2015. Of 2,244 total opioid deaths examined, 83 percent of them involved another drug. That means that, of everyone who died from opioid overdose in Massachusetts from the beginning of 2014 to the end of 2015, only a tiny percentage of them were solely consuming opioids at the time of their death.

“Poly-substance use at this point, especially in the context of opioids, is the norm and not just the exception to the rule. We’re not in an opioid overdose crisis, we’re in a drug overdose crisis.”

According to Dr. Joshua Barocas, the study author and an infectious disease physician (quoted in U.S. News), “Poly-substance use at this point, especially in the context of opioids, is the norm and not just the exception to the rule. We’re not in an opioid overdose crisis, we’re in a drug overdose crisis.”

In the Massachusetts example, medical experts believe that sociodemographic factors are at the foundation of much of that state’s poly-drug use. Again according to Dr. Barocas, “Expanding treatment (and) expanding prevention services directly related to substances is paramount and key, but at the same time, we’re not going to just treat our way out of this. We really have to address these social determinants of health … if we’re ever going to really get ahead of the curve.”

Dr. Barocas’s full study can be found in the Science Direct journal. The study goes on to discuss other factors which lead to addiction, factors which make certain areas of the population more likely to succumb to poly-drug use than others. It is valuable to know this data, as the more we can understand what happens to people to make them want to use multiple drugs, the more prevention efforts we can take to prevent those circumstances from coming about.

Helping Your Family Member or Loved One

A mother is helping her daughter.

If you have a family member or loved one who is addicted to drugs and who is using more than one drug at once, your mission must be to get them help, to get them into an inpatient drug and alcohol treatment center, and to do so as soon as possible.

A lot of times, poly-drug use is a complete roadblock to addicts getting treatment. If an individual is using multiple drugs at once, say heroin and opioid pain relievers, he may consider the heroin use a problem, but not the opioid pain reliever use. He may conceive the pain reliever use as “acceptable” since pain relievers are technically legal.

But if you are trying to seek help for your loved one, trying to get them into treatment, it’s important that they get off of all drugs. Without even touching on the lethal risk of poly-drug use, just getting a loved one to seek treatment for all of their drug problems and addictions can be challenging. Be prepared to face additional objections to treatment for all substances when confronting your loved one.

Drug addiction by itself can be and often is a lethal condition, a gripping and crippling crisis that grabs hold of people and prevents them from making any forward progress in life. When people struggle with a drug habit, they are indeed slaves to the addiction until they are helped to overcome it.

Now imagine someone whose burden is double, or triple that. That is the day-to-day life situation of someone who engages in poly-substance abuse. These poor souls need our help immediately, and they usually need our help for some time before they come out victorious. Do not give up on them. Make sure they get help through residential rehab and keep helping them until they have overcome all of their drug-use habits. It might be challenging to do so, but drug use, especially poly-drug use, is a life-or-death matter.


Reviewed and Edited by Claire Pinelli, ICAADC, CCS, LADC, RAC, 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.