Polysubstance Abuse, Pharming, and Comorbid Psychiatric Disorder

Polysubstance abuse is the use of multiple substances with no single predominant substance of abuse. There is an increasing trend of polysubstance abuse with prescription medications and over-the-counter (OTC) products known as pharming. The medications which are not known to have dependency potential are being abused in super high doses to attain euphoria. Some of the medications/substances that are abused have a higher risk of lethal consequences. Psychiatric comorbidity is frequently found accompanying polysubstance abuse in the patients. Comorbidity complicates the presentation and management. Personality disorder, also commonly found with polysubstance use, worsens the chance of recovery and achieving remission even further. We present three cases of polysubstance abuse, binge use of OTC medications with concurrent psychiatric illness, and a personality disorder. The awareness regarding the medications/substances with unknown addiction potential but are being abused is the need of the hour. The complexity of diagnosing and treating such patients is also worth pondering over.