Mixing Drugs: Heroin and Cocaine

When someone suffers from an addiction to any drug, overdose and death are always possibilities. Certain drugs are more likely to lead to overdose and subsequent death than others, and mixing various substances increases the risk factor. A combination that carries significant risk is a heroin/cocaine mixture commonly known as a “speedball.” It is important to understand the dangers of speedballs as well as how to help those under the influence of one.


The Dangers of Mixing

Combining heroin and cocaine is considered so very dangerous, in part, because the two substances work on different parts of the brain.

Heating heroin in a spoonThe sensations this mixing and matching can bring about might be intense, but the damage can also be extreme.

Heroin is considered a sedative drug that can make a user feel calm, relaxed and euphoric. People who take this drug without adding anything else to the mix often use words like “happy,” “sleepy” or even “silly” in order to describe the experience. They feel this way because the drug moves to the portions of the brain responsible for pleasure, and once there, they trigger a series of chemical reactions that causes the brain to release huge amounts of dopamine, a chemical signal of pleasure.

Cocaine, on the other hand, is considered a stimulant drug. People who take this drug without adding in another ingredient often use words or phrases like “energized” or “sped-up” in order to describe their sensations, and those feelings come about as cocaine moves into the brain and attaches to the cells responsible for cleaning up and shutting down dopamine signals. When those signals can persist, they bring about a smooth high that isn’t associated with sedation.

A speedball can be so dangerous, in part, because a brain under the influence of both drugs is awash in dopamine that never gets recycled. The sedation associated with heroin might be augmented as a result, and that might allow people to slip into a dangerous sleep-like state.

Additional Mental Health Concerns

Both cocaine and heroin are responsible for causing long-term damage to brain cells, meaning that people may be permanently altered by these drugs and experience the following:

  • Require more drugs to achieve the same effect
  • Feel physically ill when the drugs aren’t present
  • Struggle with extreme cravings for drugs between doses
  • Find it impossible to control how much they take

These changes are likely in anyone who abuses cocaine or heroin alone. However, people who abuse both drugs at the same time are at exponentially higher risk of long-term mental health damage.

In a study of the issue in the Journal of Substance Abuse Treatment, researchers compared the mental health status of people who took cocaine and people who took speedballs.1 Researchers found that the speedball users had significant increases in feelings of anxiety and depression when compared to cocaine users, and they were much less likely to function in a healthy way on a daily basis, as they struggled with maladjustment. Studies like this demonstrate that speedball abuse can do a significant damage to the brain, making the fall-out of addiction even worse.

For those who are addicted to speedballs, the moment of intoxication might be the only moment in which the person feels even remotely happy and adjusted. Most of the time, he feels unhappy, abused and unusual. While high, he may feel slightly better. He may know, intellectually, that he should get clean, but he might be unsure how to do that. Or, in fact, sobriety might even seem impossible.

Rehab With Support and Solutions

rehab at the oaks at la palomaPeople who are addicted to speedballs can certainly get better, but their therapeutic course might be a little complicated, according to the National Institute on Drug Abuse.2 While medications have been proven effective in people who have an addiction to simple heroin, there have been no such medications approved for people who are addicted to cocaine. Some people might benefit from heroin medications, of course, but they might still struggle with symptoms brought about by cocaine.

Thankfully, medications aren’t the only weapons addiction treatment professionals have available to them. They can also use psychotherapy approaches in order to help people to recover. Psychotherapy sessions for these addictions might involve trigger management.

People who abuse cocaine tend to feel a spark in cravings for the drug when they encounter something that reminds them of drug use, including the following:

  • People they took cocaine with
  • Movies or television shows that depict cocaine use
  • Rooms in which they took cocaine
  • Powdery substances that look like cocaine

In therapy sessions, practitioners expose their clients to these triggers and help them to learn techniques they can use to handle the sensations without using drugs. Feelings of anxiety might be addressed through meditation, for example, while negative thoughts might be challenged with simple statements of empowerment. In time, people might find that they can handle their triggers without leaning on drugs.

Support group work is helpful for people struggling with heroin and/or cocaine addictions. Addiction often leaves a person feeling isolated and completely alone, but in a support group, she can learn more about how others have dealt with the same demons andfind the power and encouragement to pursue sobriety going forward.

Find Freedom From Addiction at The Oaks

At The Oaks at La Paloma in Memphis, Tennessee, we have in-depth experience in helping people to overcome their heroin and cocaine addictions. We use medications to help some of our patients when necessary, but we also employ a staff of clinically trained addiction specialists who can design treatment programs that can increase a feeling of empowerment that can lead to real change.

We have openings in heroin and cocaine treatment available right now, and we can provide help on a residential or outpatient basis. Just call us at our 24-hour, toll-free helpline, and our admissions coordinators can tell you more.


1 Malow, Robert M. “Cocaine and speedball users: Differences in psychopathology.”Journal of Substance Abuse Treatment. 1992.Accessed 13 June 2017.

2 Martin, Kimberly R. “Combining Medications May Be Effective Treatment for “Speedball” Abuse.” NIDA. 2002 Accessed 13 June 2017.