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Polysubstance Abuse ICD 10

Polysubstance abuse occurs when someone consumes two or more drugs, including alcohol, over an extended period of time.

ICD 10 Codes

  ICD 10 codes are for billing drug and alcohol-related issues. Access complete information safely.

Drug abuse is a complex, biopsychosocial disease emerging from the interplay of genetics, history of childhood abuse/neglect, environmental factors, and personality traits. Polysubstance abuse disorder also emerges from these variables’ interaction but is reinforced by other drug addiction aspects as a disease.

For example, some people’s brain-body chemistry makes it more challenging to feel high. Consequently, they may find that drinking alcohol while smoking marijuana gives the sensations they crave. Once the brain becomes addicted to the combination of alcohol and pot, the person continues using these two drugs together.

Another scenario may involve an individual addicted to heroin who suffers a severe and painful injury. Far too often, the physician prescribing pain medication is unaware of the patient’s heroin addiction. As a result, the person mixes heroin with pain pills and the intense high of abusing both heroin and painkillers.

Use can be either simultaneously or separately. Previously, the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) included polysubstance abuse in its listings of mental health problems.

  • However, the DSM-5 has removed polysubstance dependence as a disorder. Also, the diagnostic terms “dependence” and “abuse” have been centralized and renamed “substance use disorder.”

According to the DSM-V, someone must present at least three of the following symptoms to meet professional criteria;

  • Tolerance for drugs where they need increasingly larger doses of drugs to feel high
  • Suffer withdrawal symptoms when they abstain
  • Repeated attempts to stop using drugs without succeeding
  • Spending most of their time searching for and using multiple drugs
  • Experiencing life issues due to using drugs, i.e., losing jobs, getting arrested, failing relationships with family and friends
  • Continuing to engage in polysubstance abuse when they know it is harming them physically and mentally.

Cross Addiction

Among opioid abusers, polysubstance abuse is “considered the norm instead of the exception.” These three drugs are often cross-addicted with alcohol and cocaine.

  • Heroin
  • morphine
  • pain pills

Alternately, amphetamine addicts abuse alcohol and opioids to help them “come down” off a speed high. However, it isn’t unusual for a polysubstance abuser to be addicted to various drugs, especially if they have a strong family history of drug and alcohol disorders and undiagnosed mental or physical illnesses.


Treatment for polysubstance abuse disorder involves psychotherapies, group counseling, experiential activities, and ongoing support to treat people addicted to just one drug. The primary difference in treating polysubstance abuse vs. a single drug abuser concerns supplemental anti-addiction medications that help reduce withdrawal symptoms and cravings. Depending on their addictions’ severity, patients in a recovery program may need to take several medications simultaneously, such as Naltrexone and Disulfiram used for alcohol and opioid abuse.

Since there are no standard medications to treat methamphetamine or cocaine addictions, polysubstance abusers in detox for meth and alcohol or cocaine and alcohol addiction may be given only Naltrexone, Disulfiram, or Acamprosate, in addition to medical and psychiatric supportive care.

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