Polysubstance Use: The Exception or the Rule?-View Presentation Slides

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This presentation reviewed polysubstance use as the use of more than one drug at a time, either intentionally or unintentionally, and emphasized that mixing substances is common, dangerous, and often underrecognized. Although mono-substance use is still more common in the general population, polysubstance use becomes the norm once substance-related problems emerge, especially among people receiving treatment.<br /><br />The talk highlighted major risks of combining opioids with stimulants, alcohol, benzodiazepines, gabapentin/pregabalin, and other drugs. These combinations increase overdose risk, respiratory depression, coma, relapse, and other medical harms. Alcohol was noted to be involved in a large share of drug poisonings and opioid overdose deaths, while opioid-stimulant co-use has risen sharply in recent years.<br /><br />Special attention was given to vulnerable groups, including pregnant people, infants exposed prenatally, adolescents, young adults, veterans, and individuals with mental health disorders or trauma histories. Polysubstance use during pregnancy was linked to developmental, cognitive, and behavioral problems in children. Early alcohol use and youth opioid overdoses were associated with later risk of multiple substance use. Co-occurring depression, anxiety, bipolar disorder, psychosis, and trauma increased the likelihood and severity of polysubstance use.<br /><br />Assessment should include thorough screening for all substance use patterns rather than focusing only on a “primary” drug. The presentation noted the usefulness of tools such as ASSIST and emphasized that clinicians should look for co-occurring mental health and trauma-related conditions.<br /><br />Treatment recommendations included evidence-based medications and integrated care. Emerging evidence suggests GLP-1 medications may reduce cravings for alcohol, tobacco, and opioids, while disulfiram may help some patients with cocaine/alcohol use. Broader strategies include naloxone distribution, trauma-informed care, prenatal screening, stigma reduction, and comprehensive treatment addressing all substance use and psychiatric comorbidities.

Keywords

polysubstance use

overdose risk

opioid stimulant co-use

alcohol poisoning

benzodiazepines

pregnancy exposure

mental health comorbidity

trauma-informed care

substance use screening

naloxone distribution