Polydrug Abuse: The Danger of Mixing Drugs

Last Updated: August 23, 2024

Editorial Policy | Research Policy

Drug abuse can be dangerous even if only one substance is involved. Polydrug use, or using multiple substances at once, creates even greater health risks. Further, becoming dependent on multiple substances can worsen the side effects of withdrawal. Fortunately, treatment can help people successfully recover from polydrug abuse.

What Is Polydrug Use?

Also known as polysubstance use, polydrug use occurs when someone uses more than one substance at the same time. These substances may be:

  • Illicit drugs
  • Prescription medications like opioids
  • Alcohol
  • Tobacco
  • Over-the-counter substances like cough medicine and antihistamines

Polysubstance abuse can occur for many reasons. Multiple substances may be taken at the same time to enhance a high; for example, when central nervous system (CNS) depressants like opioids and benzodiazepines are taken together, extreme sedation can occur. Drugs may also be mixed to prevent side effects or a crash; an example is combining heroin and cocaine to make a speedball.

Polydrug use is linked to addiction, depression and behavioral problems, especially in teens.

Polydrug Use Rates

Mental health is a risk factor for polydrug abuse. Research shows that New Jerseyans with mental health problems are significantly more likely to abuse multiple substances. Further, those who abuse multiple substances at once are more likely to be male and aged 34 or younger. Overall in 2004, about 13% of New Jersey residents reported engaging in polydrug use within their lifetime, and 2% did so within the past year.

People who take multiple substances may engage in risky behaviors, such as driving while impairedAs of 2019, 482 New Jersey drivers were impaired on multiple substances, making up more than one-third of all impaired drivers. This number was more than four times the national average and increased more than 89% from 2015 to 2017.

Polydrug Use Youth Statistics

Polydrug abuse is common in adolescents. Studies show that almost 31% of adolescents have used marijuana. Of these, nearly a third also take other drugs, including heroin. Among adolescents who have taken heroin, most regularly use substances like alcoholmarijuana, other opioids and ecstasy.

Dangers of Combining Drugs

Mixing drugs can be dangerous for a variety of reasons. Substances may have additive effects, such as when CNS depressants like opioids, sedatives and alcohol are mixed. Drug interactions and hidden ingredients are other dangers. For example, many illicit street drugs, including cocaine, can be tainted with the powerful opioid fentanyl.

Even drugs that are prescribed at the same time can carry risks. For example, a doctor may prescribe an opioid and a benzodiazepine together. However, combining these depressants can cause an increased risk of overdose and death. Adding other depressants, such as antihistamines, cough medicine or alcohol, can also lead to additional side effects and dangers.

Popular Drug Combinations

There are many common drug combinations. Sometimes, multiple drugs are even mixed into a single product and sold on the street. For example, cheese is a combination product mixing black tar heroin with cold medication, and Chiva is a mix of black tar heroin and antihistamines.

Related Topic:Marijuana and Alcohol

Some common combinations include:

  • Marijuana and alcoholespecially in youth
  • Heroin and alcohol, marijuana, psychedelics, stimulants or sedatives, especially in youth
  • Opioids and tobacco
  • Opioids and marijuana
  • Opioids and alcohol, which is dangerous as they are both CNS depressants
  • Opioids and sedatives like benzodiazepines, a combination that carries an FDA black box warning due to the risk of CNS depression and death
  • Opioids and stimulants

Related TopicMarijuana and Alcohol

Polydrug Overdose

A big challenge in polydrug overdoses is identifying and addressing the cause of the overdose. For example, a person overdosing on opioids and other substances may not fully respond to naloxone, as this drug only works on opioids. For this reason, it is important to seek emergency medical attention if you suspect a polydrug overdose. Doctors will have a better chance of keeping the person breathing and supporting the cardiovascular system while the person recovers.

Polysubstance Withdrawal

Going through withdrawal is hard enough when you are dependent on one substance. Managing symptoms and cravings can be an immense challenge, but withdrawing from multiple substances at the same time can be even harder. 

Withdrawal effects from polydrug use can be difficult to predict, and the risks may increase depending on the substances you take. For example, both alcohol and benzodiazepines have seizures as a possible withdrawal effect. If you are dependent on both substances, going through withdrawal may be even more complex. For this reason, it can be dangerous to go through withdrawal without help.

Detoxing From Multiple Substances

Having round-the-clock medical care can be invaluable if you are detoxing from multiple substances at the same time. Medical staff can respond quickly to any withdrawal symptoms you are having and may be able to prevent symptoms from occurring in the first place. Our experienced detox specialists at The Recovery Village Cherry Hill at Cooper can quickly treat any withdrawal symptoms that may arise.

Polysubstance Abuse Treatment

After medical detox, rehab can play a key role in helping you end drug use. Studies have shown that this is especially true if you struggle with multiple substances. In rehab, you learn strategies for living a substance-free life and engage in ongoing therapy sessions to explore why you began to rely on substances in the first place. 

Our polydrug experts at The Recovery Village Cherry Hill at Cooper can help you start a drug-free life in our treatment programsContact us today to learn more about treatment programs that can work well for your situation.

FAQs

What is polysubstance abuse?

Polysubstance abuse is the use of more than one drug or substance at the same time.

What are the dangers of polydrug use?

Polydrug use can increase the risk of overdose. It can also complicate withdrawal symptoms when you decide to stop taking the substances.

What happens if you mix marijuana with other drugs?

Marijuana is often mixed with other drugs. However, mixing it with certain drugs may increase the risk of side effects. For example, mixing it with stimulants may cause an increased heartbeat or high blood pressure, while mixing it with depressants may cause movement problems and sedation.

Why is it dangerous to mix alcohol and drugs?

Alcohol can increase the risk of side effects from other drugs. This is especially true if you take other depressants, such as opioids; mixing them with alcohol can increase the risk of overdose and death.

Sources

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Center for Public Interest Polling. “The 2004 New Jersey Survey of Mental Hea[…] Drug Use and Health.” 2004. Accessed November 1, 2020.

National Institute on Drug Abuse. “Monitoring the Future 2019.” 2019. Accessed November 1, 2020.

Jones, Jason D.; Calkins, Monica E.; et al. “Cannabis Use, Polysubstance Use, and Psy[…]d Sample of US Youth.” Journal of Adolescent Health, March 17, 2017. Accessed November 1, 2020.

Palamar, Joseph J.; Le, Austin; Mateu-Gelabert, Pedro. “Not just heroin: Extensive polysubstance[…]currently use heroin.” Drug and Alcohol Dependence, June 4, 2018. Accessed November 1, 2020.

City of Plano Police Department. “Heroin: Just the Facts.” Accessed November 1, 2020.

Foundation for a Drug Free World. “Cheese Heroin.” Accessed November 1, 2020.

Winkelman, Tyler N.A.; Change, Virginia W.; Binswanger, Ingrid A. “Health, Polysubstance Use, and Criminal […]Levels of Opioid Use.” JAMA Network Open, July 6, 2018. Accessed November 1, 2020.

Food and Drug Administration. “FDA requires strong warnings for opioid […]th from combined use.” August 31, 2016. Accessed November 1, 2020.

Maslowsky, Julie; Schulenberg, John E.; O’Malley, Patrick M.; Kloska, Deborah K. “Depressive symptoms, conduct problems, a[…] US national surveys.” April 10, 2013. Accessed November 1, 2020.

Florida Department of Children and Families. “Speedballing: Mixing Stimulants and Opioids.” (n.d.). Accessed November 1, 2020.

National Institute on Drug Abuse. “Commonly Abused Drugs and Withdrawal Symptoms.” (n.d.). Accessed November 1, 2020.

Wang, Linwei; Min, Jeong Eun; Krebs, Emanuel; et al. “Polydrug use and its association with dr[…]e, and cocaine users.” International Journal of Drug Policy, September 6, 2017. Accessed November 1, 2020.

Horn, John R.; Hansten, Philip D. “Drug Interactions with Marijuana.” Pharmacy Times, December 9, 2014.  Accessed November 1, 2020.

Centers for Disease Control and Prevention. “More than Half of People who Misuse Pres[…]ids also Binge Drink.” June 10, 2019. Accessed November 1, 2020.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.