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  • Mixing Heroin With Other Substances | Polysubstance Abuse

    Polysubstance Abuse | Mixing Heroin With Other Substances

    Heroin is an opioid drug made from an opiate (natural opioid) called morphine. It’s usually injected, snorted, or smoked.

    No matter how it’s used, the drug causes a rush of euphoria (intense joy). To increase this effect, some people mix heroin with other drugs. This behavior can cause serious health problems

    The substances that most commonly get mixed with heroin are:


    Both heroin and alcohol are central nervous system (CNS) depressants. That means they slow down central nervous system functions such as breathing, heart rate, and blood pressure. 

    Fatal Overdose

    When you mix heroin and alcohol, the drugs may slow down your central nervous system functions to the point of fatal overdose. Common signs of overdose include:

    • confusion
    • slow or shallow breathing
    • low blood pressure
    • weak pulse
    • uncontrolled muscle movements
    • bluish nails or lips

    If you or someone you know experiences these symptoms, seek emergency medical care right away. 

    Effects Of Mixing Heroin & Alcohol

    Along with overdose, other potential effects of mixing alcohol and heroin include:

    • dizziness 
    • shakiness
    • trouble breathing
    • lack of coordination
    • hallucinations (seeing, hearing, or feeling things that aren’t there)
    • mood swings


    Benzodiazepines are prescription drugs that cause sedation (a state of calmness or sleepiness). They’re likely used to treat anxiety, seizures, and insomnia. Popular benzodiazepines include:

    • alprazolam (Xanax)
    • chlordiazepoxide (Librium)
    • clonazepam (Klonopin)
    • diazepam (Valium)
    • lorazepam (Ativan)

    Some people abuse benzodiazepines by mixing them with other drugs, such as heroin

    Effects Of Mixing CNS Depressants

    Like heroin and alcohol, benzodiazepines are central nervous system depressants. Thus, if you mix them with heroin, they can slow down your central nervous system to the point of overdose. 

    In addition, benzodiazepines have many of the same side effects as heroin, such as:

    • drowsiness
    • dizziness
    • confusion
    • lack of coordination
    • slurred speech
    • memory issues

    When you use both drugs at once, these effects may feel more intense than usual.


    Cocaine is a powerful stimulant drug. It speeds up your central nervous system, causing a rush of energy and euphoria. Mixing heroin with cocaine (or any other stimulant) is called a “speedball.” It’s one of the most popular types of polydrug use. It’s also one of the most dangerous.

    Adverse Effects

    For example, a person who mixes cocaine and heroin may experience the negative side effects of cocaine more intensely. These side effects include: 

    • anxiety
    • irritability
    • irregular heartbeat
    • high blood pressure

    Other potential side effects of mixing cocaine and heroin include:

    • extreme drowsiness
    • confusion
    • blurry vision
    • uncontrolled movements
    • paranoia

    Life-Threatening Breathing Difficulties

    In addition, the drugs’ conflicting effects on your central nervous system can cause serious issues. For example, as a stimulant, cocaine increases your body’s need for oxygen. However, as a depressant, heroin slows your breathing rate. 

    This conflict increases your risk of life-threatening breathing difficulties. 

    Risk Of Heart Failure

    Cocaine increases your heart rate, while heroin slows it down. This can cause rapid changes in heart rate that may lead to heart failure or stroke.

    Masked Effects

    Because they act in opposite ways, the drugs can mask each other’s effects. To heighten the effects, a person may use more of the drugs than they normally would. This behavior significantly increases the risk of overdose and addiction. 

    Dangerous Additives 

    Both cocaine and heroin may contain dangerous additives, including the synthetic opioid fentanyl. According to the Centers for Disease Control and Prevention (CDC), fentanyl was involved in over 36,000 overdose deaths in 2019. 


    Methamphetamine (or “meth”) is a highly addictive illicit drug. Like cocaine, it’s a stimulant. Thus, mixing heroin with meth poses many of the same risks as mixing heroin with cocaine. For instance, it increases the risk of breathing problems, heart problems, overdose, and addiction. 

    Severe Health Risks

    Meth also brings its own unique risks, especially when used long-term. These risks include:

    • severe dental problems (also called “meth mouth”)
    • sores from uncontrollable scratching (also called “meth mites”)
    • permanent damage to the heart or brain
    • aggressive or violent behavior

    Also, like heroin and cocaine, meth may contain dangerous additives such as fentanyl. 

    Prescription Opioids

    Prescription opioids are powerful medications that provide pain relief. Examples include oxycodone, hydrocodone, and methadone. 

    Overdose & Severe Effects

    As an opioid itself, heroin acts similarly to prescription opioids. That’s why mixing the drugs significantly increases your risk of opioid overdose. 

    It can also intensify the common side effects of opioids, which include:

    • drowsiness
    • dry mouth
    • constipation 
    • itchiness
    • nausea and vomiting

    If you or a loved one struggles with heroin use or another form of drug use, please reach out to an Ark Behavioral Health specialist. We offer comprehensive substance abuse treatment options, including medical detox, support groups, and mental health counseling.

    Related Topics

    What Happens When You Use Heroin With Adderall? 

    When the illicit opioid heroin is used with the prescription stimulant Adderall, the effects can be unpredictable and dangerous. 

    While each drug may mask some of the negative side-effects of the other, you are still likely to experience an increased risk of negative and unpredictable side effects. 

    These effects may include greater or lesser euphoria, impaired judgment, psychosis, and other mental effects, and potentially sudden death or disability due to heart attack, stroke, aneurysm, or respiratory arrest.

    Learn more about Using Heroin With Adderall

    What Happens When You Mix Heroin & Meth?

    Those who abuse both heroin and meth can experience a significant high. However, since heroin is an opioid and meth is a stimulant, combining the two can increase the risk of a drug overdose. 

    Learn more about Mixing Heroin & Meth

    What Happens When You Drink Alcohol On Heroin?

    When taken in combination, both substances work together to increase the pleasurable and harmful side effects of each substance. This greatly increases your risk of dangerous or deadly overdose, along with other short- and long-term mental and physical effects.

    Learn more about Mixing Heroin & Alcohol

    Why Is It Dangerous To Mix Heroin With Benzodiazepines? 

    Mixing heroin with benzodiazepines can be dangerous due to the potential for serious side effects. Serious side effects include respiratory depression, opioid overdose, drug addiction, and withdrawal symptoms.

    Learn more about Using Heroin With Benzodiazepines

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

    Centers for Disease Control and Prevention - Fentanyl
    National Institute on Drug Abuse - Benzodiazepines and Opioids
    Substance Abuse and Mental Health Services Administration - Know the Risks of Meth
    United States National Library of Medicine - Heroin
    United States National Library of Medicine - Heroin overdose

    Medically Reviewed by
    Kimberly Langdon M.D.
    on April 27, 2022
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