Polysubstance use disorder is a mental health condition in which someone uses more than one substance at the same time or within a short period of time, despite a pattern of negative effects.
Previously called polysubstance abuse, polysubstance use disorder is a mental health condition that involves combining more than one substance or taking one substance shortly after another. People with it may not be able to stop or reduce their use of substances due to changes in the brain from substance use.
People may use more than one substance for various reasons, including to prolong the high or reduce certain effects from one substance.
But combining substances can have unpredictable effects that may increase the risk of overdose and death.
If you’re experiencing (or a loved one is experiencing) polysubstance use disorder, know that help is available.
Keep reading to learn about the effects, causes, and treatment of polysubstance use disorder and how to get help.
Substance use disorder vs. polysubstance use disorder
Substance use disorder, a diagnosis that is the combination of what was previously called substance abuse and substance dependence, is a health condition in which a person experiences a pattern of symptoms surrounding compulsive substance use that occurs despite adverse effects on their life and daily functioning, including issues with:
- health
- work
- school
- home
- relationships
Polysubstance use disorder occurs when a person experiences this pattern of symptoms while using more than one substance.
You may experience different symptoms relating to polysubstance use disorder depending on your use patterns, including how much of the substances you use and how often you use them.
Substances release chemicals like dopamine that make you feel good. When using them, you may feel positive emotions such as excitement or euphoria (intense joy), which is known as a “high.” The substances may also make you feel relaxed or sleepy.
Polysubstance use disorder can cause symptoms when the substances begin to wear off. These withdrawal symptoms can depend on the specific substances but may include:
- changes in your mood and emotions, such as anxiety, depression, agitation
- insomnia (difficulty sleeping)
- sweating
- digestive issues, like diarrhea, nausea, and vomiting
- muscle pain or cramping
Complications of polysubstance use disorder
Using more than one substance together may cause unpredictable symptoms, including changes in your heart rate and consciousness. It can also increase the risk of overdose and death.
If a person is experiencing severe symptoms after using one or more substances, contact 911 or your local emergency medical services for immediate medical attention. Symptoms may include:
- loss or change of consciousness
- gurgling sounds
- slow breathing or no breathing
- pupils the size of a pinpoint
- blue lips or fingernails
Diagnosis typically involves talking with a healthcare professional about your experience of substance use.
Polysubstance use disorder is not listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), though substance use disorder is.
According to the DSM-5-TR, the criteria for substance use disorder include:
- Using more of a substance than you intend to or using it for longer than you intend to.
- Trying to reduce your use or stop using the substance, but being unable to.
- Experiencing intense cravings or urges to use the substance.
- Needing more of the substance to get the desired effect (tolerance).
- Developing withdrawal symptoms when not using the substance.
- Spending more time getting and using the substance and recovering from use.
- Neglecting responsibilities at home, work, or school because of substance use.
- Continuing to use even when it causes relationship problems.
- Giving up important or desirable social and recreational activities due to substance use.
- Using substances in settings that put you in danger.
- Continuing to use despite the substance causing problems to your physical and mental health.
Substance use disorder can also range from mild to severe, depending on the number of criteria a person meets.
- One symptom could indicate a person is at risk of a substance use disorder.
- Two or three criteria point to a mild substance use disorder.
- Four or five symptoms show that someone has a moderate substance use disorder.
- Six or more criteria indicate a severe substance use disorder, which signals an addiction to that substance.
Like many other health conditions, polysubstance use disorder disrupts the functioning of body organs, has serious harmful effects, and may be preventable and treatable.
Polysubstance use disorder involves using more than one substance at the same time. Substances do not need to be illegal in order to be used as part of substance use disorder. Substances can include:
- alcohol
- opioids
- cocaine
- methamphetamine (meth)
- cannabis
- ketamine and other “club” drugs
- steroids
- inhalants
- prescription medications, even when prescribed by a doctor
Prescription medications can lead to substance use disorder when initially prescribed by a doctor and taken according to the directions. Misuse can happen if you use them with other substances or use them in a way other than prescribed.
People with substance use disorder may develop polysubstance use disorder if they use more than one substance at the same time (or in a short period) in an effort to:
- enhance or prolong the high from one substance
- balance the undesired effects of one substance with another
- prevent withdrawal symptoms
- reduce their use of one substance
- mimic the effect of another substance that’s unavailable or too expensive
- self-medicate for a pre-existing health condition
Risk factors for polysubstance use disorder
Anyone can develop polysubstance use disorder. However, some factors may increase the risk. These can include:
- having substance use disorder
- current or past physical, sexual, or emotional abuse or neglect
- history of trauma
- having access to these substances
- having mental health disorders, such as:
- beginning substance use at an early age
- family member or peer substance use
- attention deficit hyperactivity disorder (ADHD)
If you are trying to reduce or stop your substance use, help is available.
Depending on how often, how much, and which substances you use, stopping use abruptly after habitual use can be dangerous or life threatening. Some of the substances that can cause withdrawal syndromes include:
It’s best to talk with a healthcare professional if you are trying to stop using substances after heavy, habitual use. Because polysubstance use disorder can cause increased risk and complex withdrawal, they typically admit you for monitoring under the guidance of a medical professional during the withdrawal period.
Treatment typically includes:
- detoxification (“detox”)
- medications to reduce withdrawal symptoms
- therapy to support your recovery
- monitoring and developing a plan to prevent relapses
Medications for treating polysubstance use disorder can depend on the specific substances you have been using, such as opioids or alcohol.
Stopping substance use can be difficult and requires time and effort. Some people may experience relapse during their recovery and begin treatment, including detox, again. But recovery is possible. Building a strong support system may help.
Resources for substance use disorder
If you (or a loved one) may have polysubstance use disorder, the following resources may help:
- Above the Influence provides information targeted at youth and young adults regarding substance use, peer pressure, and treatment options.
- The Substance Abuse and Mental Health Services Administration (SAMHSA) offers free resources and referrals to treatment. If you have questions or need help, call the 24/7 helpline at 800-662-HELP (4357).
The National Institute on Drug Abuse provides information and research for teenagers and young adults about substance use disorders.- The National Association for Children of Alcoholics provides information and resources for children of parents with alcohol use disorder.
- Al-Anon provides confidential groups and meetings across the United States for adult friends and family members of people who misuse alcohol. Call 888-4AL-ANON (888-425-2666) for more meeting information.
- Alateen provides confidential groups and meetings across the United States to help teenagers and young adults cope with a friend or family member’s alcohol use. Try Alateen chat.
- Alcoholics Anonymous (AA) offers in-person and virtual meetings and support groups for people in recovery from alcohol addiction or misuse.
- Narcotics Anonymous (NA) offers in-person and virtual meetings and support groups for people in recovery from narcotic addiction or misuse.
If you are not ready to seek treatment for polysubstance use disorder, you can follow certain steps to reduce harm.
These may include:
- keeping an overdose reversal medication like naloxone (Narcan) with you in case of emergencies
- using fentanyl test strips to detect fentanyl on substances you may use
- keeping the phone number of a trusted loved one with you in case of emergencies
- receiving psychotherapy for any co-existing mental health conditions
- taking steps to prevent infectious diseases, such as hepatitis C, by using sterile supplies
Polysubstance use disorder is a form of substance use disorder that involves using more than one substance and experiencing a pattern of symptoms that lead to negative life effects.
Using more than one substance at the same time can have complex and unpredictable effects and may increase the risk of overdose and death.
If you (or a loved one) may have polysubstance use disorder, help is available.