I’m addicted to more than one substance. What do I do?

Recovery is a hard journey to go through with one addiction, but it’s even more difficult when you find yourself recovering from more than one substance. But it’s not impossible. While everyone’s experiences are different, coping skills, learning triggers, finding support, and harm reduction can help you overcome your addictions and heal.

Reflecting on your substance use

When starting your recovery, it’s important to go back to square one and ask yourself: why did I start using or drinking? You like a specific drug because it’s doing something for your brain. People who like stimulants are often depressed or have low energy. People with a lot of trauma want to feel numb and like opioids. Finding and addressing your why can help you figure out what you need to do to address underlying issues, identify triggers, and start your process of long-term recovery.

Are you self-medicating?

Knowing if you are self-medicating is an important step in self-reflection. Self-medicating is using a substance that isn’t prescribed or part of a treatment process to help you feel better about a physical or mental problem. People self-medicate for many reasons like dealing with trauma,  treating undiagnosed mental illnesses or just trying to “relax.” Using these substances may make you feel better in the short term, but over time, using more and in uncontrollable ways leads to more problems.

If you are self-medicating, then you might be taking different drugs for different reasons. Think about the following:

• Do you need to use different types of substances to make it through the day (for example alcohol to calm you down and meth, cocaine or speed to hype you up)?
• Do you find yourself needing to combine substances because you don’t want to feel the pain or emotions you are experiencing?
• Do you find yourself at parties or events using more to create a “better high or better experience?” 
• Do you use different substances depending on the people you are around?

If you are self-medicating, It’s OK to ask for help. To address the underlying problem we normally have to start talking to professionals  like a doctor or mental health provider. Or you can talk to peer support specialists, go to a 12 step program, or find someone in your support system.

Have you tried harm reduction?

Harm reduction saves people’s lives. It meets people where they are in their addiction or recovery journey.

Harm reduction is designed because we know cutting off use completely and overnight is hard and sometimes unsafe. Harm reduction is designed to have you use another substance that is less dangerous than the one you’re using. For example, addiction treatment facilities provide medications like suboxone or methadone to treat opioid drug disorder.  Or harm reduction can mean cutting back from use in a way to reduce harm. This limits or tapering off the amount you use or drink over time instead of going cold turkey—stopping everything at once.

In some places there are syringe service programs that provide clean syringes for people who are using so they don’t end up with other physical illnesses like hepatitis or HIV/ AIDS. Other programs help you find substance abuse treatment programs.

For people who struggle to quit, harm reduction services can be a first step to recovery.

Detox one drug at a time or multiple at one time? [1][2][3][4]

Both approaches have pros and cons to them, but ultimately you have to figure out which approach is best for you. The end goal of either approach is the same—to detox from alcohol or substances and begin your recovery and healing journey.

Some people prefer to detox one drug at a time because this approach brings them closer to recovery faster. But, this approach could lead to more intense withdrawal symptoms. Sometimes people start with their drug of choice because they know it’s the harder substance to stop using, because they know they use other drugs when their drug of choice isn’t available, or because getting sober is dependent on giving up their drug of choice.

Many people find themselves equally addicted to multiple substances and behaviors and find that it’s important to go into an intensive program where they can start sobriety entirely. Someone who is trying to detox from multiple substances shouldn’t do it alone. Having the support of your doctor or medical providers at rehab or treatment facility is important when trying to detox from polydrug use—the use of more than one substance.

For others, it’s too difficult or dangerous to go cold turkey and they decide to detox by focusing on one drug at a time. With this approach, usually the substance with more severe withdrawal symptoms—like alcohol or benzodiazepines—is the substance they detox from first.

While detoxing from one substance, you may want to practice harm reduction by reducing or replacing your use of other substances. For example, you may try replacing one drug with something “less harmful” like using marijuana or tobacco instead of using meth or something else.  And then eventually stopping altogether. Sometimes in treatment facilities, they provide medications to help people taper off of substances. This approach takes longer than detoxing all at once, but the withdrawal symptoms are often less severe.

Finding help and support

Recovery is a life-long journey. You must maintain your sobriety daily and in order to do so you have to set standards and boundaries for yourself.  So many people battle with addiction, and if you want to heal, there are resources to help. Some of the following steps might be helpful for someone that is trying to get and stay clean:

• Find help and support. There is help, and there are treatment options. Continue educating yourself, listening, and getting support and access to resources. The SAMHSA national helpline 1-800-662-4357 and find treatment locator helps with treatment and mental health.
• Peer specialists or peers who do not use or drink are supportive. These life changing mentors help you see your self-worth and why you deserve recovery.
• Avoiding certain situations and people. Sometimes being around certain people or in certain environments may be a trigger for you to use. There are support groups like Narcotics Anonymous that have people on the same journey as you
• Talking about it is very helpful and important.  Talking about your journey can help you to see yourself and to want to change, just by hearing your own voice speak out loud about your experiences. Many people find therapy and support groups helpful to help them address past traumas that may have led to their polydrug use.
• Set boundaries for yourself. You deserve respect and your body does too. Be mindful of what you are putting into it. Remove yourself from situations that trigger you or people who do not respect your recovery.
• Give yourself time and compassion. Taking one minute at a time to figure out what is best for you, right now, is progress. Self love is a huge part of recovery.  Learning that self care and self compassion are priorities teaches you what healthy relationships look like and you want to emulate that.

In your fight to get better, it’s important to think about your strengths to help you with your recovery. Make sure you pat yourself on the back for small victories, even if it is turning someone down who offers you a high.  In order to succeed you have to acknowledge the small steps in getting back to sobriety.

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