TITLE:
The Challenge of Polysubstance Use Overdose
AUTHORS:
Joseph V. Pergolizzi Jr., Giustino Varrassi, Jo Ann LeQuang, Robert B. Raffa
KEYWORDS:
Opioid Crisis, Overdose, Drug Abuse, Polysubstance Use, Naloxone
JOURNAL NAME:
Open Journal of Social Sciences,
Vol.9 No.7,
July
30,
2021
ABSTRACT: Despite the urgency of the public health crisis of opioid overdose
morbidity and mortality, and the widespread intense attention and effort
directed toward its elimination, or at
least its mitigation, deaths due to drug overdose are on the rise, and in fact are reaching all-time record highs. Fentanyl (real or counterfeit) and its legal and illicit analogs
are certainly a major contributor to the problem, but another important driver
is the significant increase in polysubstance abuse, which now occurs in the
majority of overdose deaths. Polysubstance overdose presents a particular
treatment challenge. Overdose victims might not be able to state what drugs
they have taken, and if the products were adulterated, they themselves might not even know.
Mechanistically, the resultant additive, or even synergistic, interaction between drugs adds a level of
complexity above the standard treatment of using a mono-mechanistic receptor
antagonist. We review these challenges.