Combined Drug Intoxication
In This Article
What is Combined Drug Intoxication (Polydrug Use)?
Combined drug intoxication (CDI), also known as multiple drug intake (MDI) or polydrug use, is the effect of abusing multiple drugs. It occurs when an individual combines more than one drug or multiple substances at a time.
Polydrug use is not limited to illicit substances.
Combined drug intoxication is a form of substance use that involves taking two or more drugs simultaneously.
Examples include mixing:
- prescription drugs (legally or illegally obtained)
- over-the-counter drugs
- herbal mixtures
Generally, combining substances at the same time tends to have stronger effects than using just one substance. While polydrug use is not limited to illicit substances, people abusing/misusing drugs are usually more prone to CDI. People who are struggling with addiction mix multiple drugs to get heightened effects.
What Does Combined Drug Intoxication Look Like?
Multiple drug intake is not the same as a drug overdose. A drug overdose means taking one drug or substance in high doses, while multiple drug intake means taking more than one drug at a time.
Combined drug intoxication involves mixing multiple drugs and ingesting them at the same time. It could include mixing prescription drugs, mixing illegal drugs like cocaine and heroin, or even combining over-the-counter medications or supplements/vitamins.
Combined drug intoxication is an unnatural cause of death in humans. Aside from illicit drugs, some common drugs used in CDI include multivitamins, analgesics, and antihypertensives.4
Abusing drugs is easier when they are readily available. Multiple drug intoxication is dangerous and can lead to death.
Signs of Polydrug Toxicity
The rate of deaths resulting from psychostimulant overdose increased by 37 percent in 2017.2Centres for Disease Control and Prevention (CDC)
Psychostimulants are among the most commonly misused drugs. They include illegal drugs and prescription stimulants (such as Adderall) used to treat attention deficit hyperactivity disorder (ADHD).
An article published in The Pharmaceutical Journal stated that multiple drug intake was reported on the death certificate of about 40 percent of drug poisoning cases in Wales and England.6
Effects of polydrug toxicity will vary depending on the drugs used. Some common signs of polydrug toxicity include:
- Bradycardia (slower than normal heart rate)
- Pinpoint pupils
- Respiratory depression (shallow breathing)
- Runny nose
- Gastrointestinal upset
- Dysphoria (a mental condition characterized by a profound sense of unhappiness and dissatisfaction)
- Joint aches
- Hypothermia (a dangerous and abnormal drop in body temperature)
- Nystagmus (rapid, involuntary eye movement that can blur vision)
- Cardiac arrhythmias (improper or irregular heartbeat)
Dangers of Mixing Substances
Mixing substances can amplify pleasure, as well as unpleasant adverse effects. While mixing stimulants like cocaine and ecstasy can increase the high, it also increases the risk of a heart attack.
One of the greatest risks of mixing drugs is 'combined drug intoxication.’ Combined drug intoxication is one of the common causes of emergency room admissions.
When you take two or more drugs simultaneously, it can have a profound negative effect on the heart. This can cause cardiovascular distress, which can lead to death.
Dangers of combining drugs include:
- Heart problems
- Tremors and seizures
- Brain damage
- Suppressed bleeding
- Respiratory problems
- Liver damage and failure
What Drugs are Most Commonly Mixed Together?
Alcohol is one of the most commonly misused substances. Many people put their lives at risk by combining it with other stimulants.
Some drugs commonly combined with alcohol include marijuana, painkillers, cocaine, heroin, amphetamines, antidepressants, and illicit drugs like Ecstacy.4
Note that polydrug use is not limited to stimulant or illicit drugs. It is common for patients suffering from chronic diseases to use different drug combinations. Recently, drug interactions have increased because there are more drugs available now than ever before.3
Some drugs commonly misused and sometimes combined include:
- Acetaminophen and warfarin
- Painkillers and supplements
- Xanax and Molly
- Amphetamines and benzodiazepines
- Over-the-counter diet medications
- Prescription drugs for treating conditions like ADHD
Lethal substance Combinations
Not all substance combinations are equal. Some drug combinations are very deadly. They include:
- Cocaine + heroin
- Benzodiazepines + prescription opioids
- Alcohol + opiates
- Alcohol + cocaine
- Alcohol + benzodiazepines
How to Treat Combined Drug Intoxication
Any substance can be poisonous depending on the nature of the substance, dosage, and duration of exposure.5
The chances of toxicity increase with combined drug intake. Fortunately, patient recovery can be attained, especially when prompt care is delivered.
Every treatment plan should be tailored to meet the patient’s specific needs. A patient’s need might go beyond substance use. Thus, combined drug intoxication programs might also address issues like physical ailments, family problems, and mental health disorders.
The different methods used by experts to treat polydrug use include:
- Alternative medicine
- Medication-assisted treatment (MAT)
- Peer-to-peer-support groups
A proper treatment program will help find out what led to a patient’s multiple substance use.
One treatment method that focuses on finding out the root cause of substance use is cognitive-behavioral therapy (CBT). Also, someone that is into polydrug use will often require professional counseling and support.
How to Prevent Polydrug Toxicity
Aside from stimulants, over-the-counter medications are some of the most misused drugs. To avoid polydrug toxicity, follow instructions carefully if you are taking two or more drugs.
Below are some ways to prevent polydrug toxicity:
- Do not self-medicate
- Use one drug at a time (unless your doctor states otherwise)
- Do not mix alcohol with drugs
- If you use multiple drugs, quitting is the best way to prevent toxicity
- Depression and suicidal thoughts, which can lead to polydrug use, should be treated promptly
- People addicted to multiple drugs should get immediate psychiatric care
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- "Common Alcohol and Drug Combinations." US Santa Cruz. Student Health and Outreach Promotion.
- "Drug Overdose." Centers for Disease Control and Prevention, 26 January 2021.
- Erickson, Timothy et al. "The Approach to the Patient with an Unknown Overdose." Emergency Medicine Clinics of North America, Vol. 25, : 249-281.
- Kumar, Sampath. “A Case of Combined Drug Intoxication.” Journal of Forensic Toxicology and Pharmacology, 2015, Vol. 4,3.
- Lesser, Ben. "Dangerous Combinations of Drugs." Dual Diagnosis, 27 May 2021.
- Parsons Graham. "Illicit Drug Overdose: Managing Emergency Care." The Pharmaceutical Journal, 22 April 2015.