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  • Heroin, an illicit opiate narcotic, and Adderall, a prescription stimulant widely used to manage attention deficit hyperactivity disorder (ADHD) and narcolepsy, are two very different drugs. However, both are commonly used and abused by people to get high, sometimes in combination

    But mixing stimulant drugs in higher doses with opioids is an especially dangerous, unpredictable, and deadly form of drug abuse, in both the short- and long term.

    ADHD Medications & Heroin

    Heroin provides euphoria and calm by stimulating your opioid receptors and provoking the release of dopamine. As a CNS depressant, it can slow your central nervous system down to the point where you hover between being awake and asleep, as if in a trance. 

    At this point, Adderall or other ADHD meds could provide a jolt of energy for focus and wakefulness. 

    Adderall, on the other hand, contains amphetamines that work by increasing the action of the neurotransmitters dopamine and norepinephrine in the brain. 

    This puts the central nervous system in overdrive and can provoke strange or bizarre behavior including panic and paranoia. But heroin could be used to calm a person who is high on Adderall, helping them to behave more normally or keep partying longer.

    Dangers Of Concurrent Heroin & Adderall Abuse

    Speedballing,” or taking an opioid like heroin with a stimulant like Adderall, is an unpredictable and deadly way to get high for a few different reasons:


    By masking negative or euphoric effects and inhibiting judgment, polydrug abuse makes it more likely you’ll take more of one or both drugs than you would otherwise. This can increase the risk of overdose.

    Mental Health Issues

    Abusing Adderall and heroin together can trigger unpredictable mental effects, including psychosis, paranoia, mania, depression, and delirium.

    Disrupted Physical Processes 

    The push-pull reaction between these drugs can cause dramatic swings in blood pressure, body temperature, breathing, heart rate or rhythm, and other physical processes. 

    This is because of concentrations of one drug or the other shift over time, or the body’s reaction to the drugs changes.

    Sudden Death

    Speedballing increases the risk of drug-induced sudden death or permanent disability from cardiac arrest, stroke, aneurysm, or respiratory arrest.

    Long-Term Effects & Risks Of Polysubstance Abuse

    Chronically abusing Adderall and heroin together intensifies the risks compared to abusing either drug alone. 

    This will likely accelerate and intensify the development of tolerance, physical dependence, and addiction to one or both drugs, leading to more or less severe withdrawal symptoms when you stop taking either drug in the future. 

    Other potential long-term effects can include:

    • sleep problems and insomnia
    • problematic weight loss, dehydration, and malnutrition
    • ​brain damage
    • development of mental health disorders, including psychosis, mania, depression, and antisocial personality disorder
    • suicidal ideation
    • seizures
    • organ damage, including damage to the heart, pancreas, lungs, and liver
    • reproductive or sexual dysfunction and impotence
    • constipation
    • immune system dysfunction
    • increased risk of stroke, heart attack, or aneurysm
    • high risk of future overdose and accidental injury or death

    Substance Use Disorder Treatment

    Prescription drug use, especially when combined with illicit substances, can quickly get out of control. Adderall addiction and heroin addiction can be safely and effectively treated at an addiction treatment center. 

    Professional treatment likely starts with a detox program to monitor heroin or Adderall withdrawal symptoms. If dependence is severe, inpatient detox is likely recommended.

    Following detox, treatment services may include residential care at a rehab center, outpatient therapy or counseling, and peer support group meetings.

    If you or a loved one would like to learn more about our treatment programs, please 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.

    Florida Alcohol & Drug Abuse Association (FADAA) - “Speed-balling”: Mixing Stimulants and Opioids Micro-module
    Food and Drug Administration - ADDERALL® (CII)
    National Institute on Drug Abuse (NIDA) - What are the medical complications of chronic heroin use?
    National Library of Medicine: MedlinePlus - Substance use - amphetamines

    Medically Reviewed by
    Kimberly Langdon M.D.
    on April 28, 2022
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