Majority of drug-addicted individuals have a “drug of choice”, whether it is cocaine, methamphetamine, alcohol, or other substances, they all have that one drug that they abuse. People who are suffering from multiple addictions, however, do not have a substance of choice but abuse several drugs at once. Multiple addictions, also referred to as polysubstance dependence, is a type of substance abuse disorder wherein the individual does not have a specific drug of choice but uses at least three different classes of substances indiscriminately. It is listed on the Diagnostic and Statistical Manual of Mental Disorders (DSM) under substance disorder.

 Individuals can suffer from multiple addictions either intentionally or unintentionally. There are those who knowingly engage in polysubstance abuse with the hope of experiencing more powerful effects from multiple substances. In some instances, people on several prescription medications by different doctors may accidentally combine medications that interact negatively and later develop a tolerance and dependence on them.


Signs of Multiple Addictions

 To know whether you or someone you love is suffering from multiple addictions or polysubstance dependence, the DSM specifies that three or more of the symptoms below should be present during a 12-month period and that these symptoms are causing a substantial level of distress:

Development of Tolerance

After regularly using different types of substances for some time, the individual may discover that using these substances in the same amount no longer provide the same effects. When this happens, he already developed tolerance to the substances which means he needs to increase the dose of drugs he uses to at least 50% to experience the desired effects

Experience Withdrawal Symptoms

The person experiences withdrawal symptoms when he ceased using the substances or when he starts taking other drugs to counter the discomforting symptoms of withdrawal.

Lack of Control

The person starts using a combination of three or more types of substances more frequently and for longer periods than he originally intended to.

Inability to Stop Drug Use

He finds himself unable to stop using drugs even though he tries hard to do so. He may also find himself attempting numerous times to quit but to no avail.

Preoccupation with Drugs

The person spends practically all his time around drugs – getting it, using it, being under its influence, and recovering from its effects.

Impact on Daily Activities

The person either completely gives up or significantly reduces the amount of time and energy he spends on his usual daily activities – occupational, social, recreational – because of drug use. His world revolves around the use of drugs instead of spending time with family and friends, going to work, or engaging in other worthwhile activities.

Impact on Health

The individual continues to abuse various drugs even though the habit is already causing various physical and psychological issues.

Effects of Multiple Addictions


The specific effects of polysubstance dependence depend largely on the types and combination of substances being abused, but here are some of the general negative consequences of multiple addictions:

  • Increased negative effects of each drug – Polysubstance abusers use a combination of substances primarily to boost its desired effects. Unfortunately, while it may do so, the practice is also increasing the potential negative effects of each substance. Considering the dangers of combining various substance (e.g. various medications with alcohol), the University of Michigan published an article and produced a video, informing students on the matter.
  • Increased risk of overdose – While overdosing is always a possibility, regardless if the person is abusing one or numerous substances at once, the risk increases when multiple substances are abused.
  • Increased risk of experiencing acute medical conditions – abusing one type of substance can already wreak havoc on your health, how much more if someone is abusing different types of substances all at the same time. Imagine how much he is opening himself up to various health risks.
  • Increased risk of developing comorbid psychiatric conditions – research studies found that people who abuse a wide range of substances have poorer mental health and are more likely to experience mental health issues like generalized anxiety disorder and depression.

Treatment for Multiple Addictions

As specified in the Principles of Effective Drug Addiction Treatment by the National Institute on Drug Abuse, there is no single fool-proof treatment that is suitable for everyone. Polysubstance dependence treatment, as with other substance abuse disorder, should depend largely on the condition, needs, and characteristics of the polysubstance abuser.

Whether one chooses an inpatient or outpatient care, the important thing is that the treatment program should not only focus on stopping the use of drugs but address his multiple recovery needs (medical, psychological, social, vocational, and legal) as well. Moreover, it is also critical that the type of rehab setting, treatment approaches, and services should match the person’s age, gender, culture, and other recovery requirements.

Ultimately, while addiction recovery is an extremely difficult process, particularly for those with multiple addictions, it is still treatable. Medications, behavioral therapies, and other treatment methods are available to help the recovery of those suffering from polysubstance dependence.