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The Recovery Village
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Andrew Proulx, MD

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Updated on 12/20/19

Heroin and cocaine have some commonalities. The two drugs are widely abused, incredibly addictive, illegal and can destroy. However, they have many differences.

Heroin and Coke | The Difference Between Heroin and Coke

What is Heroin?

Heroin is an opioid that’s in the national spotlight unlike ever before. Heroin is front and center in the United States opioid epidemic that’s damaging communities and families. Heroin is similar to prescription opioids in many ways, including how the drug interacts with the brain and develops a dependence.

When someone uses heroin, which is derived from poppy plant resin, the drug binds to the person’s opioid receptors, which creates a euphoric high and also a sense of deep relaxation. People become physically and psychologically dependent on heroin quickly as it causes increased production of the feel-good chemical dopamine and alters the brain’s reward pathways.

Heroin is dangerous not only because of its effects on the brain and body. However, it’s also usually injected via needle, which leaves people vulnerable to infections and blood-borne diseases.

When people become physically dependent on heroin and attempt to stop use, they tend to go through withdrawal and feel ill.

So what is the best way to describe cocaine?

What is Coke?

Cocaine, often just referred to as coke, is a powerful stimulant derived from the coca plant. Cocaine interacts with a person’s central nervous system and speeds up transmissions through the body. Cocaine’s common effects include euphoria, energy and alertness. For some people, cocaine use can cause increased paranoia and hostility.

Cocaine can be injected, consumed orally or snorted. The use of cocaine can lead to serious side effects or death from respiratory failure, stroke or heart attack. Despite the dangers of cocaine, it remains widely used.

Mixing Heroin and Coke

Before describing the difference between heroin and coke, it’s important to talk about what happens when heroin and coke are mixed. The combination of the two drugs is called a speedball.

The two drugs have opposite effects — heroin depresses the central nervous system while cocaine speeds up internal transmissions and other functions. A person may take cocaine to combat drowsiness caused by heroin.

When someone takes heroin and cocaine together, the potency is much higher and there is an increased risk of overdose.

The Difference Between Heroin and Coke

What are some differences between heroin and cocaine? For starters, heroin is a depressant of the central nervous system while coke is a stimulant. Heroin slows down body functions, including breathing. People who use heroin often lose consciousness. Coke has the opposite effect. People on coke can stay awake for long periods of time.

When people die from heroin, it’s usually the result of respiratory depression, while with cocaine it’s because of cardiotoxicity, also called damage to the heart. While it is possible to inject cocaine, most people snort it, while heroin is primarily injected.

Key Points to Remember

There are a few factors to remember when comparing cocaine and heroin:

  • Heroin is a depressant of the central nervous system while coke is a stimulant
  • Both can be extremely addictive but have different effects
  • Each can result in severe injury or death

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