A speedball is a dangerous combination of heroin and cocaine, which are potent and highly-addictive drugs with opposing effects on the body. Unfortunately, using a speedball is highly dangerous and can result in severe health complications, including dependence, overdose, permanent health issues, and death. In addition, combining these two drugs can cause conflicting effects that lead to unpredictable and adverse reactions.
If you or someone you know is struggling with the use of cocaine, heroin, or both, seeking professional help from an addiction treatment center is recommended to reduce the many risks of using multiple substances or polysubstance misuse.
Guardian Recovery specializes in treating substance use disorders and co-occurring diagnoses, such as addiction combined with mental health conditions like anxiety or depression. Contact us to learn more about our effective programs and multiple levels of care, including medical detox, inpatient and outpatient programs, medication-assisted therapy, aftercare planning, and more.
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Why Do Substance Users Combine Heroin & Cocaine
Because heroin is a depressant and cocaine is a stimulant, many are under the impression that cocaine’s stimulating effects will offset the sedative effects of heroin. Moreover, they anticipate the experience will be euphoric with minimal adverse effects. However, some users also begin experimenting with multiple substances attempting to achieve more intense highs when their current level of drug use becomes mundane, often due to tolerance development. (1)
The Dangerous Effects of Mixing Opioids & Stimulants
Combining opioids (e.g., heroin) and stimulants (e.g., cocaine) can have detrimental effects on the body and increase the risk of severe health consequences such as overdose and death.
Dangerous Effects of Combining Opioids & Stimulants Include:
- Adverse Interactions—Opioids and stimulants have opposite effects on the central nervous system (CNS). Combined use can result in unpredictable interactions, such as heart rate and blood pressure changes, cardiovascular issues, seizures, or stroke.
- Increased Overdose Risk—Stimulants can dampen the sedative effects of opioids to some extent. When this occurs, users may not be aware they’ve taken enough opioids to cause life-threatening CNS depression as the effects of cocaine subside.
- Increased Risk of Addiction—Combining opioids and stimulants can increase a person’s risk of developing tolerance, dependence, and addiction to one or both drugs.
Increased Psychiatric Issues—Using opioids and stimulants can cause or exacerbate symptoms such as anxiety, depression, and more severe mental health disorders such as psychosis.
Risks & Dangers of Polysubstance Use
Polysubstance use, defined as the use of more than one substance, is dangerous unless approved by a licensed health provider. (2) Using two substances simultaneously increases the likelihood of adverse health consequences. Like combining heroin and cocaine, the general risks of polysubstance use include adverse health effects, dependence, addiction, overdose, and death.
Risks of Polysubstance Use Include:
- Overdose and death.
- Adverse health effects.
- Dependence and addiction.
- Mental health issues.
- Social and financial issues.
Symptoms & Side Effects of Using a Speedball
Using a speedball can result in many physical and psychological symptoms and side effects.
Side Effects of Using a Speedball Include:
- Confusion.
- Agitation.
- Anxiety.
- Hallucinations.
- Paranoia.
- Blurred vision.
- Drowsiness.
- Chest pain.
- Rapid or irregular heart rate.
- Increased blood pressure.
- Elevated body temperature.
- Nausea and vomiting.
- Uncontrollable movements.
- Stupor.
As noted, using a speedball can lead to unexpected detrimental effects that can be life-threatening. Using cocaine or heroin independently or in conjunction increases the risk of dependence and addiction to either substance.
Speedball Overdose Symptoms Also Include:
- Cyanosis, or bluish lips and nails.
- Shallow, labored, or stopped breathing.
- Unconsciousness/coma.
- Seizures.
- Stroke.
- Respiratory failure.
- Death.
If you suspect you or another person are overdosing or in danger of overdosing on a speedball, it is crucial to seek immediate medical attention. Call 911 or your local emergency services and wait for first responders to arrive.
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Speedball With Other Depressant/Stimulant Combinations
Although the term speedball has traditionally been associated with combining heroin and cocaine, it can also refer to any combination of depressant and stimulant substances. All of the stimulant/depressant combinations noted below come with the same risks and side effects as cocaine and heroin. (3)
Other Possible Speedball Combinations Include:
- Cocaine and prescription opioids, such as oxycodone.
- Cocaine and opiates, such as codeine and morphine.
- Cocaine and benzodiazepines, such as Xanax.
- Methamphetamine and any of the above depressants.
- Amphetamine, such as Adderall, with any of the above depressants.
- Methylphenidate, such as Concerta, with any of the above depressants.
Cocaine & Fentanyl
Fentanyl is an opioid that deserves special mention because it is much more potent than most other opioids found illicitly. Fentanyl is up to 100 times stronger than morphine, and even a tiny amount can rapidly cause death. (4) Misusing fentanyl in any way can easily lead to tragic consequences, and combining it with cocaine or another substance makes the odds of avoiding an overdose even smaller.
Is Cocaine More Addictive When Used With Other Substances?
Using cocaine with other substances does increase the risk of addiction, and there are a few reasons for this. One, most recreational drugs promote dopamine release, a neurochemical that plays a vital role in the brain’s reward system. When two or more drugs are used together, their effects will compound and increase dopamine release beyond what one drug alone would do, thereby intensifying the pleasurable effects of drug use and increasing the likelihood of addiction. (5)
Secondly, polysubstance use can increase tolerance, a mechanism the body uses to defend itself from the repeated use of a foreign substance. Tolerance occurs when repeated exposure to a drug leads to changes in the brain’s chemistry and physiology, resulting in a decreased sensitivity to the drug’s effects.
As tolerance develops, larger and larger doses of a drug are needed to achieve the effects the user is accustomed to experiencing. When two substances are used, tolerance can occur in tandem, increasing the risk of addiction to both.
Cocaine Speedball Overdose Statistics
The statistics on speedball overdose are not always reported separately from those on heroin and cocaine overdoses, as many overdoses involve the simultaneous use of multiple drugs. However, according to the National Institutes on Drug Abuse, opioid-involved overdose fatalities increased from 2010-2017 from 21,089 to 47,600. (6) This remained constant through 2019, but another significant increase in deaths occurred in 2020 68,630) and again in 2021 (68,630).
Furthermore, according to the Centers for Disease Control and Prevention (CDC), in 2017, nearly three-quarters (72.7%) of cocaine-involved overdose fatalities also involved an opioid. (7) Previous research has shown that synthetic opioids appear to be contributing to increases in cocaine-involved overdose deaths.
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While using cocaine and heroin together is extremely dangerous, misusing either drug alone can still lead to tolerance, dependence, addiction, and overdose. Stopping drug use now, however, can reduce the number and intensity of complications later on and possibly save your life.
If you are struggling with a substance use disorder, we encourage you to reach out to Guardian Recovery for a free, no-obligation assessment and health insurance benefits check. Contact us today to discover more about our individualized programs, full continuum of care, and evidence-based therapies and services.
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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.
