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  • A “speedball” is created by mixing the drugs heroin and cocaine. Using this combination is known as “speedballing,” and is a well-known method of taking both drugs at once.

    Speedballing is a form of drug abuse, and can cause many negative side effects. Some side effects can even be fatal.

    How Speedballing Works

    Speedballing creates a “push-pull” effect between cocaine and heroin. This is because the effects of stimulants and depressants are mostly opposite. 

    Cocaine is a stimulant that increases brain activity and heart rate. Heroin is a naturally occurring opiate and depressant, which relieves pain and causes sedation.

    The negative effects of both drugs are meant to cancel each other out when taken together. This creates a more intense rush by combining the positive effects. 

    Common side effects such as drowsiness, anxiety, agitation, and high blood pressure may be reduced when these drugs are combined.

    Mixing Heroin & Cocaine

    In practice, taking these drugs together can also cause new and dangerous side effects. One way to “speedball” is to mix heroin and cocaine, and then inject them together. Another way is to inject heroin and snort cocaine at the same time. These are all forms of illicit substance use.

    Side Effects Of Heroin & Cocaine

    Heroin and cocaine have many side effects on their own, which are often caused by how these drugs are taken. Cocaine is usually snorted, which can lead to frequent nosebleeds, collapse of the nasal septum, and long-term lung damage.

    Heroin is usually injected, which can lead to a number of side effects at the injection site. Abscesses (pus-filled pockets of tissue) and collapsed veins can be caused by injecting heroin.

    Speedballing will likely involve either injecting, snorting, or both. While it can reduce other side effects, it will not reduce issues caused by injecting or snorting. It can also lead to other serious side effects.

    Serious Side Effects Of Speedballing

    Both cocaine and heroin can be habit-forming. Both are controlled substances according to the DEA (Drug Enforcement Administration), with a high potential for substance abuse. Long-term use of these substances can lead to long-term health effects.

    Reported side effects of speedballing include physical and mental impairment, reduced motor skills, insomnia, and paranoia. Speedballing can also increase your risk of withdrawal from both of these substances, which can be uncomfortable and difficult to beat long-term.

    Risk Of Overdose

    The risk of overdose on either heroin or cocaine increases when speedballing. The effects of both drugs cancel each other out, which can lead to ingesting large amounts of the drugs without feeling the desired effects.

    Respiratory failure is much more likely when speedballing. Cocaine wears off much faster than heroin, which will likely cause the full effects of heroin to set in later. Respiratory depression and respiratory failure can all come on strongly once the effects of cocaine wear off.

    Stimulant and opioid overdoses both affect the central nervous system, which can also lead to:

    • heart attack
    • stroke
    • aneurysm

    High-profile fatal overdoses on speedball include celebrities such as River Phoenix and John Belushi. Despite these well-known overdoses, speedballing remains an issue in the United States today.

    Other Speedball Drugs

    While speedballs are traditionally a combination of cocaine and heroin, the term has evolved to include other drug combinations. Fentanyl, morphine, Ritalin, methamphetamine, and other stimulant/depressant combinations have seen use in speedballs.

    Addiction Treatment

    If you or a loved one are speedballing, you may put yourself at risk of overdose or other serious side effects. To come off these drugs safely, an addiction treatment program can help.

    To learn more about our potential treatment options, talk to your healthcare professional or contact us today.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    National Institute on Drug Abuse - Commonly Used Drugs Charts
    National Institute on Drug Abuse - Heroin DrugFacts
    National Institute on Drug Abuse - Real Teens Ask About Speedballs - NIDA Archives
    USA Today - River Phoenix's death: Samantha Mathis breaks silence about the tragic night 25 years ago

    Medically Reviewed by
    Davis Sugar, M.D.
    on July 9, 2022
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