Polysubstance Use: How Does It Affect People and What Are the Risks?

Fifth, the Yale-Penn cohort did not recruit participants less than 18 years of age. Accordingly, further studies will be needed to investigate PSA patterns in adolescents. While sex and gender differences in polysubstance use have not been a major topic of research, sex and gender differences need to be considered in both the population and neurobiology studies. Patterns of opioid consumption and progression vary according to sex and gender and detailed analysis of these patterns for polysubstance use are needed as well to optimize individualized strategies for prevention and treatment. Additionally, sex differences can be used as a tool to elucidate the neurobiological mechanisms underlying polysubstance abuse. Results from observational studies of returning Vietnam Veterans and samples of heroin users in Miami and California confirm other drug use as a prominent risk factor for subsequent heroin use and overlapping co-use of heroin with other substances [30,31,32,33,34].

  1. The high rate of polysubstance use is alarming given the impact it can have on both the severity and treatment outcomes of SUDs [2].
  2. Treatment may need to focus on general factors, rather than drug-specific features.
  3. Because of its very high potency and its ubiquity in mixtures with heroin and sometimes with other drugs such as cocaine or counterfeit prescription medications, polysubstance use with fentanyl may be responsible for the high fatality rate in many areas of the United States.

Synergistic pharmacological interactions occur with drugs that have different mechanisms but a common end consequence, such as increasing dopamine (DA) release in the nucleus accumbens (NAC). With synergistic interactions, the effect of the combination is greater than the sum of the separate drug effects. This contrasts with additive pharmacological interactions, which occur between drugs that share a common mechanism and would result in an effect that is equal to the sum of both agents.

Getting treatment for polysubstance abuse

Use of other substances appears to play a role in overdose from heroin [54–56], and combinations of opioids with other substances, especially sedatives and respiratory depressants such as alcohol and benzodiazepines, increase the risk of overdose [51, 57–59]. Treating one disorder before addressing the other disorder will likely undermine the patient’s ability to improve from either type of problem.69, By offering fully integrated services, coordination of care, and consistent treatment, goal messaging is achievable. Contingency management has been used in combination with medications in the treatment of cocaine and opioid use and/or dependence, as well as cocaine, alcohol, and opioid use.

Inpatient treatment center

For example, certain dose combinations increased ratings of “high” and “liking” and cocaine administered to methadone-maintained individuals produced greater subjective ratings of “high” and “liking” [74, 75]. In drug discrimination studies in non-human primates the drug combination produces a unique discriminative stimulus that shares characteristics with the individual drugs but does not completely overlap them [76]. A neurobiological basis for polysubstance use is that combining drugs that converge on a common circuit at different points can produce additive or synergistic rewarding effects.

The changing opioid crisis: development, challenges and opportunities

Researchers should avoid overly broad definitions of “polysubstance use.” The methodology should explicitly define specific substance use patterns and whether measures of use meet diagnosis criteria for a substance use disorder. Precise and consistently used terminology will enhance communication and enable researchers to compare findings of emerging substance use trends. Additionally, clinical trials of treatments for substance use disorders should carefully document a participant’s co-occurring substance use. cocaine addiction As the co-use of multiple substances increases, it is important to generate evidence on treatment efficacies in the context of co-occurring substance use. Interventions and research to address the U.S. opioid crisis have, for the most part, targeted opioid use, misuse, and addiction specifically. To account for polysubstance use, prevention approaches may benefit from targeting universal, common factors across substances [100], and treatment development needs to account for this polysubstance use as well.

Healthcare providers often supervise this process to manage and alleviate withdrawal symptoms. Alcohol may represent one of the most widely used substances lsd: what to know for a poly-abuser. Recently, research using Latent Class Analysis (LCA) focused on identifying patterns of use of multiple substances [21,36,37,38,39,40].

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