Heroin is a highly processed form of morphine, derived from the opium poppy. It is a central nervous system (CNS) depressant, so it creates relaxation in the body as the neurons fire less, and the brain floods with dopamine. It also reduces pain sensations. Although it is related to prescription painkillers like oxycodone and hydrocodone, heroin is intentionally far more potent, and it is illegal to use. The primary method of ingesting heroin is through injection, so the substance changes brain chemistry rapidly. The heroin “high” typically wears off quickly too – within 5-15 minutes.
Cocaine is technically a Schedule II medication, according to the Drug Enforcement Administration (DEA), since it can have limited use as an anesthetic for some patients. However, this drug is typically found illicitly, either as a white crystalline powder or as opaque white rocks (crack cocaine). Powdered cocaine is snorted, while crack cocaine is melted, mixed with water, and injected. Cocaine is derived from the coca plant, which has been used as a stimulant for millennia; however, cocaine also has some pain-reducing qualities, which are more like CNS depressants than other stimulants. The high from cocaine is also very short-lived, like that of heroin.
These two substances may not, at first, seem like they would mix together, since they would cancel each other out. This idea of cancelling out the effects of another substance is not accurate, however. Instead, intoxicating substances tend to enhance each other’s effects when they are mixed together, which increases the risk of overdose. This is true of the popular combination of cocaine and heroin, whether these two substances are taken at different times to regulate each other or taken together in a “speedball.”
The Dangers of Mixing Heroin and Cocaine
Mixing heroin and cocaine has been popular for decades – at least since the 1980s, when reports of speedballs hit newspapers. Reasons for combining the two, according to medical surveys, include:
- Combining a stimulant like cocaine with a depressant like heroin increases the “rush.”
- Administering one alleviates negative side effects of the other.
- There are unique experiences from combining heroin and cocaine.
- STD infection, especially HIV and hepatitis
- Other infections from sharing contaminated needles
- Very high risk of overdose, due to higher rates of injecting these substances together
- Physical harm from “dirty” drugs, such as heroin or crack cocaine laced with other substances
- Inability to feel the negative effects of either drug, so unable to feel the body’s limit on those substances, leading to rapid overdose
- Psychological effects like hallucinations or paranoia
- Stupor, or being awake but unresponsive
- Slurred speech
- Loss of coordination
- Damage to the heart and brain due to changes in blood pressure
- Respiratory failure, heart attack, stroke, and aneurysm
Since both cocaine and heroin create very short-lived highs, people who mix the two can experience an extreme rush that they immediately crave again. This can lead to overdose if the individual is able to continually consume the combination in one sitting.
Who Is Most Likely to Mix Heroin and Cocaine?
According to the 2011 DAWN report, published by the Substance Abuse and Mental Health Services Administration (SAMHSA), the combination of heroin and cocaine resulted in 10,388 visits to the emergency room due to overdose. Combinations of illicit drugs in general, which include combining cocaine and heroin, rose 116 percent since 2009.
People who struggle with an addiction to heroin may begin using cocaine or crack cocaine to give them a “lift.” Heroin creates sleepiness, including an effect called “nodding,” in which a person nods in and out of consciousness. Using a stimulant like cocaine, whether in a speedball or not, can help keep the person awake through their heroin intoxication, so they may feel they enjoy it more.
People who struggle with crack cocaine abuse specifically are at a greater risk for adding heroin in a speedball to temper the edginess they feel when coming down from crack.
People who abuse either heroin or cocaine are more likely to struggle with polydrug abuse, or mixing multiple intoxicating substances together to extend or change intoxication levels. This is particularly true for injection drug users, who, according to an analysis in PubMed, frequently mix the two substances. Speedball use was reported in 92 percent of surveyed heroin users.
People who struggle with polydrug abuse, such as combining heroin and cocaine, put themselves at an increased risk of dangerous side effects, including overdose and death. It is very important to work with a doctor to develop a treatment plan that addresses all the substances a person struggles with. As medical research offers a better understanding of polydrug abuse and addiction in general, treatment programs have become more advanced at effectively helping people to withdraw from all substances of abuse safely and achieve long-term recovery.