Polysubstance Dependence

Atleast 3 of the following symptoms must be present during 12 months period for diagnosis of Polysubstance Dependence.

1. Tolerance as manifest by tendency to use higher amount than before and in more frequent intervals in order to achieve the desirable effects.

2. Withdrawal symptoms develop if the substance is not available for use, loss of control, unsuccesful attempts to cut down, giving up recreational, social and occupational responsibilities for spending a lot of time to obtain the substance. Use of substances, despite self damage in physical or psycho-social problems caused or getting worse by use of substance.

Causes: 1. Biological: Genetic predisposition and role modeling may cause a peron vulnerable to get addicted. Dopmine and Opioid receptors involvement can play role but not conclusive. Nicotinic and Acetylcholine receptors genes were found in these individuals.

             2. Psychological: Comorbid illness such as personality disorder, depression, bipolar disorder, anxiety disorder, eating disorder, self medication and negative reinforcement can play significant role for a person to become addicted.

Tretment: Consultation with addiction specialist, Inpatient rehab, outpatient rehab, twelve steps and self help groups, cognitive behavioral therapy and medication are helpful to achieve recovery and prevent relapse.



Latif Ziyar MD

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