What is Polysubstance Dependence?

Polysubstance dependence is a form of drug dependency where a person uses three or more substances indiscriminately within a year period and experiences dependent symptoms like interference with daily activities because of the drug use. In people with this condition, there is no favorite or preferred drug, and the symptoms of drug dependence occur collectively; instead of being separately addicted to each substance, the patient has an interlocking set of addictive behaviors. Treatment is available, and can be complex because of the need to address multiple substances.

Patients with polysubstance dependence need to meet several criteria for a diagnosis. People with dependence on drugs tend to have issues like spending a lot of time procuring and using drugs, having difficulty completing tasks like work because of intoxication, experiencing drug tolerance, and feeling like they have lost control of their drug use. Patients will experience withdrawal symptoms if they stop taking drugs. In the case of polysubstance dependence, the patient relies on three or more drugs at varying points in time to achieve intoxication and experiences symptoms of addiction.

For example, a patient might use cocaine, alcohol, and prescription opiates. The opiate use might cause the patient to miss work due to fatigue and illness, while the alcohol intoxication could lead to problems like driving under the influence or making mistakes at work. The cocaine could lead the patient to engage in risky and self-harming behavior. Independently, the problems associated with each drug might not be enough to label the patient as dependent on that substance, but in combination, the patient clearly has a substance abuse problem.

Treatment of patients with polysubstance dependence can include psychotherapy to talk about why the patient started using drugs and to develop strategies for controlling drug use and leading a healthier life. The patient may also need to detoxify in a clinical setting to deal with the symptoms of withdrawal, and may benefit from a living in structured home environment with other recovering drug users who offer support to one another when they feel like using again.

A history of polysubstance dependence in a family can be an indicator of risk, but the exact causes of this condition are not known. Young men tend to be more likely to develop substance dependence in general, but people of all ages, races, and genders can experience this condition. Treatment outcomes depend on the type of care provided, the patient's commitment to treatment, and support after treatment to keep the patient from using again.