Speedballing: The Deadly Combination of Heroin and Cocaine

People who use more than one drug (polydrug users) often do so to stack the effects of the drugs. One popular combination is called speedball, which is a combination of cocaine and heroin.

The two drugs have opposite effects: heroin depresses the central nervous system while cocaine speeds it up. A person may take cocaine to combat drowsiness caused by heroin. When the two drugs are combined to form a new substance – known as speedball – the new drug can be dramatically more potent and dangerous.

What Is a Speedball?

Speedball is a liquid mixture of cocaine and heroin that is drawn up and injected into a vein. Both substances are extremely potent and addictive on their own. Unfortunately, these dangerous drugs are even more lethal when taken together as speedball was responsible for a marked increase in cocaine-related deaths in the United States.

Side Effects of Speedball

When someone takes heroin and cocaine together, the overall potency is much higher and there is an increased risk of overdose. Some people might think that because cocaine is a stimulant and heroin is a depressant, they might counterbalance each other’s effects. However, that is just not the case. Consuming speedball carries a higher risk of overdose than using heroin or cocaine on their own.

There are three main reasons that speedball has a higher overdose rate:

• The body has to deal with more drugs
• The stimulant (cocaine) increases the body’s oxygen use, while the depressant (heroin) slows breathing
• People who speedball usually inject more frequently than those who use either drug alone

When consuming speedball, users feel that their tolerance to the drugs is higher than it is because the two drugs mask each other’s overdose symptoms. The heroin lasts longer than the cocaine does, so when the cocaine wears off, the respiratory suppression of the heroin can quickly set in, causing coma and death. The combination can cause death by heart attack or stroke.

Speedball increases the adverse consequences of drug abuse, such as increased severity of mental health disorders, higher incidence of failure in drug abuse treatment and increased risk of contracting HIV or Hepatitis infection.

Using speedball lowers the individual’s chances of recovery because withdrawal and cravings will be based on two different drugs. The medical detox process for speedball users is also difficult, because medications for heroin abuse, such as methadone, are not at all effective for cocaine withdrawal.

Someone high on speedball may show certain physical and psychological side effects, such as:

• Severe anxiety or paranoia
• Confusion, incoherence, stupor or drowsiness
• High blood pressure
• Strong, rapid or irregular heartbeat
• Loss of motor skills

How is Speedball Taken?

Cocaine and heroin are used together by either injecting the two drugs separately or combining them in a solution that is injected all at once (i.e., speedball). The experience can be intense, and the side effects can be frightening, which is worsed by the paranoia effect of speedball. Many users are so frightened by the side effects that they do other drugs while they are high to try to counter the effects.

Speedball Statistics

Data from the U.S. Centers for Disease Control and Prevention (CDC) shows that between 2005 and 2009 there was a marked decrease in cocaine-related overdoses. However, starting in 2012 there was a sharp increase in cocaine-related deaths, a trend that is still rising. Further investigation shows that this increase in cocaine deaths is due to people mixing opioids with cocaine.

In 2015, according to the same CDC report, there were 6,784 cocaine-related deaths in the United States, and 2,565 of them were from mixing cocaine and heroin. A further 2,619 of the deaths were from mixing cocaine with other opioids, which means that 63% of cocaine-related deaths were from mixing cocaine and opioids.

Celebrity Speedball Overdose Deaths

Speedball became popular in the middle of the 20th century, originally as a combination of cocaine and morphine. Since then, most people have replaced morphine with heroin. The drug became popular among celebrities and speedball has been blamed for the deaths of numerous beloved actors and musicians.

In 1982, comedian John Belushi was found dead in his Los Angeles hotel room after overdosing on speedball. Another well-known comedian, Chris Farley, overdosed in 1997. In 2013, musician Chris Kelly died from a speedball overdose. Philip Seymour Hoffman overdosed a year later on a speedball combination that also included benzodiazepines and amphetamines.

Many other actors and musicians have survived life-threatening experiences caused by the drug combination. Guns N’ Roses guitarist Slash went into cardiac arrest for eight minutes after taking the drug. Slash’s band-mate, drummer Steven Adler, suffered a stroke due to taking a speedball and now has a permanent speech impediment. David Gahan, the singer of electronic rock band Depeche Mode, survived a heart attack that was caused by a speedball overdose.

Differences in Heroin and Cocaine

Heroin slows down body functions, including breathing. People who use heroin often lose consciousness. Cocaine has the opposite effect: cocaine users become charged up and can stay awake for long periods. When people die from heroin, it’s usually the result of respiratory depression, while with cocaine it’s because of overloading the heart or brain.

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 nerve transmissions through the body. Cocaine’s common effects include euphoria, energy, and alertness. For some people, cocaine use can cause intense paranoia and hostility. Cocaine can be injected, consumed orally, smoked or snorted. The use of cocaine can lead to serious side effects or death from stroke or heart attack. Despite the known dangers of cocaine, the drug remains widely used.

Heroin is an opioid that’s in the national spotlight because of its high lethality (there were more than 15,000 heroin deaths in the United States in 2017). Heroin currently has no medical uses and is available only as a street drug. When someone uses heroin, which is derived from poppy plant resin, the drug creates a euphoric high and a sense of deep relaxation. People become dependent on heroin quickly.

Stimulants such as cocaine activate the body’s fight-or-flight (parasympathetic) system, while the depressant heroin activates the rest-and-digest (parasympathetic) system. This difference causes some of the side effects associated with each drug to overlap.

Key Points: Heroin, Cocaine and Speedball

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

• Heroin is a depressant of the central nervous system while cocaine is a stimulant
• Speedball is a deadly combination of the two substances
• Combining cocaine and heroin does not negate their side effects — the result can be deadlier than many people believe
• A resurgence of speedball-related deaths occurred due to the Opioid Epidemic

If you or a loved one live with a cocaine or heroin addiction, contact The Recovery Village to speak with a representative about how addiction treatment can help. It’s time to address risky behavior, like combining drugs and move on toward a healthier future. One telephone call can save your life, make it today.