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How polysubstance abuse is worsening the American opioid crisis

America's addiction crisis is being ushered into a dangerous new era by rising levels of polysubstance abuse, as more people become addicted to deadly combinations of synthetic opioids and stimulants. The alarming trend is causing concern among addiction specialists and medical professionals, who say the rise of polysubstance abuse is making it harder to treat opioid addiction and taking the crisis to a new, more perilous level… Non-opioids being taken alongside drugs like fentanyl and heroin include animal tranquilizer xylazine, known as tranq dope, prescription pills like Valium and Klonopin and illicit stimulants like cocaine and meth. None of these drugs are safe to mix with opioids, but…

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 Polysubstance drug use a ‘fourth wave’ of opioid epidemic

Opioids increasingly propelled by fentanyl and meth. The United States is knee-deep in what some experts call the opioid epidemic’s “fourth wave,” which is not only placing drug users at greater risk but also is complicating efforts to address the nation’s drug problem.

Articles of Interest

A Monster’: Super Meth and Other Drugs Push Crisis Beyond Opioids

Millions of U.S. drug users now are addicted to several substances, not just opioids like fentanyl and heroin. The shift is making treatment far more difficult.

Fentanyl mixed with cocaine or meth is driving the '4th wave' of the overdose crisis

"We're now seeing that the use of fentanyl together with stimulants is rapidly becoming the dominant force in the U.S. overdose crisis," says Joseph Friedman, the lead author of the study and a researcher at UCLA's David Geffen School of Medicine. "Fentanyl has ushered in a polysubstance overdose crisis, meaning that people are mixing fentanyl with other drugs, like stimulants, but also countless other synthetic substances."

Fewer deaths, new substances and evolving treatments in Philly’s opioid epidemic − 4 essential reads

Forensic testing has revealed that over 90% of street heroin and fentanyl samples in Philly now contain xylazine, an animal tranquilizer with no FDA-approved use in humans.

One Is Not Enough: Understanding and Modeling Polysubstance Use

Although the majority of research on SUDs has focused on individual substances in isolation, with a multiple drug use history often considered an exclusion criterion for clinical studies, it is important to recognize that many drug users engage in polysubstance use. For instance, 30–80% of heroin users have been reported to also use cocaine

Polysubstance Abuse: Struggling with Multiple Substances

This pattern of substance use can vary widely, with individuals combining substances for various reasons, such as enhancing the effects of one drug, counteracting undesirable effects, or simply due to availability. Common combinations include alcohol with opioids, stimulants with sedatives, or multiple illicit drugs taken together, each posing unique dangers to the user.

Polysubstance use in the U.S. opioid crisis

Interventions to address the U.S. opioid crisis primarily target opioid use, misuse, and addiction, but because the opioid crisis includes multiple substances, the opioid specificity of interventions may limit their ability to address the broader problem of polysubstance use. Overlap of opioids with other substances ranges from shifts among the substances used across the lifespan to simultaneous co-use of substances that span similar and disparate pharmacological categories.

Polysubstance Use: A Broader Understanding of Substance Use During the Opioid Crisis

Viewing opioid trends in a “silo” ignores the fact not only that polysubstance use is ubiquitous among those with opioid use disorder but also that significant changes in polysubstance use should be monitored alongside opioid trends.

The Future of Drugs Is a Synthetic Cocktail From Hell

“Eventually, there’s not going to be anything to do with heroin and fentanyl. It’s going to be all chemical, all from the dark web, all just something people have thrown in a bowl and sold as fent or heroin,” Keisha said.

The State of Our Ongoing Polydrug Use Epidemic

Polydrug use is the new normal and a significant factor in opioid-related overdose deaths. Of course, fentanyl and other opioids can cause deaths by themselves. However, as more individuals take multiple drugs, the risks of death increase due to the lethality of drug interactions. Among opioid-related deaths, nearly two-thirds (63%) involve other substances, such as cocaine, methamphetamine, or benzodiazepines...

What Everyone Needs to Know About Polysubstance Use

A massive survey recently released by a national drug-testing company strongly suggests we are well into the “fourth wave” of the opioid crisis. The three previous waves were driven by 1) prescription opioids; 2) heroin; then 3) fentanyl. The fourth and current wave involves using opioids such as fentanyl combined with other lethal substances, including methamphetamines, cocaine, and xylazine (“tranq” or “tranq dope”).