Poly drug use

Tranquillizers, sleeping pills, opiates and alcohol. Opioid-related deaths often involve alcohol.

Poly drug use often carries with it more risk than use of a single drug, due to an increase in side effects, and drug synergy. The potentiating effect of one drug on another is sometimes considerable and here the licit drugs and medicines – such as alcohol, nicotine and antidepressants – have to be considered in conjunction with the controlled psychoactive substances. The risk level will depend on the dosage level of both substances. If the drugs taken are illegal, they have a chance of being mixed (also known as "cutting") with other substances which dealers are reported to do to increase the perceived quantity when selling to others to increase their returns. This is particularly common with powdered drugs such as cocaine or MDMA which can be mixed with relative ease by adding another white powdery substance to the drug. This cumulative effect can lead to further unintended harm to health dependent on what is being covertly added. Concerns also exist about a number of pharmacological pairings: alcohol and cocaine increase cardiovascular toxicity; alcohol or depressant drugs, when taken with opioids, lead to an increased risk of overdose; and opioids or cocaine taken with ecstasy or amphetamines also result in additional acute toxicity.[7] Benzodiazepines can cause death when mixed with other CNS depressants such as opioids, alcohol, or barbiturates.[8][9][10]

A spoonful of promethazine/​codeine syrup showing the characteristic purple color that gave rise to the name purple drank.

Within the general concept of multiple drug use, several specific meanings of the term must be considered. At one extreme is planned use, where the effects of more than one drug are taken for a desired effect. Another type is when other drugs are used to counteract the negative side effects of a different drug (e.g. depressants are used to counteract anxiety and restlessness from taking stimulants). On the other hand, the use of several substances in an intensive and chaotic way, simultaneously or consecutively, in many cases each drug substituting for another according to availability.[7]

The phenomenon is the subject of established academic literature.[11]

A study among treatment admissions found that it is more common for younger people to report polydrug drug use.[12]

• Drug overdose
• Recreational drug use
• Responsible drug use
• Speedball (drug)