Polysubstance Use- Stimulants and Opioids

What is Polysubstance Use?

Polysubstance use is when a person takes more than one drug at the same time. This can happen with and without a person’s knowledge (someone choosing to take multiple drugs vs. someone who meant to take only one drug but it was mixed with others) (1).

Some polysubstance examples are:

  • illicitly manufactured fentanyl and heroin
  • illicitly manufactured fentanyl and cocaine
  • heroin and methamphetamine
  • prescription/ illicit opioids and benzodiazepines

Polysubstance use is common and always dangerous. Whether a person mixes prescription drugs, drugs of similar classes, or drugs of different classes(1).

One polysubstance use combination that has been on the rise in recent overdose trends, is the combination of methamphetamine and opioids (prescription or illicit).

Why are people combining meth and opioids?

There are a few reasons people are using both methamphetamine and opioids (2, 3):

  • Meth is very easy to find in Washington right now and it is often cheap to purchase
  • People enjoy the combined effects
  • Other people around them are using multiple substances at the same time
  • To help with daily activities
    • Stimulants and opioids can balance out the effects of each other
    • To help with opioid withdrawals
    • Increase a person’s energy while they are using opioids
    • To help with pain
    • To cope with life in general

Meth and Opioid Overdose Trends

In 2020 overdose deaths caused by meth and opioids were responsible for 23% of all drug poisonings that year. This is an increase from 2018 when they represented 19% of all drug poisonings. About half of all overdose deaths involving methamphetamine, also involved at least one opioid (4).

The graph below shows that people whose main drug is heroin are more likely to engage in polysubstance use than people whose main drug is methamphetamine.

What are the risks?

Using multiple drugs at the same time can also lead to (3):

  • Increase the risk of worsening mental and physical health
  • Increase the risk of passing on HIV and Hepatitis C
  • Increase the difficulty in securing housing and employment.


1. Centers for Disease Control and Prevention. (2021, July 19). Polysubstance use facts. Centers for Disease Control and Prevention. Retrieved September 17, 2021, from https://www.cdc.gov/stopoverdose/polysubstance-use/?s_cid=DOC_Poly_PaidSearch_018.

2. Newman , A. (n.d.). Methamphetamine & opioids in Washington. Retrieved from https://www.wapc.org/programs/education/overdose-awareness-series/.

3. July 12, 2021. (2021, July 12). Mixing heroin & meth: Effects, dangers & treatment. American Addiction Centers. Retrieved September 16, 2021, from https://americanaddictioncenters.org/heroin-treatment/combination.

4. Methamphetamine trends across Washington State. Washington state meth trends. (2021, August 4). Retrieved September 16, 2021, from https://adai.washington.edu/WAdata/methamphetamine.htm#combinations.