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What Is Poly Substance Dependence? What Are the Symptoms?

Polysubstance dependence involves using multiple classes of substances. Read on to learn more about its symptoms and treatment.

What Is Poly Substance Dependence?

Poly substance dependence or polysubstance dependence occurs when someone uses several different substances instead of being reliant on just one substance of choice. In these cases, it is often not the sensation caused by a specific substance that creates a dependence, but instead the feeling of “getting high” that causes ongoing use. This pattern of use is called poly substance dependence.

Poly substance dependence is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a “type of substance use disorder that occurs when someone uses at least three different classes of substances and does not have a particular drug they are uniquely dependent on.”1

Polysubstance Dependence

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Poly substance Dependence vs. Polysubstance Abuse

Although the terms poly substance dependence and polysubstance abuse are sometimes used interchangeably, it is crucial to note that there is a difference. Substance abuse occurs when someone misuses a substance, either once or multiple times.

In time, this abuse evolves into dependence. Dependence occurs when using a substance becomes a priority. The desire to become drunk or high is usually noted as needing to drink or use to get through the day.2

What Are the Signs of Poly Substance Dependence?

The DSM lists several defined diagnostic criteria or signs of poly substance dependence. For medical or mental health providers to diagnose it, at least three of the below symptoms must occur during a 12-month period:3


When someone has developed a tolerance, they generally have to use a substance more often and at higher doses to achieve the same effects that were once achieved with lower and less frequent doses.


Withdrawal symptoms occur when someone attempts to reduce or stop using substances. When someone experiences withdrawal symptoms, it is often a sign of tolerance or dependence. Someone with poly substance dependence may relapse in order to control withdrawal symptoms.

Loss of Control

Another sign of poly substance dependence is the inability to stop using substances, despite wanting to or trying to. An individual may also have trouble controlling how much and how often they use it.


Much of their day focuses on thinking about substances. This may involve researching, obtaining, using, or recovering from using substances.

Interference With Activities

Polysubstance addiction often affects one’s ability to complete daily tasks. Someone may become more isolated and withdrawn or may avoid socializing or participating in recreational, family, or work activities in favor of substance use.

Harm to Self

In time, polysubstance reliance changes one’s physical and emotional health. Cravings to use and reliance on the effects of drugs or alcohol may lead to continuing substance use, despite knowing about the physical and psychological harms caused or worsened by drug or alcohol use.

Most Commonly Polyabused Drugs

There are several reasons why someone may mix or combine multiple substances. Polysubstance reliance evolves from the desire to achieve a more intense high. Some people who abuse multiple substances do so to reduce the negative effects of a prescription medication or drug withdrawal. They may also substitute one drug for another or use substances while intoxicated.
Certain drug combinations are more common than others. These generally include:
  • Alcohol
  • Marijuana
  • Cocaine
  • Methamphetamines
  • Heroin
  • Benzodiazepines, such as Xanax, Ativan, Klonopin

Causes of Poly Substance Dependence

Challenges related to substance use and abuse are generally unique to the individual. The causes of polysubstance dependence and addiction are varied. Thus, it is difficult to pinpoint one root cause of polysubstance dependence. In fact, there are many possible causes, such as:
  • Age (younger people have a higher risk)
  • Lower levels of education
  • Unemployment
  • Race and biological gender
  • Living with a disability
  • Anxiety, depression, and other mood disorders
  • Severe tobacco or alcohol use

Why is Poly Substance Dependence Dangerous?

It is important to mention that poly substance dependence and polysubstance abuse are not always intentional. As noted above, polysubstance use can occur when someone is already under the influence and uses again. Unintentional polysubstance use can also occur when someone uses a drug that has been cut with another substance without their knowledge. Any kind of polysubstance dependence is dangerous and potentially fatal.4

The effects on the body from combining drugs may be stronger and more unpredictable than using a single substance. Actively engaging in polysubstance use, whether known or unknown, can lead to one or all the following potential dangers:

Risk of Overdose

The risk of overdose exists with the use of any drug, including alcohol. When combining the effects of two or more substances, it is difficult to know they will affect the body. For example, taking two substances that are both depressants may slow breathing and heart rate to the point where they shut down. This increases your risk of overdose.

Mental Health Issues

Many substances affect the function and sometimes the structure of the brain. When using, new or worsening mental health effects can occur. Also, when attempting to stop using or while withdrawing, many people experience changes in their mental health.

Health Complications

As with mental health challenges, regular use of drugs and alcohol often causes health complications as well. In some instances, medical complications that evolve from substance use are irreversible. Using multiple substances can increase the possibility of various health complications and illnesses.

Medical Emergencies

Polysubstance use is highly unpredictable. Without medical help, the risk of medical emergencies or death resulting from the effects of combining two substances is high.

Relationship Problems

Relationships, including personal, social, and work interactions, often suffer due to substance abuse. Unfortunately, when someone lives with poly substance dependence, cravings and the “need” to get or use usually takes priority. This can quickly lead to complicated or lost relationships.

Treatment for Poly Substance Dependence

The treatment for poly substance dependence is similar to treatment for addiction to a single substance. The first and most critical step in recovery from polysubstance use is detox. It is crucial to remember that detox is not a substitute for treatment for poly substance dependence. For treatment to be effective, your program must include therapy to understand the root causes behind substance use.

The most effective treatment programs are individually designed based on your specific needs and goals as you enter treatment, as no two people experience addiction in the same way. While some people may use the same substances, the effects of those substances on their mind and body will vary. Treatment plans for poly substance dependence are usually a combination of therapy, medications, and comprehensive aftercare planning.5

Individual Psychotherapy

Cognitive-behavioral therapy (CBT) is a key component in all substance abuse treatment programs. CBT focuses on helping you or a loved one understand the thoughts and behaviors that led to substance abuse. CBT also aims to change negative thoughts to help you achieve behavioral change.

Group and Family-Focused Therapy

In addition to individual therapy, group and family sessions are another critical component of healing from substance dependence. Group therapy provides an opportunity to work with others who share a similar recovery journey.
Group sessions allow participants to help and support group members while receiving support and guidance from others, while family therapy sessions help family members better understand polysubstance reliance. 

12-Step Programs

12-step programs and peer support groups such as Alcoholics Anonymous or Narcotics Anonymous are another vital element of substance abuse treatment. Like group therapy, these support sessions offer an opportunity for participants at all stages of their recovery journey to support and hold one another accountable as they work towards lasting sobriety.

Holistic Programs

Our programs at Ripple Ranch Recovery Center focus on a holistic approach to healing. We work closely with each patient to develop primary treatment and ongoing care programs that allow you to heal physically, emotionally, and spiritually.
Treatment for Polysubstance Dependence

Overcome Poly Substance Dependence at Ripple Ranch Recovery Center

The road to recovery from polysubstance dependence looks different for everyone. Choosing a program where the treatment models are selected based on your recovery needs is crucial. Let us help you take the first steps toward freedom from drugs and alcohol.
At our recovery center, we focus on helping you heal on an individual basis. Our providers use evidence-based treatment models and approach treatment from a holistic approach.

Experience the Benefits of Personalized Health and Wellness Plans

We will meet you where you are in your recovery journey and support you as you meet your goals and overcome substance abuse.
Our kind and supportive staff will be with you every step of the way in order to make sure you receive the care and treatment you may need to treat polysubstance dependence.

Reach Out and Begin Healing

To learn more about our treatment programs for either you or a loved one, contact a member of our team at Ripple Ranch Recovery Center today.