Using more than one substance, including mixing alcohol with other drugs, is sometimes called polydrug use, and it is common. Therapy can help whether your goal is to cut down, to stop, or to make sense of why you use.
What this covers
Some people use alcohol with cocaine at the weekend. Some use one drug to keep going and another to come down. Some take prescribed medication alongside other drugs or alcohol. If your use does not fit neatly into one box, or you are not sure which substance is the problem, you are still welcome here.
Signs use may be becoming a problem
- Using more than one thing in the same session, or to manage the effects of the last one
- Not being sure which substance is causing the most harm
- Using one drug to cope with the comedown from another
- Losing track of how much you have taken in total
Risks and safety: read this
- Mixing drugs is always risky, and some mixtures are more dangerous than others.
- Alcohol, benzodiazepines, opioids, and pregabalin and gabapentin all affect the central nervous system and can slow your breathing. Taking any of them together, with or without alcohol, raises the risk of overdose and death.
- Heroin mixed with other downers, including methadone, alcohol and benzodiazepines, is extremely dangerous.
- Pregabalin or gabapentin with opioids can stop people breathing. The MHRA, which regulates medicines in the UK, has warned about this.
- Ketamine mixed with alcohol, benzodiazepines or opiates is dangerous, and ketamine can be fatal when mixed with other drugs.
- Using several stimulants at once can put your heart under a lot of stress. Mixing cocaine with other drugs or alcohol raises the risk of overdose.
- If someone cannot be woken, or is struggling to breathe, call 999. Naloxone can reverse an opioid overdose, but it does not replace calling 999.
- Stopping several substances at once can be dangerous, particularly alcohol and benzodiazepines. Please get medical advice before you stop.
Support you can get alongside therapy
Therapy sits alongside medical care, not instead of it. How to get treatment without going through your GP, and where to find helplines.
What therapy can offer
- Working out which substances do which job for you (energy, calm, sleep, switching off)
- Practical strategies for cravings and for the comedown
- Support to decide where to start, and to change your mind
- Harm reduction while you decide what you want
Confidentiality
Worried about your job or your driving licence? What I report, and what stays between us.
If it is someone you love
It can be hard to know what you are dealing with when someone uses more than one thing. Support for families and loved ones.
Short answers to common questions
What if I do not know which substance is the problem?
You do not need to know. Working that out is part of what we do together.
Should I stop everything at once?
Not suddenly, if alcohol or benzodiazepines are involved. Stopping those suddenly can be dangerous. Talk to your GP or a drug treatment service first, and we can talk through the safest way to approach it in our sessions.
Is it safe to mix two particular drugs?
I cannot tell you that any combination is safe. Mixing drugs is always risky. FRANK’s pages on each drug explain what is known about mixing.
Can I come if one of them is prescribed?
Yes. I am not a medical service and cannot prescribe or change your medication, so please keep your prescriber involved.
Do pregabalin and gabapentin make opioids stronger?
FRANK says both can intensify the euphoric effects of heroin and other opioids. It says gabapentin lowers opioid tolerance, which raises the risk of overdose when it is combined with opioids, and describes pregabalin as also lowering opioid tolerance. So the usual amount of an opioid may affect you differently if either is in your system. If you take both, tell your prescriber or a drug service.
Can I drive if I have taken more than one drug?
GOV.UK says it is illegal to drive if you are impaired by legal or illegal drugs, and also to drive with certain drugs in your blood above specified limits. The defence applies only to medicines prescribed to you, taken as advised, that are not making you unfit to drive. A conviction carries a minimum 1-year driving ban, an unlimited fine and up to 6 months in prison.
Can a drug service help if I use several substances?
The NHS says staff at a first appointment ask about your drug use, work, family and housing, then agree a treatment plan with you that may combine several approaches. You are given a keyworker. You can approach your local drug treatment service yourself, and FRANK on 0300 123 6600 can help you find one. I can help you decide what to say, and what you want from it.
What should I tell the ambulance crew if someone has taken a mix?
FRANK says to call 999 for an ambulance and tell the crew everything you know about what has been taken. With a mix, that means every substance you can think of, including alcohol and prescribed medicines. If you have naloxone, GOV.UK’s training guidance says to tell the call handler, follow their instructions and stay with the person until help arrives.