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Mixing Cocaine and Heroin

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Polydrug use is a dangerous practice that is all too common in the recreational drug culture. When users grow accustomed to a substance, they may try to mix it with something else to create a new novel sensation. In some cases, peers may introduce would-be drug users to new combinations. Because recreational drug use is often associated with parties and social atmospheres, some users may mix drugs with alcohol without thinking about how the substances might affect one another. 

There are various dangerous drug combinations, but one stands out as being as deadly as it is popular. Cocaine and heroin are popular recreational drugs. Heroin is cheap and easy to get. In terms of availability, marijuana is the only illicit drug that is easier to get your hands on in the United States. Cocaine is more expensive, but it’s also a popular choice for hard drug users. Together, they can create a dangerous combination that can lead to a deadly overdose. 

Mixing heroin and cocaine was a popular practice in the 1980s and 1990s that lead to the deaths of many notable figures including John Belushi, Chris Farley, and Philip Seymour Hoffman. Learn more about mixing these two potent drugs and how polydrug use can be treated.

The Effects of Speedballing

A speedball is a form of polydrug use in which cocaine and heroin are mixed into one injection, or taken at the same time. In some cases, morphine or other opioids are used instead of heroin. It’s taken recreationally to achieve a rush of euphoria and a high that produces the effects of both substances. Users may also hope to reduce some of the adverse side effects of each drug such as anxiety, hypertension, drowsiness, and heart palpitations. 

In terms of drug categories, heroin and cocaine are opposites. Cocaine is a stimulant that, which means that it works to excite the nervous system. Cocaine blocks a process called reuptake, which is when the brain removes and recycles a chemical that is released into the nervous system. 

Cocaine specifically blocks dopamine (and serotonin to a lesser extent) reuptake, allowing the chemicals to build up, causing an intense rush of excitement, a feeling of being empowered, and alertness. Dopamine and serotonin are two chief feel-good chemicals that occur naturally in the brain and body. They are responsible for creating a sense of excitement, reward, and motivation, which is also why cocaine can be extremely addictive, encouraging binge use. Coming down from a cocaine high can cause unpleasant fatigue, depression, and general feelings of discomfort. 

On the other hand, heroin is an opioid that acts as a depressant in the central nervous system. Heroin can suppress excitability in the nervous system causing drowsiness, fatigue, and sedation. Heroin attaches to opioid receptors in the brain that are responsible for regulating pain throughout the body. It can also cause a feeling of deep relaxation, allowing you to rest and recuperate from an injury or other damage. 

Heroin causes these effects in a way that is more intense than the body’s natural opioids (endorphins), which can also lead to addiction and dependence. Coming off an opioid can cause flu-like symptoms.

Together, the two drugs activate both your fight-or-flight and rest-and-digest responses, which work to regulate each other. However, the two drugs aren’t perfectly balanced chemicals. One will usually overpower the other. In many cases, the drugs counteract each other enough to give users a false tolerance, or the feeling that they are less affected by the drug than they actually are.

Why Is Mixing These Drugs Dangerous?

Mixing two drugs that have similar effects, such as alcohol and benzodiazepines, can cause the drugs to potentiate each other, which means their effects are boosted. This can lead to a dangerous overdose with smaller amounts of either of the individual substances. 

Mixing two opposing substances like depressants and stimulants can have the opposite effect, causing you to feel milder effects with more of one or more drugs. While taking the drug, users may take more than normal or even other substances like alcohol, thinking they are only slightly affected. 

This can lead to a fatal overdose on one or both of the drugs. A cocaine high will wear off more quickly than heroin, essentially opening the floodgates to severe central nervous system depression. As excessive opioids are left in your system, the cocaine that was counteracting it wears off and leaves the opioid to its effects. An opioid overdose depresses your nervous system to a dangerous degree. The specific chemical mechanisms in your body that lead to a dangerous opioid overdose are poorly understood, but scientists believe it has to do with the body’s ability to detect a build of carbon dioxide. 

In simple terms, a breath is triggered by your nervous system noticing a carbon dioxide buildup in your chest, and an opioid overdose suppresses that reaction. Overdose leads to respiratory depression, oxygen deprivation, brain damage, and death. 

You may encounter dangerous cocaine and opioid mixing without even knowing it. Illicit drugs are often mixed with various substances including some dangerous additives. In recent years, fentanyl, a powerful opioid, has made its way into both heroin and cocaine supplies. The drug can be lethal, even in small doses, and it’s possible to take a deadly amount of the drug without even knowing it until it’s too late. The lethal dose is so small that it’s difficult for untrained hands to add a safe amount to any drug mixture. A fentanyl overdose can quickly lead to respiratory depression and death, without medical intervention.  

Treating Polydrug Use

When you enter an addiction treatment program, you’ll go through an assessment process to determine the best level of care and treatment options for your needs. If you’ve been using multiple drugs at once, you can go through a detox process that’s designed to treat both sets of symptoms. 

As soon as you can, you’ll sit down with your therapist to create a treatment plan that’s designed around treating your individual needs. Your personalized plan can take you through treatment options that address both cocaine heroin use disorders, as well as any other underlying factors. 

Both cocaine use and heroin use aren’t known to be life-threatening during withdrawal, but medical detox can help alleviate uncomfortable symptoms and potentially dangerous effects like dehydration. After detox, you will be placed in a level of care according to your needs. 

If you have high-level psychological or medical needs, you may go through an inpatient program that provides 24-hour medically or clinically monitored treatment. Once you can live on your own, you can go through a wide range of outpatient treatment involving anywhere from 12 hours of therapy a day to fewer than nine hours per week. 

Sources

ASAM. (n.d.). What is the ASAM Criteria? from https://www.asam.org/resources/the-asam-criteria/about

Layton, J. (2018, March 08). How Fear Works. from https://science.howstuffworks.com/life/inside-the-mind/emotions/fear2.htm

Soltis, A., & Soltis, A. (2014, February 28). Hoffman died from toxic drug mixture. from https://nypost.com/2014/02/28/philip-seymour-hoffman-died-from-speedball-drug-mixture/

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