What Is Polysubstance Abuse?

Polysubstance abuse occurs when an individual is dependent on three or more drugs, excluding nicotine and caffeine, within a 12-month period, without a dependence on any individual drug.


Multiple drug use is especially common among those with severe addictions. Individuals may use more than one drug to amplify the effects of a drug, to minimize the negative effects of a drug or due to developing a tolerance to a drug.

In defining what polysubstance abuse is, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) states that at least three of the following symptoms must be evident:

  1. Tolerance
  2. Withdrawal
  3. Lack of control
  4. Inability to stop using
  5. Spending inordinate amounts of time using
  6. Interference with other activities and harm to one’s physical or mental health.

What Is Polysubstance Abuse?

Causes of Polysubstance Abuse

Polysubstance abuse may be a symptom of an underlying problem, such as depression, anxiety or stress. Scientists have found a strong genetic component to drug abuse through family and twin studies, and have found allelic markers that distinguish drug abusers as a group from others.

Others point to cultural influences impacting substance abuse, such as peer pressure among youth as well as the glorification of drug use in Hollywood movies. Understanding both the environmental and genetic factors will help mental health professionals in preventing and treating polysubstance abuse.

What Is Polysubstance Abuse Treatment?

Each person with polysubstance abuse must be treated individually, based on his or her drug use, personal history and family relationships. Treatment may involve medication, group and behavioral therapy.

Those with severe cases of polysubstance abuse may need to spend time in a residential treatment center for up to 12 months. It is important that a polysubstance abuser receiving treatment remain in treatment for a sufficient amount of time to allow recovery.

Certain medications lower cravings, reduce withdrawal or neutralize the effects of a drug. Polysubstance abuse may require the use of more than one medication to treat a patient. For example, methadone and naltrexone have been found to be effective for some abusers of opiates, and naltrexone, acamprosate and disulfiram have been found to be effective for some alcoholics.

One form of treatment that has been effective for many substance abusers is group therapy. During group therapy, participants, led by a counselor or therapist, recount their experiences with one another, providing an atmosphere in which they do not feel judged or condemned over their substance abuse. Participants then provide one another with advice and mutual support to overcome their substance abuse. Such therapy addresses the emotional needs of substance abusers.

According to the 2007 National Survey on Drug Use and Health, the majority of substance abusers who needed treatment did not receive it. Without the adequate availability of treatment, the social costs associated with incarceration, unemployment and strained family relationships due to untreated polydrug use are likely to be substantial.

While difficult to treat, polysubstance abuse must be dealt with on an individual basis, and different treatments may have to be attempted before recovery is achieved. It is especially important to find any underlying problems rather than simply treating the symptoms in order to bring about a full recovery for the polysubstance abuser.

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