The Hidden Dangers of Polydrug Use: When Adulteration Turns Risk into Crisis (2025)
One of the more troubling trends we’re seeing is the rise in polydrug use and the mixing of drugs with unknown additives.
What Is Polydrug Use?
Polydrug use involves consuming two or more substances either simultaneously or within a short timeframe. In some instances this can be intentional — such as mixing drugs to enhance or counteract effects. It may also be unintentional — especially when drugs are adulterated or contaminated without the user’s knowledge.
Adulteration: The Invisible Threat
There are many hidden dangers of polydrug use. People may be using hazardous drug combinations—such as fentanyl mixed with xylazine, nitazenes, medetomidine, or synthetic cannabinoids—which significantly increase the risk of overdose and make treatment more challenging.
Drugs are often cut—or adulterated—with other substances to increase profits, enhance or alter effects, or stretch supply. This practice is especially dangerous when the added substances are potent, toxic, or unknown to the user.
Why Polydrug Use Is So Dangerous
- There are many hidden dangers of polydrug use. Many individuals have no idea what’s actually in the drugs they’re using—until it’s too late and potentially fatal.
- These unknown drug and substance combinations dramatically increase the risk of overdose.
- Naloxone may not work on non-opioid adulterants.
- There are diagnostic and treatment challenges in emergency settings.
Some Troubling Facts
According to a Psychology Today article published in December 2024:
- From 2010-2022 unintentional overdoses more than quadrupled and most were as a result of polydrug abuse.
- A study involving over 4 million fentanyl-positive patients revealed that 93% had also consumed at least one other drug.
- It’s a common misconception that people with a substance use disorder (SUD) are struggling with just one drug, like alcohol or opioids. In reality, most individuals with an SUD are using multiple substances—a pattern known as polysubstance use—which makes treatment and recovery even more complex.
What Are Key Signs to Look For?
While the specific symptoms can vary depending on the substances involved and whether the use is intentional or due to adulteration, according to Scottsdale Recovery the following are some signs to be on the lookout for:
- Respiratory Distress: Difficulty breathing, shallow or slowed respiration, or complete respiratory failure—especially dangerous when opioids or sedatives are involved.
- Severe or Prolonged Sedation: Extreme drowsiness or unconsciousness that lasts longer than expected, potentially leading to a coma or inability to respond to stimuli.
- Unexpected Reactions to Drug Use: Sudden mood swings, erratic behavior, or unexpected physical symptoms due to unknown drug combinations or adulterants.
- Severe or Unusual Side Effects: Intense nausea, hallucinations, muscle rigidity, or other reactions that are not typical for the drug being used—often a sign of contamination or polydrug interaction.
Emerging Trends in 2025
In 2025, the landscape of drug abuse is evolving rapidly, with several alarming trends gaining traction.
Veterinary Sedatives: One major concern is the rise of veterinary sedatives like medetomidine, which are being used to cut opioids and other street drugs. These powerful tranquilizers, originally intended for animals, can cause severe sedation and respiratory depression in humans—and they don’t respond to standard overdose treatments like naloxone.
Synthetic Drugs: At the same time, synthetic cannabinoids and opioids are flooding global markets, often sold under misleading names or disguised as legitimate medications. These lab-made substances can be far more potent and unpredictable than their natural counterparts, leading to a surge in overdoses and toxic reactions.
NPS: Adding to the complexity is the emergence of AI-designed novel psychoactive substances (NPS)—new, unregulated compounds engineered using artificial intelligence to mimic or enhance the effects of known drugs. These designer drugs often evade detection and regulation, making them especially dangerous and difficult to track. Together, these trends are reshaping the risks of substance use and challenging public health systems worldwide.
Public Health Response
In response to the growing dangers of polydrug use and drug adulteration, public health systems are shifting toward more proactive and harm-reduction-focused strategies. Expanding access to drug checking services, which allow users to test substances for dangerous additives like fentanyl, xylazine, or synthetic opioids before use is key as they help empower individuals with life-saving information and help reduce accidental overdoses.
At the same time, education campaigns are being ramped up—especially those targeting youth and vulnerable populations—to raise awareness about the risks of contaminated drugs and the importance of seeking help.
On a bigger scale, there’s a shift happening — policies are starting to focus more on helping people than punishing them. That means more support for harm reduction strategies and investing in real-time tools that track new drugs and overdose trends. It’s all about staying ahead of the curve, keeping communities informed, and ultimately saving lives.
