As the National Institute on Drug Abuse (NIDA) discusses, treatment for drug abuse (singular or poly-abuse) involves a complex interaction of an individual’s biology and behavior. The goals of treatment are always to achieve abstinence from drugs, maintain that abstinence, and help recovering substance abusers to be a functioning member of their family, work or school environments, and society in general.
Addiction is a chronic disease, and for this reason, one treatment attempt may not be sufficient. While the drug treatment process should involve commitment and not simply be a tryout, it is also a process of trial and error for many. A relapse does not signal failure as much as the need to try a different rehab plan or make a greater commitment to an existing one.
In the public, drug abuse is often seen as a monolithic problem without further consideration of the details of the number and different types of drugs abused. Although perspectives are shifting toward an understanding of substance abuse and addiction being an illness, part of the stigma drug abusers face is that the public often lumps them into an undifferentiated category of “addicts.” But no two substance abusers are the same, nor do they abuse the same combination or amount of drugs. Addiction specialists understand that some abusers may abuse more than one illicit substance at the same time. Such abusers require specialized and complementary rehab services to safely treat their poly-drug abuse.
Naltrexone Treatment
As a research study published in the American Journal of Psychiatry discusses, the majority of drug addicts are poly-drug dependent and as of the time of publication in 2012, there was no effective pharmacological remedy available for this illness (i.e., treatment is therefore based on a combination of existing methodologies). The study involved 100 heroin-amphetamine drug abusers in outpatient treatment and tested the effectiveness of a naltrexone implant as a possible treatment option. As NIDA explains, in Russia, naltrexone is the primary medical treatment for opioid dependence (dependence on heroin and prescription painkillers), and it is used in some treatment programs in the US. The implant form provides a second option to the injectable version, known as Vivitrol. The study showed that the naltrexone implant receivers had more success than the placebo group.
In specific, at the 10-week mark, 52 percent of patients who received a naltrexone implant were still in treatment compared to 28 percent who received the placebo. At the same time, 38 percent of the naltrexone group tested negative for drugs compared to 16 percent of the placebo group. Regarding improvement overall, 56 percent of the naltrexone group demonstrated much or very good improvement whereas 14 percent of the placebo group had this rating. The study was a success in that it provided the first evidence of an effective pharmacological treatment for heroin-amphetamine poly-drug dependence.
In a comprehensive research report about poly-drug use in the European Union and Norway, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) provides useful and insightful information about this form of substance abuse. When it comes to poly-drug use, knowing the separate risks of each drug abused is not enough because the interplay of drugs acting on each other presents a key danger. As EMCDDA discusses, the following are some examples of poly-drug use dangers (and they are as applicable in the US as in Europe):
- Although it is not common to overdose on benzodiazepines (sedatives), combining a large amount of this drug with a large dose of an opiate (such as heroin) or alcohol can prove fatal.
- The combination of Ecstasy and alcohol increases health risks because alcohol causes dehydration and an imbalance of thermal regulation.
- Concurrent use of cocaine and alcohol can cause greater toxicity of the heart and liver than either drug alone (e.g., alcohol is often included in cocaine-related cardiac deaths).
- Different stimulants used in combination, including energy drinks, can impair the functioning of the heart and the body’s thermal regulation.
One noted phenomenon of drug abuse is that substance abusers tend to include marijuana among the drugs they use. As the 2013 National Survey on Drug Use and Health found, 80.6 of current illicit substance abusers also used marijuana. From a treatment perspective, during intake and assessment, drug counselors or other addiction professionals must learn about the totality of a person’s drug intake and make a treatment decision based on the unique combination of drugs and quantities abused. It will be important for a substance abuser who includes marijuana in their drug intake to tell a counselor about this use because marijuana may have different interactions with different types of drugs.The 2013 survey also found an association between illicit drug and heavy drinking. Similar to previous years, in 2013, of the 16.5 million estimated heavy drinkers aged 12 and older, 33.7 percent were also current users of illicit drugs. As drug users tend to bundle in marijuana and/or alcohol with other drugs, the health risks increase, as does the treatment complexity; however, poly-drug use is treatable. An important key is for substance abusers to be honest with their loved ones and treatment program counselors about the full extent and nature of their drug abuse.Poly-drug use, because it only stokes the dangers inherent in drug use, presents not only a threat to health, but also a risk of bodily injury. It is never advisable to operate a vehicle or machinery under the influence of one drug, and certainly not under the influence of two or more. A main difficulty of poly-drug use is that the abuser compromises his ability to engage his level of intoxication. Even if the effects of each drug are known to him, the combination of drugs can present an entire new level of danger, one that makes seeking treatment for poly-drug use all the more urgent.
At FRN, our treatment centers are equipped to expertly treat poly-drug abuse with comprehensive dual diagnosis care. Our specialized staff is trained in treatment methodologies suitable to different types of addiction and combinations of illicit substances. Our admissions coordinators are available 24 hours a day to provide a free, confidential assessment to get you or your loved one on track for recovery today. Call now.
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton