“Speed-balling”: The Dangers of Mixing Cocaine and Heroin

Mixing dangerous substances like cocaine and heroin significantly heightens the chances of overdose, coma, and even death. The practice known as speedballing involves using both substances simultaneously, but it can also include other drugs like methamphetamines, prescription opioids, and synthetic stimulants. This dangerous mix has been associated with numerous overdose fatalities, with high-profile cases including River Phoenix, John Belushi, and Chris Farley. The trend of mixing drugs, often referred to as cross-fading, is becoming more common as people seek new highs or try to mitigate the adverse effects of either substance.  

Healthline reports that those who engage in speedballing often describe an intense high while feeling less of the negative impacts typically associated with heroin and cocaine. Users believe that heroin can alleviate the agitation and jitters caused by cocaine, while cocaine can counteract the sedative effects of heroin, preventing users from nodding off. However, while many users claim to experience a significant rush from speedballs, this does not mean the negative effects are entirely negated. Moreover, this practice is extremely hazardous, increasing the likelihood of overdose and addiction.

In recent years, the rise of illicit fentanyl has led many drug dealers to mix cocaine with this potent synthetic opioid, causing users to inadvertently engage in speedballing. Fentanyl is a powerful synthetic opioid, estimated to be 100 times stronger than morphine. It takes only a small amount to achieve a high, so it is often added to various substances to cut costs and enhance customer potency. However, this combination poses severe risks, not only due to the dangers of mixing stimulants and depressants but also because even a tiny dose of fentanyl can result in an overdose.

What Is Speed Balling?

Speedballing refers to the simultaneous use of a stimulant and a depressant. Most commonly, this involves the combination of heroin and cocaine. Users often inject both drugs directly into their bloodstream with needles, although snorting them nasally is also an option. Many who engage in speedballing report a heightened and prolonged high compared to using either substance on its own. Some individuals mix these drugs in hopes of counteracting the adverse effects of one with the other. Those battling addiction frequently seek new highs, particularly if they have built up a tolerance to a specific drug and no longer feel its effects. In an attempt to find new experiences, they may combine different drugs, known as a speedball, increasing the risk for adverse side effects.

Heroin, an opioid, acts as a central nervous system (CNS) depressant, slowing down breathing and heart rate, while cocaine serves as a stimulant, accelerating the CNS and increasing heart rate, energy, and breathing rate. The belief that mixing heroin and cocaine can balance out their negative effects is a widespread but dangerous myth. In truth, combining these substances poses greater risks than using either alone, as they can intensify each other’s effects or lead to unpredictable reactions. Additionally, users who engage in speedballing are at higher risk for developing addiction.

What Are the Side Effects of Speedballing?

Mixing heroin and cocaine poses significant dangers, particularly the heightened risk of overdose, coma, and even death. Cocaine alone can lead to a range of side effects, such as anxiety, elevated blood pressure, hypersensitivity, paranoia, and an irregular or rapid heartbeat. On the other hand, depressants like opioids and heroin are associated with drowsiness, slowed breathing, and a reduced heart rate. The practice of speedballing, which combines a stimulant with a depressant, sends mixed signals to the brain and body, resulting in unpredictable and potentially harmful effects. Some common side effects of speedballing include:

• Drowsiness
• Paranoia
• Blurred vision
• Confusion
• Incoherence and stupor
• Uncontrollable muscle movements
• Manic episodes
• Extreme depression
• Respiratory failure
• Heart attack
• Stroke
• Aneurysm

The long-term consequences of speedballing mirror those of using heroin and cocaine separately. Individuals who inject speedballs directly into their bloodstream may face complications such as abscesses, tissue necrosis, vascular inflammation, and an increased risk of contracting HIV or other bloodborne infections. Other potential long-term effects encompass cardiovascular problems, malnutrition, liver disease, seizures, and heart attacks. Furthermore, speedballing significantly raises the likelihood of developing an addiction, a chronic condition that is challenging to overcome without professional help.

What Are Some Statistics on Speedball-Related Deaths?

Since 2016, the prevalence of cocaine being mixed with fentanyl and related substances has surged. According to the National Institute on Drug Abuse, the number of overdose deaths linked to stimulants skyrocketed from 12,122 in 2015 to 57,497 in 2022, with nearly 70% of those stimulant-related fatalities in 2022 also involving fentanyl. Additionally, cocaine overdose deaths rose from 6,784 in 2015 to 15,833 in 2019 and continued to climb from 2019 to 2022, culminating in a staggering 73.5% increase to 27,569 deaths. These findings indicate that the rise in cocaine-related fatalities involving fentanyl has been significant since 2015, playing a crucial role in the overall increase in cocaine overdoses.

How Often Do People Overdose While Speedballing?

Speedballing poses a heightened risk of overdose compared to using cocaine or heroin separately. An article from the National Library of Medicine highlights that the combination of opioids and cocaine has increasingly contributed to overdose deaths. However, it remains unclear how much of this is due to intentional use versus the presence of fentanyl in the drug supply, which is becoming more prevalent. When speedballing with fentanyl, the danger escalates significantly, as even a tiny amount can trigger an overdose. Illicit fentanyl is often produced in unregulated labs, leading to inconsistencies in potency. This means that drug dealers who mix cocaine with fentanyl may inadvertently introduce a lethal dose.

People who engage in speedballing typically do so to balance the effects of both substances for a more controlled high. However, cocaine’s effects can diminish more quickly than those of heroin. If someone has consumed a large amount of heroin, the slowing effects of cocaine can lead to dangerously reduced breathing and heart rate. This can result in a critical lack of oxygen to the body and brain, potentially causing loss of consciousness, coma, or even death. Additionally, speedballing can send mixed signals to the central nervous system, as the opposing stimulant and depressant effects of cocaine and heroin can increase the risk of cardiac arrest. The risk of overdose is also higher in those with pre-existing heart conditions.

Access Cocaine and Heroin Addiction Treatment at Resurgence Behavioral Health

Speedballing can lead to fatal outcomes, and the only way to prevent an overdose is to stop engaging in substance abuse. Overcoming addiction is not simply about having willpower; the hold that substances can have on individuals often drives them to continue using drugs or alcohol, even when faced with severe consequences. For many, even experiencing a near-fatal overdose is not enough to get them to quit using. Fortunately, facilities like Resurgence Behavioral Health offer comprehensive treatment programs, along with the guidance and support needed to successfully overcome substance use disorders. At Resurgence, we focus on providing cocaine and heroin addiction treatment through tailored recovery plans that address the underlying issues of substance abuse. Our medical detox program ensures you receive 24/7 care and medication to navigate withdrawals safely and comfortably, preparing you to enter one of our inpatient or outpatient programs with a clear mind and body.

If you are ready to recover from cocaine and heroin addiction, contact Resurgence Behavioral Health today at 855-458-0050 to schedule your initial intake.

External Sources

• Healthline – Everything You Need to Know About Speedballs 
• National Library of Medicine – Intentional Use of Both Opioids and Cocaine in the United States 
• National Institute on Drug Abuse – Drug Overdose Deaths: Facts and Figures

David Rofofsky
After growing up in New York, David chose to get help with substance abuse in California because of the state's reputation for top-tier treatment. There, he found the treatment he needed to achieve more than nine years of recovery. He's been in the drug and alcohol addiction rehab industry for eight years and now serves as the Director of Admissions for Resurgence Behavioral Health. David remains passionate about the field because he understands how hard it is to pick up the phone and ask for help. However, once the call is made, someone's life can be saved.

Research | Editorial