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Why is Adolescent Polydrug Use so Harmful?

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT Meet The Team >

When an individual uses two or more substances at the same time, the practice is called polydrug use. Polydrug use is particularly common among adolescents experimenting with alcohol and drugs.

How Common Is Polydrug Use in Teens?

One study of teens in California, conducted by the RAND research institute in Los Angeles, found that 29% of their sample of high school seniors engaged in polydrug usage in the past year. The same study found that a pro-drug environment, rebelliousness, and family conflict can predict future substance abuse and polydrug problems in teens. Studies also show that polydrug use is common among adolescents who attend raves and dance club parties.  Other evidence shows that teen boys are more likely to engage in polydrug use than teen girls. Also, older teens are more likely to engage than younger teens.

Why Teens Combine Drugs

Teens who combine drugs together do so for a variety of reasons. Many try to enhance the effect of one drug by combining it with another. Other times, teens use the second drug to ameliorate the negative side effects of the first. And sometimes, when a teen is undergoing painful withdrawal symptoms, they will take another drug to lessen the pain, even though this is never recommended and indeed highly dangerous. (Medically supervised medication-assisted treatment is one alternative to ameliorating the painful effects of withdrawal.)

As a general rule, polydrug use is always dangerous.

Teens often engage in polydrug use in recreational settings, in an environment of peer pressure, or among others who commonly engage in polydrug use. Alcohol, tobacco, and marijuana are the most common culprits in polydrug usage. But many teens will misuse hard drugs as well, sometimes unintentionally. For instance, a teen may drink at a party. Then, later on, they may be offered benzodiazepines (benzos), Ecstasy, hallucinogens, or something else. They accept, not remembering they just drank. Meanwhile, the combined effect can be life-threatening.

Common Toxic Polydrug Combinations

Many polydrug combinations can have toxic effects on a teen’s nervous system and working memory. Below are some common combinations of drugs that are particularly toxic.

Benzodiazepines + Opioids

This is a deadly combination, even in small doses. What’s even scarier is that a teen could be prescribed both benzos and opiates at the same time. Teens with anxiety disorders often take prescription benzos to treat their anxiety. Meanwhile, teens in pain from an injury or surgery (even something as innocuous as a wisdom tooth extraction) often receive a prescription for opioid painkillers. However, benzos and opioids can be lethal when mixed. Combined, these substances can cause breathing to slow to a dangerous level. Taking both concurrently may sedate an individual so strongly that the respiratory depression becomes life-threatening.

Benzos and Alcohol

Since benzos can calm anxiety (and are often used to induce sleep), sometimes teens think that alcohol can only help the process along. However, since both benzos and alcohol are depressants, combined they can have dangerous effects on the brain and central nervous system (similar to benzos + opiates). Interaction between these drugs can cause fainting, loss of consciousness, risky behavior, memory impairment, other brain damage, and even death.

Cocaine and Opioids

In street terms, this is called a speedball. Teens who combine cocaine and opioids (most commonly, heroin or morphine) are trying to increase the effect of the “high” they receive. At the same time, the belief is that the cocaine, a stimulant, will balance out the negative side effects of the opioid, a depressant that causes drowsiness and sedation. While in theory this may be true, in practice this polydrug combination often leads to serious problems – the most severe of which is fatal overdose, since teens mistakenly believe they are less intoxicated than they actually are and self-administer too high of a dose. In fact, many well-known individuals have died after taking speedballs.

Cocaine and Ecstasy

This combination is common at raves because both these “party drugs” can lower inhibition and enhance euphoria. However, the combination can lead to cardiovascular issues (like a heart attack), risky behavior, seizures, coma, shaking, stroke, paranoia, and even sudden death.

Heroin and Alcohol

Both of these are depressants, so using them simultaneously or one after the other raises the chance of respiratory failure, overdose, permanent brain damage, and even death. The interaction between these two drugs is similar to the interaction of benzodiazepines and alcohol.

Adderall and Alcohol

Adderall is a stimulant most often prescribed to adolescents and teens with ADHD to manage their symptoms. However, alcohol is a depressant, which means it slows down your heart rate and relaxes your nervous system. Together, the interaction can cause increased/irregular heart rate, increased blood pressure, alcohol poisoning, and risky/aggressive behavior.

As a general rule, taking any drug with alcohol is never a good idea.

Mixing Drugs Can Also Lead to Mental Health Issues

Adolescents addicted to substances often take whatever drugs they can find. They won’t think about the lethal consequences of combining these drugs together. However, in addition to the individual dangers or side-effects associated with each drug, the interactions together are usually exponentially more lethal, as seen in the above examples.

These polydrug combinations can lead to mental health complications, as well. This study shows that teens who abuse alcohol together with illegal drugs are more likely to have anxiety and depression. Meanwhile, teens who abuse marijuana and other drugs are more likely to experience anxiety in addition to psychosis.

Additionally, research shows that adolescents who engage in polydrug use are at higher risk of developing substance use disorders later in life. One research study shows that teens who misuse marijuana and cigarettes together are more likely to move on to more serious polydrug combinations, involving opioids, cocaine, benzodiazepines, and methamphetamines.

Substance Abuse or Dual Diagnosis Treatment for Teens

If your teen is living with a substance use/ polydrug use problem, seek help immediately from an adolescent drug rehabilitation program. Teen polydrug use is extremely dangerous and always warrants professional treatment. A substance abuse or dual diagnosis teen treatment center can help your teen detox safely. Treatment provided by professionals can also teach them how to recover from addiction. Also, at a teen rehab center, staff can work to uncover the underlying causes of your teen’s addictive behavior. Teen rehab centers can teach teens coping skills to prevent relapse and move forward with their lives. Depending on the nature of their addiction, your teen may need residential treatment (RTC), a partial hospitalization program (PHP), or an intensive outpatient program (IOP).

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