Polysubstance use

This term refers to the use of more than one substance at a time. The term is not contested but the drivers of polysubstance use are often not explained or understood and so people involved in polysubstance use can be stereotyped or stigmatised as ‘reckless drug users’ or ‘hopeless addicts’.

Although polysubstance use is sometimes regarded as if it was something distinct and unusual, many people are involved in polysubstance use – sometimes when not realising it. This can happen even when someone thinks that they are using one substance and then waiting for the effect to pass before using another substance as, although the effect may not be apparent, a substance can still be active within the body, putting strain on the body’s systems. This can cause unintentional overdose.

People can also be involved in unplanned polysubstance use if they are forced by circumstances to consume a second drug or more than one drug. This can happen, for example, when they find themselves in possession of drugs and are suddenly stopped by the police or security staff.

Commonly polydrug use also happens when people think they are using one drug but it has become adulterated or has be diluted with another psychoactive substance – this is often the case in the supply of street drugs which is controlled by criminals and completely unregulated.

Polysubstance use is also deliberately practiced to achieve desired effects. However, often the quality of drugs is so poor (they are diluted and so less effective) or the supply is interrupted and there is less available than a person needs and for these reason a person can end up obtaining and mixing substances that they did not really plan to use.

Some people in a state of intoxication can end up using other substances that they would not have planned to use due to disinhibition – this is particularly true of people using drugs like alcohol which disinhibit people who use them.

So unregulated criminal supply, law enforcement and ignorance of the way the body processes drugs all play their part in polysubstance use.

Polysubstance use is a higher risk activity and there are specific harm reduction measures around this. The vast majority of overdose deaths in Scotland are polysubstance use deaths.