Poly-Addiction: Understanding the Complex Problem of Multiple Addictions

People sometimes develop dependence on more than one substance at the same time. This pattern, called polysubstance use, can involve alcohol and prescription drugs like benzodiazepines or opioids, stimulants with sedatives, or other combinations. When multiple substances act on the brain, stopping use suddenly can be complicated and even risky.

If you are considering quitting multiple addictions at once, we can help you do it safely. At Promises Behavioral Health, our clinicians create an integrated plan that addresses substance use and mental health together, then supports you through stabilization, therapy, and aftercare. 

We offer evidence-based addiction treatment at select locations in Texas, Georgia, Pennsylvania, Tennessee, and Massachusetts. If you want to learn about levels of care and how we individualize polysubstance addiction treatment, our team can walk you through options that match your needs. 

What Polysubstance Use Means

Polysubstance use means using more than one substance during the same period. It can mean mixing drugs at the same time, using alcohol with prescription medications, or alternating multiple drugs across days.

People might combine substances to enhance effects, to soften a comedown, or as self medication for mental health symptoms. In some cases, the combination is unintentional: for example, when illicit substances are cut with fentanyl or other drugs. The National Institute on Drug Abuse explains that mixing substances increases unpredictable effects and the risk of overdose, especially when depressants are involved.

Why Polysubstance Addiction Happens

There is rarely a single cause. Common risk factors include untreated mental health conditions, trauma, chronic pain, family history of substance use, and stressful environments. Many people start with one substance, then add other substances trying to manage side effects or withdrawal symptoms. For example, someone with alcohol use disorder might misuse prescription medications to sleep, or a person with opioid use disorder might add stimulants to stay awake.

Others combine substances during social use without realizing how the effects stack. Over time, these patterns can develop into substance use disorders that feed each other, making it harder to cut back on any one drug.

A variation on polysubstance use is switching between addictions. When you stop one drug without addressing the underlying pain, shame, or loss, other substances or addictive behaviors can take its place. That is why addiction therapy programs look beyond the drugs, so you can identify and heal what drives the cycle.

Health Risks of Using Multiple Substances

Using multiple drugs at the same time magnifies risk. Mixing drugs affects heart rate, blood pressure, breathing, and judgment.

• Combining drugs that slow breathing, such as opioids, alcohol, and benzodiazepines, sharply increases the chance of overdose.
• Alcohol and prescription drugs together can cause dangerous sedation.
• Stimulants plus depressants can mask overdose warning signs.

People who rely on multiple substances have higher rates of depression, anxiety, sleep disruption, memory trouble, and other mental health symptoms. The risks are even greater if you have other medical conditions, or if you are taking prescription medication without prescriber guidance.

From Substance Use Disorder to Process Addictions

Switching from drugs to compulsive behaviors is common in recovery communities. When alcohol or drug use stops, addictive behaviors like compulsive sex or gambling can emerge. These patterns overlap with the addiction cycle, even without substances. If this sounds familiar, you are not doing anything wrong, and you are not alone. Recovery works best when it addresses the addiction process itself and the pain underneath it.

If peer support helps you, you can explore our 12-Step support groups as one of several recovery supports. These groups can complement therapy by adding accountability and community while you practice healthier boundaries and relationship skills.

Is It Better to Quit All Addictions at Once?

There is no one right approach for everyone. Some people benefit from stopping all substances at once. This is best done in a medical setting, especially when combinations are dangerous. Others do better with a staged plan, for example, addressing alcohol dependence first, then tapering benzodiazepines, or transitioning to medications for opioid use disorder before stopping other substances. A safe decision depends on your health history, the substances involved, and your home supports.

What matters most during detox is medical oversight. Healthcare providers can assess overdose risk, monitor vital signs, and watch for withdrawal symptoms that need treatment. For certain prescription drugs, such as benzodiazepines, a slow taper is often safer than abrupt discontinuation. If opioids are involved, medications like buprenorphine or methadone can be part of substance use treatment.

What Happens When You Stop Multiple Substances

Withdrawal experiences vary by substance.

• Alcohol withdrawal can include tremors, blood pressure swings, anxiety, or confusion.
• Benzodiazepine withdrawal may bring insomnia, agitation, or seizures if stopped too quickly.
• Opioid withdrawal often causes body aches, stomach upset, and strong cravings.
• Stimulant withdrawal can include fatigue, low mood, and sleep changes.
• When more than one drug is involved, symptoms can overlap or intensify.

During medical detox, clinicians treat symptoms, maintain hydration and nutrition, and adjust medications to keep you safe. We also monitor for mental health conditions that can flare during early recovery, including post traumatic stress disorder and mood disorders.

How We Treat Polysubstance Use at Promises

We meet you exactly where you are, then tailor a treatment plan to your goals and safety needs. Your plan may include medical detox, management of withdrawal symptoms, and medications when appropriate for alcohol use disorder or opioid use disorder. We build in therapy for co-occurring mental health conditions and practical relapse prevention skills. We also involve family or chosen supports when helpful, because healthy relationships improve treatment outcomes.

Our clinicians provide coordinated care that respects your choices. We collaborate with mental health professional partners, primary care, and other healthcare providers to make sure your substance dependence care supports your overall health. If you want to discuss treatment programs that address multiple substance use, our team will explain options and recommend a level of care that fits your situation.

Evidence-Based Therapies We May Use

Some therapy approaches we use include:

• Cognitive Behavioral Therapy to change unhelpful thoughts and behaviors related to substance use
• Dialectical Behavior Therapy to build emotion regulation and distress tolerance
• Motivational Interviewing to strengthen internal motivation for change
• Acceptance and Commitment Therapy to help you live by your values while urges decrease

These therapies can be combined with peer support and family education. We also teach practical coping for triggers, sleep, and stress, then create a detailed aftercare plan that anticipates real-life challenges.

Caring for Co-Occurring Mental Health Conditions

Many people with polysubstance use have mental health conditions, such as anxiety, depression, PTSD, or other mental disorders. We screen and treat both at the same time, because care that separates mental health from substance use often misses the point. If you live with a mental health disorder, your plan will include therapy and, when appropriate, carefully managed prescription drugs to support recovery. Treating patients this way protects your progress and improves treatment outcomes.

Safe Strategies for Quitting Multiple Addictions

Things to consider if you want to remove substances from your life:

• Get a medical evaluation before making changes. This reduces danger from withdrawal.
• Create a sequence if needed. Some substances must be tapered, especially benzodiazepines and some prescription medications.
• Add medication support when appropriate. Medications for alcohol use disorder and opioid use disorder can stabilize the brain and reduce cravings.
• Use structured support. Combine therapy, peer groups, and practical planning for housing, work, and transportation.
• Build a recovery network. Community groups and 12-Step options offer structure and accountability.

Professional substance abuse treatment can help you build a combined strategy to address all of the above.

Ready to Talk with Promises?

If you are considering change, we are here to help you decide on a safe starting point. Contact Promises Behavioral Health at 888.483.7451 or visit our substance abuse treatment programs page to connect with admissions and talk about treatment in Texas, Georgia, Pennsylvania, Tennessee, or Massachusetts. Find compassionate, evidence-based addiction treatment that addresses multiple substances, co-occurring mental health concerns, and your real life.