Epidemiology

Readers of the research and clinical addiction literature face a problem in understanding what is meant by terms used to describe multiple SUDs in a specific sample population. These terms are variously given as "polysubstance abuse," "polydrug abuse," "polyaddiction," and "multiple-drug dependence." As stated earlier, "polysubstance abuse" in a narrow DSMs-IV sense, is relatively unlikely to occur, especially in clinical settings, where patients are likely to meet criteria for several SUD diagnoses. On the other hand, the terms "polysubstance abuse" and "polydrug abuse" are frequently used by clinicians and researchers as descriptors of multiple drug use in populations of patients who have an index diagnosis of substance dependence, such as opioid dependence, and who meet at least DSM substance abuse criteria for the other substances.

The use of differing phraseology to describe use of multiple drugs is not limited to the domain of mental health, and addiction clinicians and researchers. Cause of death statements from medical examiners and coroners often use terms such as "polydrug toxicity," "polypharmacy," "multiple drug poisoning," and "polypharmaceutical overdose" to describe multiple-drug-induced deaths (Cone et al., 2003).

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