Combining Drugs (Polydrug user)

Polydrug use refers to combination of more than one substance (psychoactive drugs) to achieve some particular effect. One drug is used as a primary drug with additional drugs to compensate for the side effects of the primary drug and/or make the experience more enjoyable with drug simulating effects or to supplement for primary drug when supply is low.

Drug abusers have historically tended to abuse more than one drug. However, over the last few years there has been an increasing tendency to combine narcotics, alcohol, sedatives, and/or stimulants. Polydrug use encompasses wide variations in user populations and patterns of use: from occasional alcohol and cannabis use to the daily use of combinations of heroin, cocaine, alcohol and benzodiazepines



Why do people use multiple drugs?

There are a lot of different reasons for mixing one substance with other drugs at one time. Substances, which when taken together may have cumulative or complementary effects, may be mixed to increase the overall psychoactive experience. Sometimes one drug is used with other to counteract the effect of first consumed substance, say for example, benzodiazepines (sleeping pills) is taken after consuming some stimulant to induce sleep (without being aware that using these drugs together is hazardous.). Other reasons includes, use of several substances by an individual over a longer period of time might reflect the replacement of one drug by another, due to changes in availability of drugs in particular region, legal problems, price or current trends. For instance, methadone substituting heroin, cocaine replacing ecstasy. Use of 2 or 3 drugs at a time also shows that in different settings (like age groups, type of party etc), or simply reflect regular multiple drug use due to drug dependence. Cannabis (bhang) use mainly occurs during adolescence and young adulthood, ecstasy can be associated with certain lifestyles and activities, and heroin use frequently results in major health problems. Intensive alcohol use is often a major, but overlooked, component of polydrug use. For example, stimulant drugs such as cocaine may enable users to consume large quantities of alcohol over longer periods than would otherwise be possible.

This has become particularly apparent in recent years, as increasing prevalence levels of drug use (e.g. alcohol, cannabis and cocaine) have translated into additional populations of drug users, and as an increasing range of available substances has resulted in additional drug combination possibilities.

Simultaneous/combinations tend to increase the risks of adverse health effects. Such effects can occur (generally as acute toxicity) shortly after the consumption of several substances, or within a short time. They can also occur following a long period of use, affecting body systems, including the liver and the central nervous, cardiovascular or respiratory systems.

Many drugs taken together have the potential to interact with one another to produce greater effects than either substance taken alone. The combination of drugs may produce a new or unexpected effect. For example, alcohol, opioid analgesics (like morphine, fortwin) and benzodiazepines (like alprazolam, diazepam) are all depressant drugs. When taken alone, they can cause relaxation, loss of inhibition, loss of coordination and sleepiness. If these depressant drugs are taken at the same time, these effects are increased many folds. These combinations may result in altered mental status, confusion, depressed breathing, injuries from falls, coma and death.

Many other medicines taken for treatment of other diseases like for epilepsy, nausea, allergies common cold, heart problems, blood clotting disorders, fungal, bacterial infections and diabetes when taken with other depressants like alcohol, they can also be dangerous. Combining drugs may also seriously impair a person’s ability to operate a motor vehicle or other machinery.

Medical interventions: It is not possible to arrive at a single definition of polydrug use, which would be necessary to develop standardized measures. Understanding polydrug use also requires a focus on the use of a range of drugs by the individual; but most drug monitoring information remains substance-specific and reported as aggregated national data.