What Treatment Looks Like When 61% of Addiction Treatment Patients Present with Polysubstance Use Disorder

When we think about substance use, it’s easy to look at it as a straightforward issue — maybe someone struggles with alcohol or has a history with opioids. But the human experience isn't so neatly categorized, and neither is addiction. That’s where the concept of polysubstance use comes into the picture. According to new data from the medication-assisted treatment (MAT) provider Ideal Option, polysubstance use is becoming more common, with 61% of those entering rehab needing treatment for two or more substances.

At NorthStar Transitions, we understand the complexities of dealing with polysubstance use disorders. Our treatment plans are tailored to meet the unique needs of each individual and designed to address the full scope of addiction challenges, including often overlooked or unexpected drug combinations. If you or a loved one is struggling with polysubstance use, keep reading to learn more about polysubstance use disorders and how they’re treated.

What Is Polysubstance Use?

Polysubstance use describes combining two or more substances, taking them at once or within a short period of each other. Also referred to as multiple drug intake or combined drug intoxication, polysubstance use often occurs as a patterned behavior, but it can also happen when someone takes a drug that has been cut or mixed with other substances, such as fentanyl, without their knowledge or consent. 

  • Intentional Polysubstance Use: Intentional polysubstance use is deliberately combining two or more different substances, often with the goal of enhancing the effects of each or to counteract unpleasant effects. A common example includes mixing stimulants with depressants for a “smoother” comedown.
  • Unintentional Polysubstance Use: Unintentional polysubstance use happens when individuals are not aware that they are consuming multiple substances. People may think they’re using one substance, only to be exposed to a more dangerous one without their knowledge. In Colorado, drugs like cocaine are being increasingly tainted by fentanyl, leading to a dramatic spike in overdose cases. 

Polysubstance use can involve any combination of drugs, alcohol or prescription medications. Whether intentional or not, mixing drugs is highly dangerous as it can lead to unpredictable and deadly effects. Some common polydrug combinations include mixing benzodiazepines with alcohol or opioids, heroin with cocaine (speedballs) or methamphetamine (goofballs), and cocaine with alcohol. One of the latest and most dangerous combinations is fentanyl and xylazine (known as “tranq”). Xylazine is a powerful veterinary sedative that can cause tissue death and make overdoses harder to reverse. 

Dangers of Polysubstance Use

Using multiple substances together can lead to complex health risks and treatment challenges. It's essential to understand these risks, which go beyond just the physical effects, to help individuals get sober and achieve lasting recovery. 

Worsening Mental Health

Substance use can significantly impact mental health, leading to changes in how a person feels, thinks and behaves. Using multiple substances at the same time can worsen these effects, making mental health issues more severe. For example, someone with mild anxiety might experience more intense anxiety or panic attacks when using multiple drugs. This can lead to a harmful pattern where they use more of one substance to try to lessen the distress caused by another, which further harms their mental health.

Increased Risk of Overdose

When substances are mixed, they can potentiate each other’s effects, leading to a phenomenon known as "synergistic toxicity." This can dramatically increase the risk of overdose because the combined effect is unpredictable and often greater than either substance alone. For instance, the depressant effects of opioids are magnified when taken with benzodiazepines or alcohol, which can lead to a fatal overdose by slowing or stopping breathing. With the rise in opioid contamination with fentanyl, which is exponentially more potent than heroin or prescription opioids, the margin for error narrows dangerously.

Complicates the Treatment Process

Polysubstance use can accelerate the development of tolerance and dependence, and treating an addiction to two or more drugs is often a complicated process. Withdrawal can be more severe, and therapists must tackle the reasons behind the use of multiple substances, which can be deeply rooted in an individual's psychology and life experiences.

How Is Polysubstance Use Treated?

Treating polysubstance use calls for a multifaceted approach tailored to meet the unique challenges presented by the simultaneous use of multiple drugs. Here's a glimpse into the comprehensive treatment strategies that can effectively support lasting recovery.


Not everyone needs to undergo detox, but this first step is almost always needed when multiple drug addiction is involved. Detox is crucial as it safely manages the uncomfortable withdrawal symptoms that occur when drug or alcohol use is suddenly stopped and helps set the stage for effective treatment. Undergoing detox in a supportive environment with medical supervision also maximizes patient comfort and reduces the risk of serious complications. 

Residential Treatment:

Following detox, residential treatment is particularly effective for treating polysubstance use disorders. This intensive form of treatment provides a structured environment where individuals receive round-the-clock care and support. Therapies in residential treatment are diverse and may include group sessions, individual counseling and activities designed to rebuild life skills. In this safe and controlled setting, individuals can focus entirely on their recovery without the distraction or temptation of their usual environment.

Medication-Assisted Treatment (MAT):

MAT uses medications like buprenorphine, methadone and naltrexone in combination with behavioral therapies and counseling to provide a comprehensive, “whole-person” approach to the treatment of substance use disorders. For polysubstance use, MAT can be customized to address the specific combination of drugs being used, helping to reduce cravings and withdrawal symptoms. By easing these challenges, MAT allows individuals to engage more fully in the recovery process and build a strong foundation for long-term success and stability.

Long-Term Care:

Long-term care also plays a pivotal role in reinforcing recovery from polysubstance use, providing ongoing support as individuals navigate their new sober lifestyles. This phase includes step-down treatment options like outpatient care that offer structure, flexibility and support as individuals transition back into their daily lives. Ongoing therapy and drug screening also help by promoting accountability and helping individuals stay focused on their long-term goals. 

Overcome Polysubstance Use at NorthStar Transitions

Navigating the road to recovery from polysubstance use can be overwhelming, but you're not alone. NorthStar Transitions is here to offer the specialized care, understanding and support you need to overcome the challenges of polysubstance use. If you’re ready to take the first step toward a life free from addiction, reach out today to learn more about our treatment programs and how they can help. Call us at 866-407-2240 or complete our online contact form to get in touch with our admissions team.

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