Understanding Combined Drug Intoxication
What Is Combined Drug Intoxication?
Officially, combined drug intoxication (CDI) is a cause of overdose death that involves the presence of multiple substances. Some people use CDI to describe any polysubstance use.
People who overdose after abusing multiple substances may have CDI from drug interactions. Some people with CDI may be revived after an overdose. However, generally, the term is used to describe a cause of death.
What Is Combined Toxicity?
Combined toxicity is the cumulative toxic effects of incompatible substances taken simultaneously.
People who take multiple substances that have effects that make them incompatible may experience severe or life-threatening side effects. Negative interactions from mixing drugs can put excessive stress on the central nervous system (CNS), heart, liver, and other body systems.
What Is an Example of a Combination Drug?
A combination drug, such as the HIV drug Atripla, is a prescribed medication with two active ingredients formulated together to treat multiple issues simultaneously.
Combination drugs combine two distinct ingredients with unique uses into a single medication to treat one or more conditions. People who abuse substances while prescribed combined drugs have an increased risk of overdose or other serious health complications.
What Is the Difference Between Combined Drug Intoxication and Polysubstance Use?
Combined drug intoxication is used almost exclusively in relation to overdose events, while polysubstance use can describe any instances where a person uses multiple substances simultaneously.
Polydrug use does not always lead to harmful interactions, overdose, or death. People who regularly engage in multiple drug intake may take steps to ensure the substances they take do not interact in a way that may cause health issues. However, even seemingly innocuous drugs and prescription drug abuse combined with other substances can pose the potential to cause unexpected side effects.
Dangers of Mixing Drugs
Why Does Combining Drugs Increase the Risk of Overdose Deaths?
Combining drugs, especially illicit substances, without regulatory oversight to ensure consistent drug ingredients, increases the risk of overdose due to the inability to safely measure a dose and dangerous interactions between certain drugs.
Mixing stimulants can overload the cardiovascular and central nervous systems, causing heart failure or other potentially deadly side effects. Using multiple depressants can slow heart rate and breathing to the point of coma or death. Combining stimulants and depressants can cause such strain on the body that it causes fatal damage to the kidneys, liver, heart, and nervous system.
How Does Combined Drug Intoxication Affect the Body?
CDI generally leads to overdose and death due to respiratory failure, suppressed breathing, arrhythmia and other heart issues, brain damage, or other serious health side effects.
People often do not survive the physical effects of CDI. If you or someone else has mixed substances knowingly or accidentally, it is vital to get medical treatment immediately to reduce the risk of CDI.
Why Can Mixing Drugs Make Overdose Symptoms Harder to Recognize?
Mixing drugs can cause unpredictable results that may cause confusion, delayed side effects, or unusual reactions that make it difficult for people to recognize the warning signs of an overdose.
Stimulants and depressants cause different overdose symptoms. Combining them can cause confusing symptoms and side effects, leading to a delay in treatment and serious illness, injury, or death. Anyone who has mixed substances should get medical treatment immediately, even if they do not recognize any signs of overdose. Early treatment can save lives and reduce the risk of brain damage or other permanent and long-term side complications caused by mixing drugs that interact with one another.
What Two Drugs Can You Not Mix?
Many medications cannot be mixed together without causing potentially life-threatening side effects, including benzodiazepines and opioids.
Benzodiazepines are some of the most commonly prescribed medications. You should never combine benzodiazepines and opioids.
Why Are Opioids and Benzodiazepines Especially Dangerous Together?
Both benzodiazepines and opioids depress the central nervous system and suppress breathing, which can lead to hypoxia, unconsciousness, coma, or death.
Combining depressants like opioids and benzodiazepines inhibits reaction times, leading to accidents and injuries; dangerously slows or stops breathing; and causes a slow heart rate. Many people are unaware that combining even prescription benzodiazepines and opioids can lead to dangerous medication interactions. Always follow prescribed directions and inform prescribers of all other drugs you are taking.
Common Drug Combinations That Increase Overdose Risk
What Drug Combinations Are Most Dangerous?
Some of the most dangerous substance combinations include heroin and fentanyl, heroin and benzodiazepines, heroin and cocaine, oxycodone and alcohol, prescription painkillers and benzodiazepines, or methamphetamine and MDMA.
Hundreds of drugs should not be mixed. Some of the most common combinations you should avoid include Monoamine Oxidase Inhibitors (MAOIs) and Selective Serotonin Reuptake Inhibitors (SSRIs), blood thinners and nonsteroidal anti-inflammatory drugs (NSAIDs), stimulants and depressants, or depressants and depressants, or stimulants and stimulants.
What Happens When You Mix Cocaine and Opioids?
“Speedballing,” or mixing cocaine and opioids, causes severe side effects due to the extreme stress it puts on the heart and nervous system to combine stimulants and depressants.
Your body is not built for the extreme strain of filtering stimulants and depressants simultaneously. The heart, brain, nervous system, kidneys, and liver experience stress and may become damaged by combining drugs from opposite extremes, like opioids and cocaine.
Why Is Mixing Alcohol and Prescription Drugs Dangerous?
Prescription drugs often cause drowsiness and other side effects that alcohol can amplify, leading to potential injury, accident, or substance interactions.
Polydrug abuse, including prescription medications and alcohol, increases the risk of alcohol poisoning, overdose, and severe reactions. Benzodiazepines and opiates like prescription painkillers are especially dangerous when taken with alcohol.
Why Is Combining Stimulants With MDMA or Other Illicit Drugs Dangerous?
Combining MDMA and other drugs, especially other stimulants, can put extreme stress on the cardiovascular and nervous systems, which may lead to life-threatening conditions, such as heart failure.
The heart and other body systems are not meant to withstand the effects of multiple artificial stimulants used without a medical professional’s guidance.
Signs and Symptoms of Combined Drug Intoxication
How Can You Tell If Someone Is ODing?
The signs of overdose look different depending on the substances being used and may include depressed breathing, unresponsiveness, unconsciousness, lips or skin turning blue, inability to walk or speak coherently, gurgling, choking, or snoring sounds, confusion and dizziness, pinpoint pupils, and extreme drowsiness.
People experiencing an overdose may seem deceptively quiet and relaxed, which can lull the people around them into a false sense of security. For example, people who combine depressants may become sluggish, uncoordinated, exhausted, and go to sleep. It can be difficult for people around them to notice if sleep turns into unconsciousness or a coma. Be mindful of heart rate, breathing, speech patterns, movements, and ability to engage. People going through an overdose may not make sense, move unsteadily, have an elevated or slowed heart rate, and fast or depressed breathing. If in doubt, get medical assistance.
When Is Loss of Consciousness a Medical Emergency?
Any loss of consciousness or going in and out of consciousness after taking substances constitutes an emergency, and you should seek medical help immediately to avoid a potential overdose.
All instances of unconsciousness or unresponsiveness after a person mixes substances can indicate life-threatening side effects. Always get a medical assessment.
What Symptoms Require Immediate Emergency Care?
Get emergency care immediately if you notice respiratory depression, coma, hallucinations, loss of consciousness, seizures, sedation, vomiting while unconscious, skin turning pale, or abnormal breathing sounds.
People combining substances, even prescription medications, should seek medical care if they feel any type of unusual or unexpected physical distress.
Health Risks and Complications of Mixed Drug Toxicity
What Is the Cause of Death of Mixed Drug Toxicity?
People who die from mixed drug toxicity most commonly experience either respiratory failure or cardiac arrest.
Mixed drug toxicity affects the central nervous and cardiovascular systems the most acutely, which can cause injury, illness, or death after even a single instance of combining drugs.
What Organs Are Most Affected by Drug Toxicity?
The liver and kidneys are responsible for clearing chemicals from the blood and are most affected by drug toxicity.
Your heart, brain, nervous system, liver, and kidneys experience damage from drug toxicity. The extent of the damage depends on the type of substance. Your liver and kidneys work to filter toxins from your body and generally experience the greatest impact from drug interactions.
Can Combined Drug Intoxication Cause Permanent Brain Damage?
Yes. Combined drug intoxication can cause permanent brain damage or death.
The brain is a delicate organ, and any toxic substance introduced into the body that affects the central nervous system has the potential to cause short-term or permanent brain damage.
How Can Combined Drug Intoxication Affect the Heart and Liver?
Combining drugs puts extreme stress on the brain, heart, and liver, which can lead to organ damage and failure.
CDI causes heart and liver damage by overloading the body’s systems with toxic chemicals. The liver is responsible for breaking down chemicals, and in the case of CDI, the liver cannot keep up with the strain on the system caused by combined substances.
What to Do If Someone Has Combined Drug Intoxication
When Should You Call 911?
Call 9-1-1 after administering Naloxone if a person has experienced an opioid overdose or used a combination of substances.
Contact 9-1-1 if you suspect someone may be experiencing an overdose or other medical emergency. If you have Naloxone and the person is overdosing on opioids, administer Naloxone and then call 9-1-1 for emergency services.
How Is Naloxone Used During an Opioid Overdose?
Naloxone is administered immediately upon suspected opiate overdose to reverse the effects of the drug and stop the symptoms of an overdose.
Providing Naloxone can save a person’s life by stopping the overdose long enough for medical professionals to arrive and administer treatment.
What Should You Avoid Doing While Waiting for Emergency Responders?
While waiting for emergency services, do not force someone experiencing a suspected overdose into a cold shower, give them food or drinks, induce vomiting, leave them alone, give them additional substances, or hide information from 9-1-1.
Follow instructions provided by the dispatcher on the 9-1-1 call until emergency responders arrive on the scene.
When Should Someone Seek Help for Polysubstance Use?
Anyone who has become dependent on multiple substances or has mixed substances to find relief from physical or psychological distress should seek help to receive safe and appropriate treatment for their conditions.
People mix substances for many reasons. For example, combining benzodiazepines and opioids may be an attempt at self-medication to cope with a combination of pain, anxiety, insomnia, or depression.
Treatment for Combined Drug Intoxication and Substance Use Disorders
How Is Combined Drug Intoxication Treated?
An overdose caused by combined drugs requires professional medical treatment.
Emergency medical care is the only treatment for combined drug intoxication. Most people spend several days in the hospital to ensure they fully stabilize before transferring to drug treatment.
When Is Medical Detox Necessary?
People who have abused substances that may cause harmful withdrawal side effects should participate in medical detox and not attempt to quit on their own.
Chronic polysubstance use often requires medical detox to ensure safe withdrawal. New Found Life does not offer on-site detox services. However, we do provide referrals, and our case managers can facilitate the transition from detox treatment to our programs.
Why Is Ongoing Treatment Important After an Overdose?
An overdose may indicate significant mental distress and physical dependence. Treatment can provide relief, support, and the foundation for a sober future.
An overdose does not happen in a vacuum. Addressing the underlying trauma, pain, distress, or other issues that led to the choice to abuse substances can reduce the risk of relapse. Ongoing treatment provides people with a support system, resources, and alternative ways to cope with daily stressors.
How Can Treatment Help Prevent Another Drug Overdose?
Treatment reduces the risk of relapse or overdose by educating people, providing tools for managing substance use disorder, and providing a strong support network.
People who participate in professional treatment programs and use aftercare services have a reduced risk of relapse, overdose, and future mental health issues. Rehab programs give people coping skills for managing stress, regulating emotions, building healthy relationships, and practicing self-care to support ongoing sobriety.
How Can Addiction Treatment Support Long-Term Recovery?
Addiction treatment programs provide people with coping skills and resources to help them regulate emotions and manage stress without falling back into maladaptive patterns of behavior.
New Found Life provides comprehensive residential and outpatient treatment to help people heal from the effects of polysubstance use and avoid falling back into maladaptive behaviors. We give people the tools, resources, and support they need to heal and retake control of their lives.
FAQs
Can you survive combined drug intoxication?
Yes. You can survive combined drug intoxication if you get medical assistance immediately.
Early treatment can help people survive combined drug intoxication or other types of overdose. If you or someone else has combined multiple substances, seek medical assistance immediately to reduce the risk of deadly side effects.
Does every mixed drug overdose involve opioids?
No. Opioids are only one potential drug that can cause harmful side effects. Hundreds of other drug combinations also have the potential to cause a drug overdose.
Ecstasy, ketamine, and GHB are a few other substances that can cause a mixed drug overdose when combined with alcohol, benzodiazepines, and other substances.
Can prescription medications cause combined drug intoxication?
Yes. Combining medications in a way other than as instructed may cause severe complications and combined drug intoxication.
Adderall, Xanax, methadone, and other prescription medications should not be mixed with alcohol or other substances. Combining them with other substances may cause CDI. Always take prescribed medications as instructed.
Is combined drug intoxication always accidental?
No. Some people intentionally combine substances to achieve a certain altered state, even if it causes severe or life-threatening side effects. In addition, some people use combined drug intoxication as a form of self-harm.
People may knowingly or unknowingly take substances that cause CDI. There is no way of knowing how much or what kind of substances may be added to illicit drugs, which can lead to CDI.
Can people recover after a polysubstance overdose?
Yes, people can recover from a polysubstance overdose if they get medical assistance immediately.
People are more likely to survive a polysubstance overdose if they receive quick medical care. An overdose significantly increases a person’s risk of future overdose. Professional treatment is essential for avoiding relapse or overdose after recovery.
New Found Life treats polysubstance use and educates clients on the dangers of combining multiple substances. We use relapse prevention, aftercare planning, and skill development to help clients avoid overdose or relapse during early recovery. Individuals with multiple forms of SUD benefit from professional rehabilitation treatment and the ongoing alumni support we provide.