What is Polysubstance Use: The complexity of Treating Co-Occurring Addictions

So what exactly is Polysubstance use? Polysubstance Use Disorder (PSUD) is a complex and challenging condition characterized by the excessive and simultaneous misuse of multiple substances, such as alcohol, opioids, benzodiazepines, stimulants, cannabis, and more. Individuals with PSUD engage in a pattern of drug or alcohol abuse that goes beyond single substance addiction, making it more difficult to diagnose, treat, and manage effectively.

What Do The Statistics Say?

Obtaining accurate statistics on PSUD can be challenging due to the secretive nature of substance abuse and the varying combinations of drugs involved. However, research indicates that polysubstance use is alarmingly prevalent in the United States and worldwide.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), about 9.2 million adults aged 18 and older in the United States had co-occurring substance use disorders in 2020. This means they were struggling with two or more substances simultaneously. The most common combinations involved alcohol with other substances like opioids or benzodiazepines.

Furthermore, polysubstance use is particularly common among individuals seeking treatment for substance abuse. A study published in the journal “Drug and Alcohol Dependence” found that nearly 80% of those seeking treatment for drug and alcohol addiction reported using multiple substances.

Is Treatment for Polysubstance Use Different than Treating One Addiction?

Treating Polysubstance Use Disorder presents unique challenges for healthcare professionals and requires a comprehensive, individualized approach. Compared to treating a single addiction, PSUD necessitates a more complex strategy due to several factors:

1. Multiple Dependencies: In treating PSUD, clinicians must address the effects of several substances on the individual’s physical and psychological health. Different drugs have diverse interactions with the brain and body, complicating the treatment process.

2. Withdrawal Complications: Polysubstance users are at higher risk of experiencing severe withdrawal symptoms when trying to quit. The combination of multiple substances can intensify the withdrawal process, potentially leading to medical emergencies.

3. Mental Health Considerations: Polysubstance abuse is often linked with underlying mental health issues, such as anxiety, depression, or trauma. Treating both the substance use disorder and the co-occurring mental health disorders concurrently is vital for successful recovery.

4. Relapse Risk: Individuals with PSUD may be more prone to relapse, as cravings and triggers for multiple substances can be overwhelming. Addressing these challenges requires targeted relapse prevention strategies.

5. Treatment Engagement: Polysubstance users may feel overwhelmed or hopeless about the recovery process, as they are facing the seemingly insurmountable task of stopping multiple addictions. It is crucial to build a strong therapeutic alliance and motivate them to remain engaged in treatment.

How To Treat Polysubstance Use Disorder

To effectively treat Polysubstance Use Disorder, an integrated and multidimensional approach is essential. Treatment should typically include the following components:

1. Comprehensive Assessment: A thorough evaluation of the individual’s substance use history, medical condition, mental health, and social circumstances is necessary to create a personalized treatment plan.

2. Medically Supervised Detoxification: Due to the complexities of withdrawal, medical supervision is often required to ensure safety and provide support during the detox process.

3. Behavioral Therapy: Evidence-based therapies, such as Cognitive-Behavioral Therapy (CBT), Motivational Interviewing (MI), and contingency management, can help address the underlying issues contributing to polysubstance abuse.

4. Medication-Assisted Treatment (MAT): In some cases, medication may be used to assist in the management of withdrawal symptoms and cravings associated with specific substances.

5. Support Groups: Participation in support groups or group therapy sessions can offer valuable peer support and encouragement during recovery.

6. Dual Diagnosis Treatment: Co-occurring mental health conditions should be addressed simultaneously through integrated treatment.

7. Aftercare Planning: Developing a robust aftercare plan, which includes ongoing support and resources, is crucial in preventing relapse and supporting long-term recovery.

In conclusion, Polysubstance Use Disorder is a complex and prevalent issue that requires a specialized and comprehensive treatment approach. Recognizing the unique challenges presented by PSUD and tailoring interventions to address them is vital in supporting individuals on their path to recovery and reducing the harmful impact of co-occurring addictions. With the right support and commitment, individuals with PSUD can achieve lasting recovery and improve their overall well-being.