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What you Should Know About Drug Mixing

Drug mixing or polydrug use is the practice of combining different substances. It could be done by consuming all the different substances at the same time, or by taking a different substance while one is still under the effects of another. There are legitimate medical reasons for polydrug use, but the term is most often used when describing recreational or compulsive substance use.

Polydrug does not have to involve prescription medications or illicit drugs. It may also involve the use of readily available legal substances like alcohol, caffeine, or nicotine. More than ever, it now involves the use of dangerous but still uncontrolled substances to produce so-called legal highs.

Boston Drug Treatment Centers sees a fair number of individuals check into local detox facilities and substance rehabs for polydrug use. As expected, the large number of college students and the party culture in Greater Boston do play a role in the relatively high local rates of polydrug misuse. However, it is a fairly common practice among most people with substance use disorder.

Why do people combine drugs?

People combine drugs for several different reasons. Some of the reasons include the following:

1.) To enhance the effects of different drugs. For example, party drugs like MDMA are often combined with alcohol, cocaine, or even caffeine to bring on a specific mood. People with opioid use disorder may also use benzodiazepines or alcohol to bring on even heavier sedation.2.) To counteract the effects of a drug of choice. For example, people hooked on opioids may take methamphetamines to counteract the lethargy from their drug of choice.3.) Some people enjoy the effects of polydrug use. Many recreational drug users enjoy the different unpredictable changes in mood and sensations that come with combining different substances. They may like the novelty of combining different drugs at various phases of their highs.

4.) As a substitute to stave off withdrawal symptoms. Withdrawals to certain drugs such as opioids and alcohol can be extremely uncomfortable. The choice of substitute can occasionally be deadly. For instance, there have been cases of people drinking industrial solvents when alcohol was unavailable.

5.) Combinations may be unintended. Benzodiazepines are commonly prescribed for anxiety and epileptic seizures and are mostly safe when taken as prescribed. However, they are sometimes combined with alcohol and other sedatives unintentionally, which can lead to stronger sedation.

Effects of combining depressants

Generally speaking, combining depressants produces a more pronounced, potentially fatal sedative effect. This type of combination tends to be the most lethal as it may stop a person’s breathing. Combining opioids, alcohol, benzodiazepines, ketamine, and other sedatives drugs can cause the following:

  • Confusion
  • Blackouts
  • Slurred speech
  • Difficulty breathing
  • Difficulty operating vehicles and heavy equipment
  • Depression
  • Lost episodes
  • Coma
  • Death

Effects of combining stimulants

As might be expected, combining stimulants usually has a synergistic effect. Even seemingly less harmful substances like nicotine and caffeine can heighten the effects of cocaine, methamphetamine, MDMA, and other stimulants. Some effects may include:

  • Elevated heart rate
  • Elevated blood pressure
  • Fever
  • Sleeplessness
  • Panic attacks
  • Anxiety
  • Tooth grinding
  • Paranoia
  • Heightened libido
  • Decreased appetite
  • Increased sweating
  • Irritability
  • Violent behavior
  • Hallucinations

Effects of combining stimulants and depressants

Mixing “uppers” and “downers” can create unpredictable interactions and effects in polydrug users. Multiple drugs can sometimes create different substances in the body that cause unintended effects on users. For example, consuming cocaine and alcohol together creates toxic cocaethylene in the body. Smoking different drugs can leave the lungs more vulnerable to infection compared to using just one type.

One particularly common and dangerous combination is combining alcohol and MDMA. Doing so can cause severe dehydration and cause permanent kidney damage. This type of polydrug use is fairly common around colleges and universities, of which there are many in Boston.

Other complications of long-term polydrug use

Polydrug use of all kinds tends to have some risks associated with it. This includes but is not limited to the following:

1.) More difficult treatment and recovery. It can be difficult for emergency room doctors to figure out exactly what should be done in polydrug overdoses. Many rehab centers may not also be equipped to treat people with multiple drug use disorders effectively.

2.) Heightened risk of violent incidents.

The intense and unpredictable mood swings caused by polydrug use can greatly increase the risk that a long-time multiple drug user will be involved in a violent incident.

3.) Increased risk of developing mental illnesses.

Long-term polydrug use can wreak havoc on the normal functioning of the brain. A 10-year study found that the number of drugs a person used could be a predictor of greater mental distress over time.


Mixing drugs is generally not a very good idea. Using multiple substances tends to be more harmful to your physical and mental health than using just one type of drug. Additionally, the effects of long-term polydrug use are much more difficult to treat as well.

If you are prescribed a drug that may have serious interactions with other substances, chances are your physician will warn you about them. Nevertheless, it’s important to do your due diligence and to contact a qualified medical professional if you have any concerns about your prescription medications interacting with other substances.

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