When we think about addiction treatment and drug detox, most often we think in terms of a single drug or a person’s “drug of choice”. But the reality is that most people grappling with a substance use disorder are using more than one substance when they enter detox

This article from Innovo Detox takes a look at polysubstance abuse and the impact that combining different drugs and alcohol can have on the detox and recovery process. 

What is Polysubstance Abuse and What Does it Look Like?

Polysubstance abuse refers to the misuse of more than one drug or type of drug (including alcohol) within a certain period. The term is derived from the prefix “poly-” meaning “many”. The phenomenon of polysubstance abuse is not new, of course. 

People have been using drugs and alcohol in various combinations for thousands of years. However, it wasn’t until the 20th century that the term “polysubstance abuse” was coined and started being used in medical and psychiatric literature. 

What is polysubstance abuse?

  • The misuse of any combination of intoxicating substances, drugs, or alcohol.
  • Use can be concurrent, it does not need to be simultaneous to be polysubstance abuse.
  • Getting drunk one day and using cocaine to wake up the next is polysubstance abuse.

Why Do People Combine Different Drugs? 

Polysubstance abuse can involve any combination of drugs, including alcohol, illegal drugs, and prescription medications. The reasons for polysubstance abuse vary. Sometimes people combine different drugs to “balance the effects”. 

For example, people who are drinking may use cocaine because its stimulant effects counteract some of the depressant effects of alcohol, making it possible to drink more and stay away longer. People also combine opioids and cocaine for similar reasons. For example, smoking crack cocaine while under the influence of oxycodone or injecting a solution of heroin and cocaine. The latter combination, known as a “speedball” was responsible for the death of comedian John Belushi in 1982. 

People also combine drugs with similar effects to amplify the overall effect. For example, combining opioids with benzodiazepines to enhance the euphoric effects. Sometimes the combining of drugs and/or alcohol is by mistake or simply circumstantial and not deliberate. People may also opt for another drug when their “drug of choice” isn’t available, or there is a small amount they are trying to extend the usefulness of. 

Reasons why people engage in polysubstance abuse include: 

  • To “balance” the effects, i.e. using cocaine with alcohol to “wake up”. 
  • To intensify or magnify the effects, i.e. combining benzos and opioids.
  • Because the desired “drug of choice” is unavailable. 

The Danger of Mixing Cocaine and Alcohol

Alcohol and cocaine can be a dangerous mix. When combined in the human body, cocaine, and ethyl alcohol produce a third compound called cocaethylene. This is the only known example of a new psychoactive substance being created within the body.

Cocaethylene has its own unique euphoric effects, which have a longer duration of effect than cocaine does alone. This additional, longer-lasting “euphoric boost” is one of the reasons some people who ordinarily do not use cocaine may feel compelled to seek it out when they are drinking.

Cocaethylene is dangerous because it is cardiotoxic. It can also block the reuptake of serotonin, making it potentially dangerous for people on certain antidepressants. The effects of cocaethylene can be more difficult to predict than cocaine or alcohol in isolation. 

The Dangers of Combining Opioids and Benzos and Other Sedatives

The mixture of opioids and benzodiazepines is relatively common and can be a particularly dangerous, and even deadly combination. Both drugs have CNS depressant effects and when two drugs like this are used together, the effects are often more than just cumulative, they can amplify one another in unpredictable ways. 

Death by respiratory arrest when combining benzos and opiates is worryingly common, unfortunately. The new combination of heroin or fentanyl and the veterinary tranquilizer, Xylazine (tranq), is also responsible for an increasing number of overdose deaths. Another risk comes from the fact that the drug NARCAN (naloxone) which is often used to reverse opioid overdose does not affect benzodiazepines or other sedatives like Xylazine. 

How Is Polysubstance Abuse Treated?

A medical detox is usually the first step in treating a substance use disorder that involves polysubstance abuse. The complexities of polysubstance abuse make it particularly important that a patient admitted to a medical detox be as candid and explicit as possible when describing their drug and alcohol use. A clinical interview will be done as part of the detox admissions process. This is the time to let it all out. 

Downplaying or minimizing any drug or alcohol use, or omitting information can make it more difficult to provide optimal treatment and drug detox services. It may be helpful to remember that the clinical staff and admissions personnel are professionals. 

No one at Innovo Detox is going to be shocked or dismayed by anything a patient has to tell them. You can rest assured that this is an environment free of judgment, discrimination, or bias. We simply want to help— so any person admitting to treatment here should feel comfortable in being as honest as possible about their experience. 

Innovo Detox Treats Polysubstance Abuse Disorders

Recovery from the seemingly hopeless state of mind and body that addiction brings is the birthright of you or your loved one. We believe absolutely everyone deserves recovery, regardless of how far they believe they’ve fallen. 

But recovery doesn’t simply happen spontaneously. It requires the courage and willingness to raise your hand and ask for help. The ball is in your court. Whether it’s you or someone you love who needs help with polysubstance abuse — someone needs to make the first move if anything is going to change. 

Finding the courage to admit yourself for detox and addiction treatment will be one of the best decisions you ever make. Intuitively you already know this. So what’s stopping you? If you have any questions about inpatient detox in PA or anywhere else in the country, Innovo Detox can help. One call to our confidential detox hotline is all it takes to get answers to your questions about polysubstance abuse or detox. 

You can reach Innovo Detox anytime by calling (717) 971-4566 or connect with us through our contact page here