The Complexity of Polysubstance Use
In a world where a range of substances are readily available and societal stressors have become amplified, polysubstance use is an increasingly prevalent issue. Polysubstance use is when multiple substances are taken together at the same time – or close in time – either intentionally or unintentionally. Notably, in 2019, nearly half of drug overdose deaths involved multiple drugs. Polysubstance use plays a significant role in the alarming rise in opioid deaths that we are seeing across the nation, with fentanyl as a key contributor. Because polysubstance use is complex with a range of underlying causes, substance combinations, and impacts on physical and mental health, determining effective treatment and prevention can be particularly tricky.
Understanding Polysubstance Use
Polysubstance manifests in many forms including combining multiple stimulants, combining depressants, mixing stimulants and depressants, and drinking alcohol while using other substances. This complex mixing of substances often leads to heightened risks and increased severity of health complications. For example, mixing opioids with other substances such as another opioid, heroin, cocaine, xylazine, benzodiazepines, alcohol, fentanyl, and antidepressants has contributed to the rising number of opioid overdose deaths in the U.S. Likewise, combining alcohol with prescription medications or illicit drugs can magnify the adverse effects of each substance, putting individuals at a greater risk of overdose, accidents, or long-term health issues.
The Root Causes
The reasons behind polysubstance use are diverse and complex. Some individuals engage in this behavior as a form of self-medication, attempting to cope with underlying mental health issues such as anxiety, depression, or trauma. An individual may use substances at the same time or sequentially to counteract or balance their effects, alleviate withdrawal symptoms, prolong a “high,” mimic the effect of another substance, or even reduce overall use. Older adults may deliberately or unknowingly use multiple substances as they manage an increase in chronic health conditions that require multiple prescriptions or seek to cope with significant life changes that impact mental health. As with all substance use, factors like genetic predisposition, environmental stressors, and socioeconomic conditions contribute to the development of polysubstance use disorders.
Impact on Physical and Mental Health
Polysubstance use takes a toll on both physical and mental well-being. Physically, the combination of different substances can strain vital organs, compromise the immune system, and induce a range of medical complications. The effects of combining different substances are unpredictable, which makes the practice particularly dangerous – even deadly. For instance, while naloxone may reverse the effects of an opioid overdose, if other substances have been misused simultaneously, the individual will require additional measures to counteract the body’s response.
As with all substance use disorders, mental health is also affected, with increased susceptibility to mood disorders, cognitive impairments, and heightened risk of developing psychiatric conditions. The interplay of substances can exacerbate the symptoms of pre-existing mental health issues, leading to a vicious cycle that is challenging to break.
Treatment and Recovery
Recovery from polysubstance use is a challenging journey that demands a comprehensive approach to treatment. Individuals may be addicted to multiple substances, so a specialized treatment plan is necessary to address the nuances associated with the different substances. Rehabilitation programs, counseling, and support groups play pivotal roles in the recovery process, providing individuals with the tools to overcome addiction and establish a foundation for long-term well-being.
Treatment approaches may vary based on individual needs, with some opting for inpatient rehabilitation, outpatient programs, or a combination of both. The importance of ongoing support cannot be overstated, as recovery is a lengthy process that requires commitment and perseverance. Addressing underlying mental health issues is integral to preventing relapse, emphasizing the need for integrated care that considers both substance use and co-occurring disorders. Simultaneously working as a community to address social and cultural disparities that exist is necessary, as these factors play an important role in substance use.
Conclusion
Polysubstance use is a complex and challenging issue that requires a nuanced understanding of its root causes, impact, and recovery process. By fostering awareness, promoting education, and advocating for comprehensive treatment, we can contribute to a society that supports individuals struggling with substance use disorders. Every step towards recovery, however small, is a triumph over adversity, and with the right resources and support, individuals and communities can embark on a journey toward lasting well-being.
