Learn / Can You Go to Rehab for Multiple Addictions?

Can You Go to Rehab for Multiple Addictions?

Grace Ogren
 December 12th, 2022|   Clinically Reviewed by 
Dr. Malasri Chaudhery-Malgeri, Ph.D.

Addiction takes many forms. For some people, it means relying on a particular drug. But it’s not always that simple. If you’re consistently taking more than one drug at a time, or switching between drugs, you might have polysubstance use disorder.

This condition looks a little different for everyone. You might feel like it’s safer to take more types of drugs, so you don’t start depending on any of them. Or, you might be mixing substances to get a certain result. But this behavior doesn’t protect you from addiction.

If you’re ready to make a change, there are several ways to approach recovery and rehab. And in treatment, your care team can help you understand the nuances of this complex issue.

Can You Have More Than One Addiction?

The Centers for Disease Control defines polysubstance use1 as “two or more drugs taken together within a short time period, either intentionally or unintentionally.” Often, this behavior is socially acceptable. Have you ever smoked a cigarette while drinking a beer? If so, you’ve engaged in polysubstance use.

Addiction is, among other things, a behavioral issue. In other words, you can have addiction even in the absence of physical symptoms like cravings or withdrawal. And at first, you might not even notice. It’s all too easy to use multiple drugs at the same time, especially if you’re taking illicit substances. Street drugs like heroin and cocaine aren’t regulated, and might be mixed with other things.

Addiction Can Sneak Up On You

Stigma plays a complex role in many types of addiction. Because drinking is so socially acceptable, it can be hard to know when you have alcohol addiction. On the other hand, meth addiction is so stigmatized that it’s easier to recognize the problem—even if it’s still hard to get help.

When you’re switching between substances, this metric can work against you. For instance, you might not be doing enough of any single drug to be worried about addiction. But are you taking drugs every day? This behavior can quickly become a slippery slope.

Legality makes some substances seem safer,2 but mixing any drugs has unpredictable results. Think of alcohol, marijuana, and nicotine. In many U.S. states, all 3 are both legal and socially acceptable. It makes sense that people mix these substances without thinking twice. But taking substances together can have unintended, even dangerous, effects.

The Effects of Combining Drugs

Combining drugs can be unpredictable. That’s especially true when you’re taking illegal, untested drugs, but it can even be an issue with prescriptions. For example, taking MDMA along with certain antidepressants can lead to serotonin syndrome.3 This condition is rare, but extremely dangerous. And it’s just one of several drug combinations to watch out for.

The following combinations can also put you at risk of serious side effects:

  • Drinking with benzodiazepines,4 like Xanax, makes it easier for your body to process the benzos. This can exponentially raise the concentration of drugs in your bloodstream. And because you can’t control or measure that increase, you might increase your risk of overdose.
  • Cocaine and alcohol heighten the risk of cardiotoxicity,2 or heart damage.
  • Mixing opioids and stimulants5—or “speedballing”—is dangerous and unpredictable. If the 2 drugs effectively cancel each other out, you might even feel sober. And if you respond by taking more, then you risk overdosing. Speedballing can also cause serious heart problems.
  • Mixing multiple opioids is easy to do by mistake. Many sources mix drugs like heroin with fentanyl, a cheaper synthetic opioid.6 Because fentanyl is stronger than other similar drugs, this makes it difficult to dose properly—especially if you don’t know you’re taking it. And even accidental use of fentanyl can increase your risk of addiction.
  • Mixing alcohol with any drug2 can have a direct impact on your mental health. This can cause anxiety and increase drug cravings, making it harder to begin recovery.

Numerous Ways to Treat Multiple Addictions

Recovering from even one addiction can be a complex process. And if you’ve been taking several different substances, you may need highly specialized treatment. Your care team can help you decide which types of therapy are most appropriate. A comprehensive treatment program might include therapies like the following:

Prescribed Medications

When taken under a doctor’s supervision, certain medications can support your recovery from multiple addictions.7 However, this may not be appropriate for all patients. For instance, if you have a history of misusing prescription drugs, talk therapy may be a safer treatment.

Even if you find meds helpful, they’re just one part of recovery. It’s important to combine this approach with other therapies, and with healthy lifestyle choices.

Exercise and Movement

Physical fitness has a huge impact on mental health.8 That makes it important for everyone. But data suggests it matters even more if you’re healing from addiction.

For people with multiple addictions, exercise decreases cravings9 and improves your mood. Experts say physical fitness might even guard against relapse. And best of all, you can put this data to work for you in any stage of recovery. During treatment, you might benefit from a form of movement that gets your blood pumping. And after you return home, you can take up yoga, go swimming, or just jog around the block.

Fitness can also aid in recovery by helping you build a healthy routine. Doing things you genuinely enjoy is an important part of long-term healing. Sustainable habits, like exercise, can give you the strength you need to stay on track.

Contingency Management

Contingency management (CM) activates your internal reward system.10 In treatment, patients get material rewards for achieving specific goals. For example, you might get free movie tickets after your 5th negative drug test in a row.

Data shows that CM can effectively treat patients with multiple addictions.11 This therapy can protect against relapse both during and after inpatient rehab. It even works as a virtual treatment.

Finding the Right Tools for Recovery

Multiple addictions are a complex issue. So when you start recovery, you’ll need a treatment approach that covers all your bases.

Talk to your care team about which combination of therapies will work best for you. The act of designing your treatment plan is the first step toward a healthier future. And that future can be as multifaceted and exciting as your past, even if the details are different.

Browse our list of rehab centers to learn about their locations, treatments offered, and insurance options, and to start planning your recovery.

Reviewed by Lisa Misquith

  1. Centers for Disease Control and Prevention. “Polysubstance Use Facts.” https://www.cdc.gov/stopoverdose/polysubstance-use/index.html []
  2. Crummy, Elizabeth A., et al. “One Is Not Enough: Understanding and Modeling Polysubstance Use.” Frontiers in Neuroscience, vol. 14, 2020. Frontiers, https://www.frontiersin.org/articles/10.3389/fnins.2020.00569. [] [] []
  3. Makunts, Tigran, et al. “Reported Cases of Serotonin Syndrome in MDMA Users in FAERS Database.” Frontiers in Psychiatry, vol. 12, Jan. 2022, p. 824288. PubMed Central, https://doi.org/10.3389/fpsyt.2021.824288. []
  4. Huang, Zhibin, et al. “Influence of Ethanol on the Metabolism of Alprazolam.” Expert Opinion on Drug Metabolism & Toxicology, vol. 14, no. 6, June 2018, pp. 551–59. DOI.org (Crossref), https://doi.org/10.1080/17425255.2018.1483338. []
  5. THE FLORIDA ALCOHOL AND DRUG ABUSE ASSOCIATION (FADAA). (n.d.). “SPEEDBALLING”: MIXING STIMULANTS AND OPIOIDS [Micromodule]. https://www.training.fadaa.org/Speedballing/Speedballing_PPT.pdf []
  6. Abuse, National Institute on Drug. “Fentanyl DrugFacts.” National Institute on Drug Abuse, 1 June 2021, https://nida.nih.gov/publications/drugfacts/fentanyl. []
  7. Paetzold, W., et al. “[Detoxification of poly-substance abusers with buprenorphine. Effects on affect, anxiety, and withdrawal symptoms].” Der Nervenarzt, vol. 71, no. 9, Sept. 2000, pp. 722–29. Europe PMC, https://doi.org/10.1007/s001150050656. []
  8. Physical Activity Is Good for the Mind and the Body – News & Events | Health.Gov. https://health.gov/news/202112/physical-activity-good-mind-and-body. Accessed 12 Dec. 2022. []
  9. Ellingsen, Maren Mikkelsen, et al. “Effects of Acute Exercise on Drug Craving in Adults with Poly-Substance Use Disorder. A Randomized Controlled Trial.” Mental Health and Physical Activity, vol. 21, Oct. 2021, p. 100423. ScienceDirect, https://doi.org/10.1016/j.mhpa.2021.100423. []
  10. Wise, Roy. “Neural Mechanisms of the Reinforcing Action of Cocaine.” NIDA Research Monograph. National Institute on Drug Abuse, 1976. []
  11. Opioid Use in the Context of Polysubstance Use: Research Opportunities for Prevention, Treatment, and Sustained Recovery . (2021, April 14). NIH HEAL Initiative. https://heal.nih.gov/files/2021-07/polysubstance-heal-meeting-summary.pdf []

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