Most people have seen the presentations in school or heard the lectures: your brain on drugs lights up and changes, first producing a high, but with serious long-term consequences. However, do you know what happens when you take more than one drug at a time?
The fact is that anywhere from one-third to over a half of all drug users use more than one drug regularly, depending on area and sample size. Heroin and cocaine users reportedly abused more than one drug more often than other types of drug users, the most commonly concurrent addictions being an addiction to alcohol and heavy use of marijuana.
Studies also show that polydrug use complicates treatment, increases health risk behaviors, leads to greater psychological issues, and makes it harder to treat the addiction, because of the differences between the various drugs the users commonly ingest.
Mixing drugs can lead to volatile effects. The worst-case scenario is death by accidental overdose. Drugs interact with one another, and most have contraindications – reasons and symptoms that tell doctors they should refrain from prescribing a certain treatment. Contraindications can also be syndromes or symptoms suggesting that patients are better off not taking a specific drug. Drug interactions are also something medical professionals watch out for, to prevent unintended side effects. For example, if someone suffers an allergic reaction to baker’s yeast, they shouldn’t take the hepatitis B vaccine. Warfarin is used to treat unwanted blood clotting by preventing coagulation. This interacts negatively with common acetaminophen-containing products and Tylenol. If you’re already taking a drug that acts as an antidepressant, you shouldn’t double up with an antidepressant herbal supplement. The lists go on and on.
Most drug users aren’t trained to know the counterindications for every drug they end up trying. Often, they can’t be sure the drug they’re trying is pure anyway. This makes polydrug use so dangerous, as a person could potentially be ingesting three, four, or five different drugs, all of which interact with the brain and body in very different ways, making the possibility of a severe reaction that much more likely.
Drugs and the Body
When a drug enters the bloodstream, it makes its way to the brain, passes the blood-brain barrier, and attaches to receptors in your brain cells. This process causes your central nervous system to send out signals, either reducing pain, or reducing inhibition, or increasing your heartrate, or blocking the decrease of serotonin – and so on and so forth.
One drug alone can prime the brain and body for more drug use, causing a flood of dopamine to slowly but effectively build a dependence on the substance.
But when two different drugs interact with the brain, the effects can be deadly. Here are a few different ways in which polydrug use can damage the brain.
Cocaine and alcohol are commonly combined, especially at parties, either with or without MDMA in the mix in the form of ecstasy. However, while cocaine is sometimes used to maintain the euphoric feeling of alcohol without the drunkenness, cocaine and alcohol combine in the body to produce cocaethylene, a chemical compound of cocaine and ethanol, more dangerous than either drug on its own. Cocaethylene can cause sudden death once enough of it builds up inside the system. It can stay in the body much longer than either drug, and it takes longer for the body to metabolize it.
Heroin and cocaine are also commonly combined, usually referred to as a speed ball. Cocaine is used to limit the withdrawal effects of heroin, but at an increased risk of:
- Renal disease
- Paranoia and anxiety
- Depressed breathing/respiratory failure
While MDMA in its purest form is not a strong stimulant, MDMA is usually cut and mixed with cocaine and other stimulants when sold as a party drug, and can have serious neurological consequences, including neurotoxicity and other long-term mental consequences.
Any given drug combination can heavily affect your organs, especially the kidneys, liver, and brain. Drugs combine in the liver and create different compounds, with a higher likelihood of long-term damage, including an increased risk of several different cancers.
Mixing Like and Like
With two very different drugs can elicit a mixed response in the brain and body, two similar drugs will combine to boost shared effects, massively increasing the risk of an overdose. An influx of illegal fentanyl, a powerful synthetic opioid, has led to a growing number of opioid overdoses in the US through fentanyl-laced heroin. Similarly, taking a mild opioid like codeine and mixing it with alcohol can cause the depressant effects of both drugs to ramp up violently, leading to unconsciousness, respiratory failure, and death through lack of oxygen.
Mixing several different types of stimulants can increase the risk of heart failure, as well as lead to greater long-term risks in the brain, including anhedonia (killing the ability to feel pleasure) and permanent damage to cognitive abilities.
Alcohol in the Mix
Alcohol is the most dangerous concurrent drug because it is common, cost-effective, and usually available wherever other drugs exist. Even among drug users used to stronger ‘uppers’ and ‘downers’, alcohol is still a common staple due to its effectiveness and ubiquitous nature. However, it’s also one of the more dangerous drugs to mix other drugs with.
Cocaine and alcohol create a toxic compound that leads to sudden death over time, and an increased risk of liver damage and stroke. Alcohol and depressants (including opioids) can cause an overdose death through respiratory failure. When mixed with hallucinogens, alcohol can cause increased risk taking, fatal accidents, and generally place the user in extremely unsafe situations.
Always Consult Your Doctor
Drug use is dangerous one way or another, and most drug users may not feel comfortable openly discussing their drug use with a medical professional unless they’re already seeking treatment.
However, regardless of whether you’re addicted or thinking of using drugs recreationally, don’t take medication without talking to a doctor about it, even if it’s over-the-counter, or simply a herbal alternative. Even the pills you get from a naturopath can negatively interact with regular medication, given the right combination of chemicals. A professional can let you know whether it’s a good idea to take something if you’re presenting certain symptoms, have certain allergies, or are already on a certain drug.