Is addiction a disease or a choice?

Addiction is classified as a chronic brain disease by the American Medical Association, NIDA, and the World Health Organization. While the initial decision to use may be voluntary, repeated use changes brain structure and function in ways that impair judgment and self-control.

Can you recover from addiction?

Yes. Millions of people live in sustained recovery from substance use disorders. Evidence-based treatment significantly improves outcomes. Recovery is a process, not an event, and many people benefit from ongoing support for years.

Substance-specific

Polysubstance use: When someone is addicted to multiple substances

Published October 1, 2025 · 8 min read · Updated April 2026

Last medically reviewed: April 2026

Reviewed for accuracy by licensed clinical professionals. Editorial process.

Polysubstance use — the concurrent or sequential use of multiple substances — is becoming the norm rather than the exception. Overdose data increasingly shows multiple substances present: fentanyl combined with methamphetamine, cocaine mixed with opioids, alcohol alongside benzodiazepines. This clinical reality demands treatment approaches that address multiple dependencies simultaneously.

Why polysubstance use is more dangerous

Each substance affects different neurotransmitter systems, and combinations create compounding risks. Opioids plus benzodiazepines both suppress breathing, dramatically increasing overdose risk. Stimulants plus opioids mask the sedating effects of opioids, leading users to take more than they realize. Alcohol plus any CNS depressant multiplies the risk of respiratory depression. The presence of illicitly manufactured fentanyl in non-opioid drug supplies means that people who use cocaine, methamphetamine, or counterfeit pills may unknowingly be exposed to opioids.

Treatment challenges

Polysubstance use complicates treatment in several ways. Detox protocols must account for multiple withdrawal syndromes, some of which require different or even conflicting medical interventions. MAT medications that address one substance (like buprenorphine for opioids) do not address co-occurring stimulant or alcohol use. Treatment planning must prioritize which substance is most medically dangerous to withdraw from first (typically alcohol or benzodiazepines, then opioids). Relapse triggers differ for each substance, requiring more complex relapse prevention strategies.

Finding the right program

Look for programs that explicitly treat polysubstance use — not programs that primarily treat one substance and address others as an afterthought. Ask: How do you manage concurrent withdrawal from multiple substances? Does your treatment plan address each substance individually? Do your clinicians have experience with complex, multi-substance presentations? Can your psychiatric team manage the medication interactions involved?