Speedball Drug (Heroin and Cocaine) Abuse and Dangers

Combining heroin and cocaine, also known as speedballing, significantly raises the risk of a deadly overdose. Continue reading more about speedball effects and addiction treatment.


What is a Speedball?

Speedballing is the mixing of heroin and cocaine, often by injection or snorting. Some believe it intensifies the high, but it’s a dangerous practice. While heroin slows down bodily functions, especially breathing, cocaine speeds them up. This combination increases the likelihood of overdose and severe harm, disrupting the body’s oxygen intake and creating a dangerous push-pull effect. Also, because cocaine’s effects wear off quickly, users may inject more frequently, compounding the risks associated with speedballing.

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Effects of Speedball Drugs

Cocaine is a stimulant with nearly the opposite effect of heroin (such as rapid breathing and increased heart rate and energy). It is a widespread mistake and misconception that combining cocaine with heroin will either balance or cancel out the harmful side effects of heroin. In reality, mixing these substances is more threatening than using either alone because their adverse effects can be doubled when combined.

Heroin is a popular illicit opioid (which is derived from morphine) that slows breathing and can lead to respiratory collapse, especially when mixed with another depressant, such as alcohol.

Side Effects of Speedballing

The side effects commonly associated with cocaine are:

  • Anxiety.
  • Hypersensitivity to sight, sound, and touch.
  • High blood pressure.
  • Abdominal cramps.
  • Irregular or strong heartbeat.

Opioids like heroin are often linked to:

  • Drowsiness.
  • Slowed breathing rate.

When combined, the side effects of speedballing primarily negatively impact the brain. Mixing cocaine and heroin is a potent cocktail with a very high risk of unpredictable side effects.

Common side effects of speedballing may include the following:

  • Paranoia.
  • Drowsiness.
  • Confusion or incoherence.
  • Blurred vision.
  • Incoherence.
  • Stupor.
  • Mental impairment due to lack of sleep.
  • Uncontrollable movements.

The combination can also result in uncoordinated and uncontrolled motor skills and the risk of dying from a heart attack, stroke, aneurysm, or respiratory failure.

Respiratory failure is particularly likely with speedballs because the effects of cocaine wear off far more quickly than the effects of heroin. Fatal slowing of breathing can happen when the stimulating cocaine wears off, and the full effects of the heroin are felt on their own.

What are the Long-Term Effects of Speedballing Drugs?

A primary concern for those who continuously inject speedballs is the increased risk of overdose. But, other long-term potential consequences of injecting cocaine and heroin include, but are not limited to:

  • Abscesses.
  • Cellulitis (tissue necrosis from injection use).
  • Contracting HIV or other bloodborne diseases through injection use.
  • Vascular inflammation and clogging of the blood vessels from injected substance.
  • Anorexia.
  • Heart attack.
  • Seizures.
  • Malnourishment.
  • Problems with impulsivity.
  • Ischemic or hemorrhagic stroke.
  • Other ischemic organ damage.
  • Ulcerations in the GI tract.
  • Liver and kidney injury.
  • Heart muscle inflammation.
  • Aortic ruptures.
  • Long-lasting cognitive impairments.
  • Increased risk of developing Parkinson’s disease.
  • Addiction.
Speedballing, the mix of heroin and cocaine, is very risky and dramatically raises the chances of severe health problems and overdose. Also, because cocaine's effects wear off more quickly than heroin, users may inject more frequently, compounding the risks associated with speedballing.
Speedballing, the mix of heroin and cocaine, is very risky and dramatically raises the chances of severe health problems and overdose. Also, because cocaine’s effects wear off more quickly than heroin, users may inject more frequently, compounding the risks associated with speedballing.

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Why Do People Abuse Speedballs?

According to research published in the National Center for Biotechnology Information, users who combine heroin and cocaine are trying to avoid some of the worst side effects of either substance while simultaneously undergoing a unique euphoric and energizing response from combining the two.

Here are some risk factors associated with speedball drug addiction:

  • Polydrug Use: Engaging in the simultaneous use of heroin and cocaine increases the risk of addiction and overdose.
  • Previous Substance Abuse: Individuals with a history of drug or alcohol abuse are at a higher risk of developing speedball drug addiction.
  • Mental Health Issues: Co-occurring mental health disorders, such as depression or anxiety, can contribute to the vulnerability to substance abuse.
  • Social Environment: A lack of supportive social networks and exposure to environments where drug use is prevalent can increase the likelihood of addiction.
  • Genetic Predisposition: A family history of substance abuse may contribute to a genetic predisposition for addiction.
  • Trauma or Stress: Exposure to traumatic events or chronic stress can be a contributing factor to the development of substance use disorders.
  • Lack of Treatment: Limited access to or engagement in addiction treatment programs increases the risk of ongoing drug abuse.
  • Unstable Living Conditions: Homelessness or unstable living situations can contribute to the risk of drug addiction.
  • Age of Onset: Starting drug use at a younger age can increase the risk of developing addiction later in life.
  • Lack of Education: Limited knowledge about the risks associated with speedballing and drug use, in general, can contribute to higher rates of addiction.

The general theory is that the stimulant’s energizing effects will neutralize the unwanted aspects of the depressant. At the same time, the depressant can decrease some of the undesirable physical symptoms of the stimulant. The reality, unfortunately, isn’t quite that simple. Many celebrities have died of overdoses related to depressant-stimulant combinations, including actors Chris Farley, John Belushi, Philip Seymour Hoffman, and River Phoenix.

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Those who are addicted to drugs often mix heroin and cocaine in speedballing, but many don't realize that some of them can be laced with fentanyl.
Those who are addicted to drugs often mix heroin and cocaine in speedballing, but many don’t realize that some of them can be laced with fentanyl.

Speedball Drug Overdose

The spread of illicitly manufactured fentanyl (a synthetic opioid up to 100 times stronger than morphine and 50 times more potent than heroin) caused a sharp increase in overdose deaths. Some purposely took fentanyl because they knew of its deadly, powerful properties. However, many people were not aware of the presence of fentanyl in counterfeit pills (like oxycodone) and heroin. Overdose deaths increased as a result.

The combination of cocaine (currently at an all-time purity high) and fentanyl (potentially deadly at only 2 milligrams or the weight of 6 grains of salt) was present in 1,542 deaths in 2015. Many researchers believe the actual number of deaths is higher due to the way counties report drug deaths.

Symptoms of Speedball Overdose

The symptoms of a speedball overdose can vary depending on the composition of the drug, but the leading cause of overdose deaths are:

  • Stroke.
  • Aneurysm.
  • Heart attack.
  • Respiratory failure.

If you witness someone overdosing on speedball drugs, it’s crucial to call for emergency help immediately by dialing your local emergency number or calling 911.

While waiting for assistance, if you’re trained and equipped, administering naloxone (if available) can potentially reverse the opioid effects and save a life. Stay with the person, monitor their breathing, and provide any information to emergency responders when they arrive.

Speedball Drug Addiction Treatment

Speedball dependency and addiction will take their toll and make you feel trapped. But you must understand there is a way out, and help is available. You are not alone in this.

Admitting that dependency and addiction have caused many problems in your life and hinder your ability to live life is the first step to successfully recovering. It is a significant step and the best thing you can do to reclaim your life. This is a difficult time in your life, but that does not mean it is over. Instead, you can seek the help you need.

Here are the top effective programs that can help treat speedball drug addiction:

  • Detoxification: This is the initial step to rid the body of drugs. Medically supervised detox helps manage withdrawal symptoms safely.
  • Counseling and Therapy: Behavioral therapies address the psychological aspects of addiction. Cognitive-behavioral therapy (CBT) and contingency management are commonly used.
  • Support Groups: Group therapy or support groups provide a sense of community and understanding. 12-step programs like Narcotics Anonymous can be beneficial.
  • Medication-Assisted Treatment (MAT): Medications like methadone or buprenorphine may be used to help with opioid dependence. However, there are currently no specific FDA-approved medications for cocaine addiction, so treatment often focuses on managing withdrawal symptoms and addressing underlying issues.

Do you have questions about speedballing drugs or addiction treatment in general? Call our helpline 24/7.

We Level Up NJ provides proper care with round-the-clock medical staff to assist your recovery through our medically-assisted speedball drug detox program.
We Level Up NJ provides proper care with round-the-clock medical staff to assist your recovery through our medically-assisted speedball drug detox program.
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Fentanyl and Cocaine Speedball

Speedballs of any kind are incredibly risky, but the influx of fentanyl speedballs has hugely increased the drug cocktail’s life-threatening effect. Fentanyl in speedballs is often used to increase strength and potency while keeping costs down, and many dealers don’t inform their customers that they’re using a drug 50 to 100 times more potent than morphine. Unintentionally consuming a speedball of cocaine mixed with fentanyl can be deadly, and sadly, the rate of such overdoses is on the rise as the use of fentanyl spreads.

The US Drug Enforcement Agency (DEA) reports that the mixture of cocaine with fentanyl and other synthetic opioids remains a significant threat throughout the United States. The high availability of both cocaine and fentanyl drives the dangerous trend into new markets, particularly in the Midwest and Great Plains regions.

Fentanyl and Meth Speedball Combo

Since 2015, the US Drug Enforcement Agency (DEA) and other law enforcement agencies have confiscated meth mixed with fentanyl. Although fentanyl is typically either sold or combined with heroin, forensic laboratories have analyzed exhibits containing meth and fentanyl or FRS since 2015. Methamphetamine has historically been mixed with heroin to create a “speedball,” although such combinations have been rare.

Mixtures of methamphetamine with fentanyl are also a rare occurrence but may be used to achieve the same effect as traditional speedballs. Many of these mixtures have methamphetamine as the primary substance, with fentanyl or FRS as a secondary or tertiary substance in the sample.

Mixing heroin and cocaine in speedballing dramatically increases the risk of overdose.
Mixing heroin and cocaine in speedballing dramatically increases the risk of overdose.

Speedballing Drugs Statistics

Cases of polydrug use, such as speedballing (combining cocaine and heroin), increase the risk of overdose due to the contrasting effects of these substances.


93,000 Overdose Deaths

The CDC reported over 93,000 drug overdose deaths in 2020, with opioids playing a significant role.

Source: CDC

15,800 Overdose Deaths

According to the CDC, in 2019, there were over 15,800 overdose deaths involving cocaine in the United States.

Source: CDC

20 Million

Around 7 in 10 adults (72.2% or 20.9 million) who faced substance use issues see themselves as either in recovery or on the path to recovery.

Source: NSDUH


About half the people with mental illness will abuse drugs to battle the devastating symptoms of mental illness. Unfortunately, this is only a short relief from their distress. Using speedballs covers up the actual problem and creates more issues, such as further mental health deterioration and dangerous physical health problems. Speedball abuse and recovery are essential to identify and get help for.

If you know that you have a preexisting mental condition or illness, staying away from drugs is the safest thing to do. However, any psychoactive substance comes with its risks, especially in those with mental illness, who are more susceptible to adverse effects.

Speedballs can worsen depression, mania, delusions, anxiety, auditory and visual hallucinations, insomnia, psychosis, and cognitive problems. If you have a speedball abuse and dependency problem, you must know that help is available.

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Finding the Right Treatment for Speedball Abuse at We Level Up New Jersey

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