Polysubstance-Related Disorder

What is Polysubstance-Related Disorder?

Ordinary dependence on any given drug by a person is considered simple dependence by mental health professionals, but when the criteria for dependence are present for at least three different classes of substance by the same individual, it is then considered to be a disorder, namely polysubstance related disorder.

Another important point which must be present in order to qualify for this particular disorder is that the dependence on these three different classes of drugs must all occur within the same 12-month period. This means that the individual drug user has become dependent on this grouping of substances and is using them all concurrently, as opposed to using one at a time over a number of years, before moving onto the next.

There is one more fine point associated with this disorder, which relates to the definition dependence. While an individual might not necessarily meet the criteria for dependence on each one of the three substances being abused, when taken collectively, the criteria for dependence on the entire grouping does meet the medical definition of dependence.

This multiple substance disorder has an official listing in the Diagnostic and Statistical Manual of Mental Disorders (DSM – IV), which is the reference manual commonly consulted by all mental health professionals for the diagnosis of mental disorders.

There are many reasons why an individual would include multiple substances in his/her usage program. In some situations, a drug user may become somewhat tolerant to the effects of a specific drug, and may no longer receive the same kind of euphoric sensation as during the first several usages, so other substances become appealing as well.

Some individuals afflicted by polysubstance-related disorder have reported that they simply preferred the effects of more than one substance, because each one provided a different feeling, and altogether they were much more satisfying.

Then too, there is the question of availability, with specific drugs being less obtainable through street markets at various times, so that others must be used in their stead. In any case, a substance abuser could be using three or more drugs, all of which have addictive characteristics, without actually favoring any of them, but still becoming dependent on this collection of drugs as a whole.

Polysubstance-Related Disorder symptoms

In order for a person to be considered as a sufferer from polysubstance related disorder, there are a specific set of symptoms which must be present and observable in the person.

Polysubstance-Related Disorder symptoms include:

Time component

The individual is willing to spend a great deal of time in the acquisition of drugs, the usage of drugs, the enjoyment or entertainment provided by those drugs, and the recovery period which is necessary afterward. This means that a significant portion of an individual’s life is dedicated to the collective pursuit, usage, and recovery from whichever substances have been included in their particular program or drug usage.


The substance abuser either has no desire to stop using the drugs, or has unsuccessfully attempted to withdraw from the usage of the drugs, or he/she might even have a legitimate and overwhelming desire to stop using the drugs, but is simply unable to do so. Some persons afflicted with polysubstance-related disorder began as weekend substance abusers, but found that once dependence crept into the picture, they were unable to isolate usage to the weekends, and it spilled over into weekdays as well.

Loss of control

This factor goes hand-in-hand with the dependence, and is actually an extension of it. Once a substance abuser experiences loss of control, it means they repeatedly use more drugs than planned, or higher amounts, and that they allow it to consume more of their daily life than planned. It happens in the progression of drug use very frequently that this loss of control becomes more prevalent as substance abuse continues. In effect, the substance abuser begins to lose control, while the drugs themselves gradually begin to take over control of the individual’s life.


This component of the polysubstance-related disorder relates to the fact that when a person does try to stop using drugs, all the classic characteristics of withdrawal become apparent. On the other hand, some individuals afflicted with polysubstance-related disorder elect to continue using the drugs because they are unwilling to face the unpleasant consequences of withdrawal itself.


Over a period of time, the substance abuser will generally find that higher amounts of the drugs are necessary in order to achieve the same effects as when they originally started, due to the effects of tolerance. Stated another way, the drug abuser will find that the same amount of any given drug has a noticeably lower effect on him/her than in the beginning. It is very common for any substance abuser to reach the point where he/she realizes that drug intake must be increased by 50% or more, in order to achieve the same euphoric effect they desire from the drugs.

Self-destructive tendencies

The substance abuser will continue to use three or more different drugs, even though he/she is aware that a physical problem or a psychological problem has become part of their individual profile, and that whatever the issue is, it is being exacerbated by usage of multiple drugs. In other words, the drug user is aware that substances are causing physical or mental harm to themselves, and they continue to use the drugs in spite of that.

Causes of Polysubstance-Related Disorder

The causes of becoming addicted to specific drugs are various, and for any given individual there could be a single cause, or there could be multiple reasons which push them into substance abuse.

One of these factors is biology, meaning that the actual biological makeup of a person, i.e. their genetic makeup, comprises at least 50% of their risk for addiction. In the same general category of biology, a person’s gender, ethnicity, and the concurrent presence of other kinds of mental issues or disorders may also significantly increase the likelihood of drug addiction.

Another major factor considered to be a high risk component for substance abuse is that of the person’s environment. In this case, the environment doesn’t mean physical surroundings and landscaping, but their social environment instead. All of the diverse influences from family, friends, and other persons a potential substance abuser comes into contact with, can have an impact on their tendency toward abuse.

Peer pressure is one element of this social interaction, as is physical or sexual abuse, and exposure to drugs early in life, severe stress and anxiety factors, and in some cases a lack of parental guidance. There is an enormous number of possibilities all attributable to a person’s social environment which can have a powerful tendency to push them toward drug usage, and eventual abuse.

The third factor which contributes strongly to causing substance abuse is a person’s development. The genetic and environmental factors mentioned above can intertwine at various points in a person’s life to have an extremely powerful impact on them, which greatly increases the risk of drug usage.

While drug usage can obviously occur at any age, when exposure to it happens early in someone’s life, there is a much greater chance that it will eventually lead to substance abuse and addiction. More than any other demographic, teenagers are powerfully impacted by this risk factor, because their emotions and their brains are still evolving, and that means they’re still learning about judgment, self-control, and making good choices. This makes teenagers extremely vulnerable to trying exciting and exotic sounding new experiences, including the usage of drugs.

Once an individual has started down the road to drug addiction, the potential always exists for polysubstance-related disorder, because of the factors previously mentioned – availability of specific drugs, diminishing effects after prolonged usage, and appreciation of different effects provided by different drugs.

Treatment of Polysubstance-Related Disorder

Treatment for polysubstance-related disorder is not a very broad field, and very little documentation exists on the subject because it has not been the subject of anything like thorough research or investigation.

Some of the treatment programs which have been tried with varying degrees of success are psychological evaluation and tests on specific individuals. It seems that each individual afflicted with polysubstance-related disorder has very personal reasons or causes for having drifted into their specific state of being, and this fact partially accounts for why there is no broad program of universal treatment.

That’s why psychological evaluation has thus far been the most fruitful avenue of treatment, as it seeks to uncover factors from a person’s past which influence their progression to substance abuse of multiple drugs. If these causes can be identified with any level of certainty, steps can then be taken to minimize or eliminate those causes, so that the reason for substance abuse no longer exists.

The psychological component must of course then be coupled with a program to wean the substance abuser away from dependence on each of his/her drugs of choice to complete the treatment.

Prevention of Polysubstance-Related Disorder

Prevention of polysubstance-related disorder really boils down to avoiding those circumstances and causes which can lead to drug usage in the first place. Obviously, very little can be done about the biology factor, since everyone inherits the genes they have from parents, and that risk factor is already programmed into a person’s genetic makeup at birth.

However, much more can be done in the way of social environment, i.e. all those influences from peers, parents, and all the daily influences that a young person may be exposed to, which may have a tendency to push them toward trying drugs. Many schools have instituted drug awareness programs for this reason, and regularly provide programs of education which depict the serious downside of addiction, as opposed to glorifying the euphoric feeling from usage.

Many organizations exist in communities to provide support and counseling for those who may be at risk. Parents can be a huge influence in steering teenagers away from drug usage by staying involved in their lives, and by providing a family environment which is satisfying and fulfilling for youngsters.

It is especially incumbent upon parents to become involved with teens when it’s obvious that some kind of major stress or anxiety is troubling them and needs to be addressed. It must be recognized that the teen years are extremely susceptible years, and that all the things a teen is exposed to at this time can have a much greater impact, because everything is a new experience. It goes without saying that, as the persons closest to their youngsters, parents need to do everything in their power to discourage the use of alcohol and drugs, so that abuse never has a chance to take hold of a person’s life.