Polydrug Use: Get the Facts
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Drug abusers and addicts often find themselves combining drugs, either out of “necessity” when they can’t get their usual fix, or to enjoy the altered effects of ways one drug might interact with another in the body. These people are called polydrug abusers.
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Polydrug Abuse: An Overview
Polydrug abuse involves abusing one or more drugs in combination with one another. Sometimes this is done intentionally for one drug to play off another, either by heightening the effects or by allowing one drug to downplay the effects of the other. For instance, taking cocaine with a sedative allows the sedative to dampen or stabilize some of the “high” usually offered by cocaine.
In some cases, drug users will combine drugs without rhyme or reason. This is often because they can’t access, either due to money restraints or inability to find a dealer, their drug of choice. Haphazardly combining pills and other drugs is a dangerous game. Many drugs interact with one another in dangerous ways, and this can quickly lead to deadly interactions or even drug overdose if the wrong pill combinations are taken nearby. Many drug users do not care whether they live or die, and once combinations of drugs are started, it’s only a matter of time before an overdose occurs.
How dangerous is polydrug abuse?
Polydrug use is extremely dangerous because of each drug’s potential to interact poorly with other drugs. Taking the wrong combination of pills within proximity of each other can easily result in overdose or death.
Common Drug Combinations
There are some drug combinations that are more common than others among drug users. These can include:
- “Speedball” – Combining a depressant medication with a stimulant is often referred to as a “speedball.” While the two drugs cancel each other out in the beginning (the depressant lowering heart rate and blood pressure, while the stimulant increases them), the stimulant often wears off much faster than the depressant. This leaves an amplified opiate effect on the user and can lead to cessation of breathing.
- Cocaine and cigarettes – Since both drugs act on the brain chemical dopamine, which is one responsible for addiction, one substance helps make addiction to the other stronger and vice versa. Users of both may find it harder to quit both drugs.
- Antidepressants and MDMA – Many people combine these two types of drugs for the antidepressants to balance out the reduction in serotonin caused by drugs like ecstasy and psychedelics. While those who use an SSRI may achieve this goal, using another classification of antidepressant, such as an MAOI inhibitor, may cause a fatal reaction known as serotonin syndrome. This is caused by too much serotonin in the brain.
- Marijuana and other drugs – Marijuana can have fatal interactions with other drugs. For instance, when used in combination with some antidepressants, heart rate irregularities are common. It may also increase the effects of cocaine and offset the results by antipsychotic medications.
How to recognize polydrug addiction?
Factors that can help one recognize polydrug addiction:
- Loss of interest in favorite activities
- Lack of personal hygiene
- Goes through large amounts of money quickly and in secret
- Mood swings and changes in behavior
- Decreased ability in regards to memory and focus
Drugs and Alcohol
One of the most common combinations of drug users like to use is that of various drugs and alcohol. This is especially common with cocaine, marijuana, Barbiturates, Benzodiazepines, antidepressants, and antihistamines. Alcohol can be especially dangerous when combined with depressants. Because alcohol suppresses the central nervous system, it is also a depressant. Combining the two can slow down the nervous system too much, which can easily lead to respiratory arrest, irregular heart rate, slowed mental function, dizziness, coma, or death.
600,000 ER visits every year are related to the use of drugs and alcohol in combination. This makes up over half of all drug-related hospital visits. Alcohol is highly dangerous to use with any drug, as it has been shown to interact with over 150 separate substances, including recreational and prescription drugs.
Recognizing Polydrug Addictions
The signs and symptoms of someone using multiple drugs are similar to those of someone who only uses one drug. They may be amplified, however, as the risk of overdose and other complications are much higher among those who use drug cocktails vs. any single drug. The following are the signs of drug use:
- Doesn’t care about activities he used to enjoy
- Has decreased his level of personal hygiene
- Seems secretive, withdrawn, or less talkative than usual
- Spends money but won’t indicate where it’s being spent
- Has mood swings and other erratic behavioral changes
- Lacks focus, memory, or seems easily confused
- Struggles at school or work
The following signs or symptoms are indicative of drug overdose and warrant immediate medical attention:
- Severe nausea and vomiting
- High or low blood pressure
- Trouble breathing
- Headache or migraine
- Irregular or rapid heart rate
- Emotional outbursts or severe mood swings
- Loss of consciousness
- Slurred speech
- Respiratory arrest
The most commonly combined drugs are:
- Depressants and stimulants— “speedball” often refers to combining cocaine (a stimulant) with heroin or morphine (depressants)
- Cocaine and cigarettes— intensifies each drug’s effects on dopamine levels in the brain
- MDMA and antidepressants— counteract each other to balance out the brain’s serotonin levels
- Marijuana and other drugs— can cause adverse, sometimes fatal, drug interactions
Treatment of Polydrug Abuse
Often time, polydrug addiction and abuse are harder to treat than the treatment of single drug addiction. This is due to many factors:
- Drug addicts using multiple drugs are often more deeply ensnared in addiction. Often, by the time a drug user tries multiple drugs or combines drugs with alcohol, he has been using for a while, and addiction has had time to “rewire” his brain. These people are highly addicted.
- Drugs play off one another to cause heightened reactions, as well as more addictive dependency. Combining drugs often make quitting any of them more difficult to accomplish.
- Withdrawal symptoms are often compounded. The more drugs at play, the more severe withdrawal symptoms can be. Additionally, quitting some drugs or combinations, cold turkey can lead to dangerous side effects. These can often be deadly.
- Users are more resistant to help. Higher levels of addiction often mean more resistant addicts. The saying “the first step is admitting one has a problem” is true and those who aren’t open to getting help usually won’t. Unfortunately, many polydrug users will die before they reach that point.
The most effective treatment for polydrug addicts is an inpatient rehabilitation facility. While there are outpatient counseling and programs available, they are often less effective at treating the most severe cases of addiction. An inpatient center will provide a higher level of care which will include:
- Medical monitoring during detoxification to ensure any side effects or withdrawal symptoms are kept under control
- Intensive counseling to get to the root of the drug use
- Treatment for any underlying co-occurring disorders, such as anxiety or depression
- Group therapies for peer to peer support and advice
- Ruiz, P., & Strain, E. 2011. Substance Abuse: A Comprehensive Textbook, Fifth Edition. Philadelphia, PA: Lippincott Williams & Wilkins.
- The National Center for Biotechnology Information. 2006. Simultaneous and Concurrent Polydrug Use of Alcohol and Prescription Drugs: Prevalence, Correlates, and Consequences. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1761923/.
- National Institute on Drug Abuse. 2015. DrugFacts: Treatment Approaches for Drug Addiction. https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction.
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