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Understanding Polysubstance dependence disorder

What is in a Name? I would never have thought that I could ever be accused of substance abuse. I am a health professional for goodness sake! I know all the chemical bla bla bla of these drugs and their resultant effects; so I know not to indulge. I would never have made money as...

Polysubstance dependence

What is in a Name?

I would never have thought that I could ever be accused of substance abuse. I am a health professional for goodness sake! I know all the chemical bla bla bla of these drugs and their resultant effects; so I know not to indulge. I would never have made money as a community pharmacist because I am the type to give medications as a last resort. I know how many times I quarrelled with clients over my refusal to dish out antibiotics over something uncalled for.

Fast forward a couple of years and I was diagnosed with a mental illness, albeit a wrong one. Thus, I was constantly being put on new medications and regimens until the proper diagnosis was made and I had some stability. But that opened my eyes to the magical world of psychotropics and related substances capable of numbing all things ‘numbable’. My best kind of high. And when everything else failed I clung to my drugs for comfort. The tougher work and life got, the more pills I popped. My in-depth knowledge of drugs combined with varied experience with psychotropics made it easier for me to know which to combine to get the most numbness. I didn’t have a favourite, I used what was available and could do the job. I remember looking forward to Fridays when I popped my cocktail of 3 to 5 different drugs that kept me in a daze all weekend. With time, I incorporated a couple of week days while still sticking to my prescribed meds and therapy sessions. Then I discovered new levels of bliss with alcohol as a potentiator.

You see, I took long breaks severally swearing never to go back but once withdrawal symptoms hit, I fish out my drug bag (my backup plan) and on we go. It got to point where I was struggling with my mental health, my job and social life and I hit rock bottom when I passed out after one of my cocktails and was discovered (luckily) by a friend who I had miraculously dialled in my disillusioned state. I was started on yet another treatment regimen (meds, CBT, therapy sessions) and have continued on a path of recovery with the help of friends and group support therapy. My stash has been taken and fortunately I am in a place where I don’t have such access to drugs as before.

I got lucky but the same can’t be said of the multitudes of people who suffer from polysubstance dependence disorder; a high-tech name for what I call ‘multiple drug abuse’ and I am about get serious.

Polysubstance dependence refers to a type of substance dependence disorder in which an individual uses at least three different classes of substances indiscriminately and does not have a favourite drug that qualifies for dependence on its own. Studies have shown that alcohol is commonly used with another substance. Substances range from inhalants, painkillers, benzodiazepines to heroin, cocaine, cannabis and lots of others in-between. In fact, anything that can cause a high as listed in Olamide’s Science Student.

How do I know I have this?

According to the DSM-IV (a manual used by mental health professionals to diagnose mental disorders), a diagnosis of polysubstance dependence must include a person who has used at least three different substances (not including caffeine or nicotine) indiscriminately but does not have a preference to any specific one. In addition, they must show a minimum of three of the following symptoms listed below, all within the past twelve months: Tolerance, withdrawal, loss of control, inability to stop using, interference with activities, harm to self.

NOTE THAT there is a distinct difference between a person having three separate dependence issues and having Polysubstance dependence. With polysubstance dependence, they are not specifically addicted to one particular substance which tends detract from the fact that they are drug addicts and need help. I was under this illusion.

How do people get to this point?

Causes can be psychological as well as sociocultural. It has also been shown that mental illnesses (depression, bipolar) and polysubstance dependence are often both present at the same time. If a person is predisposed to be depressed then they are at a higher risk of having polysubstance dependence.

Possibly the most widely accepted cause of addictions is the self-medication hypothesis. People use drugs as a form of self-medication to deal with difficulties of self-esteem, relationships, and self-care. Individuals with substance use disorders often are overwhelmed with emotions and painful situations and turn to substances as a coping method. Story of my life. We claim to be better than people who cut themselves but abeg, all na the same thing!

Peer-pressure and environment can also predispose one to start experimenting with various drugs e.g. the codeine + tramadol + alcohol gang.

Can polysubstance dependence disorder be treated?

It is important to know that polysubstance dependence leads to serious neuropsychological impairment which cannot be recovered much over the span of a year. However, there are treatments available with many critical aspects. Treatment must be individualized and last a sufficient amount of time to ensure the patient has kicked the addictions and to ensure the prevention of relapse.

The most common forms of treatment for polysubstance dependence include: in and outpatient treatment centres, counselling and behavioural treatments (twelve step programs, cognitive behavioural therapy), and medications. Medications are a useful aid in treatments but are not effective when they are the sole treatment method. It is a good idea that recovering addicts continue to attend social support groups or meet with counsellors to ensure they do not relapse. 

The way forward

The best single thing an individual can do to prevent polysubstance dependence is to avoid using drugs including alcohol altogether. However, if this struck a chord with you or made you feel like you have been exposed, do reach out to someone (do reach out to us in Mentally Aware Nigeria Initiative) and you will be singing songs of freedom in no short time. You are not alone


-Ezinne VC

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