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What Is a Speedball?


One reason people struggling with substance abuse begin to abuse two or more drugs at the same time is to enhance the euphoric effects associated with intoxicating substances while reducing the experience of side effects, at least for a short time. A speedball – a potent combination of heroin and cocaine – allegedly does just that.

How a Speedball Works

Heroin is a very addictive opioid that depresses the central nervous system and induces a powerful, relaxing high. The drug leads a person to feel a rush of euphoria, as the brain releases neurotransmitters like dopamine and serotonin, and that euphoric sensation is followed by relaxation, heavy extremities, reduced blood pressure, and depressed breathing. Cocaine, which is also very addictive, is a stimulant: the drug also releases neurotransmitters to create a pleasurable high, but it increases heart rate, blood pressure, emotional stimulation, talkativeness, and anxiety, among other effects.

A speedball mixes these two drugs, and it is typically injected intravenously for the fastest possible high. The combination of drugs hits the brain within a minute or two, leading to both stimulation and relaxation. While the drugs allegedly remove some of the negative effects – cocaine keeps the person awake; heroin reduces the agitation and paranoia from cocaine – in reality, these two dangerous drugs together can quickly cause an overdose.

Why Speedballs Are Abused

The combination of cocaine and heroin may reinforce addiction and substance abuse patterns more than either drug alone. Cocaine affects the mesolimbic dopamine neurons while heroin modulates how these neurons release this neurotransmitter, and how it is absorbed.

Many people who abuse cocaine seek out depressants, like alcohol, benzodiazepines, prescription opioids, and heroin, to ease the comedown from the stimulant. Similarly, people who struggle with heroin addiction may seek stimulants like amphetamines, crystal meth, and cocaine to prevent them from passing out or to elevate their mood. A natural progression of this form of polydrug abuse is the speedball – combining these two drugs into one for an intense, long-lasting high.

Taking either heroin or cocaine alone is risky; however, combining these drugs increases the risk of serious complications, including overdose.

The Dangers of Speedballs

Negative effects from abusing cocaine and heroin together include:

  • Intense anxiety or paranoia
  • High blood pressure
  • Rapid heart rate, leading to cardiac arrest
  • Depressed breathing, leading to oxygen deprivation
  • Passing out

The most dangerous risk from a speedball is the combination of rapid heartbeat and suppressed breathing. If a person has a heart attack and suffers oxygen deprivation at the same time, they are much more likely to die.

Mixing Other Stimulants and Depressants

A speedball is not the only dangerous combination of a stimulant and depressant, although it is one of the most famous. People who struggle with polydrug abuse are very likely to mix these two types of intoxicants in an effort to modulate the negative side effects from either drug.

Some other combinations of stimulant and depressant drugs include:

  • Ecstasy and marijuana
  • Methamphetamine and alcohol
  • Cocaine and alcohol
  • Cocaine and benzodiazepines
  • Methamphetamine and opioids

One report found that people who took methadone to slowly taper off heroin used their daily dose in combination with several other drugs to get effects similar to a speedball; the combination included gabapentin, Klonopin, clonidine, and over-the-counter allergy medicine.

Taking multiple kinds of drugs together greatly increases acute risks, including poisoning or overdose. There are also long-term risks, such as damage to the liver, kidneys, heart, and brain.