What is a Speedball?

What happens when you mix a powerful stimulant drug with a powerful depressant drug? Speedballing. Powerballing. Snowballing. Screwball. Spaceball. Dynamite. All these different slang names represent a dangerous type of polysubstance drug use most commonly referred to as speedballing. It involves using stimulant and depressant drug. Cocaine and heroin are the most popular and commonly combined drugs in speedballing. Both drugs are highly addictive and when taken together can cause intense and dangerous side effects.

A common misconception about mixing heroin and cocaine is because they produce opposing effects, they are able to balance each other or cancel each other out. Users often engage in speedballing to achieve a unique high that is more intense or longer lasting than the effects of each single drug on its own. In reality, the combination of the two can amplify negative side effects as the body is forced to take in a process multiple drugs at the same time.

On a black background, a spoon filled with white powder cocaine mixed with heroin lays next to an empty syringe shows what is a speedball.

What is a Speedball?

The term speedball was developed in the 1950s and is used to describe the practice of mixing crack cocaine and heroin. Both highly potent drugs own their own, and are even more powerful when taken together. In 2018, an estimated 63% of opioid overdose deaths involved stimulants such as cocaine and meth. The combination of two categories of drugs with contradicting effects can produce unpredictable results.

Stimulants commonly used in a modern speedball include cocaine, methamphetamine or a prescription amphetamine such as Adderall or Ritalin. Depressants commonly used in a modern speedball include heroin, fentanyl and prescription opioids such as hydrocodone, morphine or codeine. Two newer additions to the speedball formulation that have recently become popular amid the alarming opioid overdose crisis are xylazine, a veterinary tranquilizer used for sedation; and street fentanyl, a powerful synthetic opioid.

Heroin is an illegal central nervous system depressant drug. It is typically snorted, smoked or injected. It is a substance derived from the poppy seed plant and produces feelings of intense relaxation, calm and euphoria. Cocaine is an illegal central nervous system stimulant and one of the world’s oldest known stimulants. It can also be snorted, smoked or injected. It produces feelings of focus, concentration, energy and euphoria. When combined with a speedball, it can produce amplified adverse effects.

Infograph showing the risks of mixing heroin and cocaine.

Why is Speedballing so popular?

Why are users turning to speedballing? Many drug users who speedball do so in an attempt to achieve an intense rush of one drug while canceling out the negative effects by using the other drug. Heroin is often taken to cut down on the cocaine-induced agitation and jitters associated with use. Cocaine is often taken to lessen the sedative effect of heroin so users do not completely knock out. Ultimately, users seek to achieve a more pleasurable high and easier comedown when the drugs begin to wear off. The goal of speedballing is to achieve an intense euphoric high, stay in that high for a longer period of time, and counteract negative withdrawal from one drug by using another.

Speedballing is most popularly associated with the deaths of famous Hollywood celebrities and musicians including John Belushi, River Phoenix and Phillip Seymour Hoffman. Through Hollywood, the polydrug practice is often glorified. However, it produces severe consequences including death.

How does a speedball work?

When engaging in a speedball combination of drugs, both the stimulant and depressant are typically injected directly into the bloodstream intravenously. They can also be snorted together. When both cocaine and heroin are used, it creates a dangerous push a pull effect on the body. As the two are a different class of drugs with contradicting side effects, it can confuse the body and overwhelm the body’s central nervous system. It sends mixed signals to the brain and can result in unwanted and unpredictable effects.

A speedball mixture forces the body to process more than one toxic substance at a time. This can overwhelm parts of the body such as the liver and kidney. These organs have to work overtime to try and process the toxins which can lead to improper functioning, a slowdown in the processing time and a build of toxins in the body. The contradicting effects of speedballing can also cause strain on the circulatory and cardiovascular system resulting in the body’s confusion and disorientation.

An example of the opposing effects is its impact on the respiratory system. Speedballing makes it more difficult for the body to receive an adequate amount of oxygen it needs to keep the body in balance. Cocaine is known to use up increased amounts of oxygen in order to create its stimulating effects. While at the same time, heroin slows down breathing resulting in less oxygen being produced. The need for more oxygen combined with lower production of oxygen can result in the inability to receive enough and lead to respiratory failure.

Infograph comparing and contrasting between signs of heroin and cocaine use.

Cocaine causes symptoms such as:

  • High blood pressure
  • Irregular heartbeat
  • Anxiety
  • Agitation and irritability
  • Increased body temperature
  • Tremors

Heroin causes symptoms such as:

  • Drowsiness
  • Slowed breathing
  • Slowed heart rate
  • Clouded mental function
  • Depression
  • Nausea

Speedball produces symptoms such as:

  • Extreme confusion
  • Hypersensitivity to light, sound and touch
  • Blurred vision
  • Paranoia and psychosis
  • Incoherence
  • Cognitive mental impairment
  • High blood pressure and irregular heart rate
  • Heart attack and stroke
  • Insomnia
  • Impaired motor skills and uncontrollable movements
  • Development of psychiatric disorders – depression and anxiety
  • Respiratory failure
  • Overdose

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The Dangers of Speedballing

Polysubstance use is a dangerous practice. The dangers are especially heightened when combining two contradictory substances such as a stimulant and a depressant. In fact, users who buy premade speedballs illicitly rarely know what is inside the mixture. It could be laced with other substances and unknown toxins leading to a risky outcome. Fentanyl contamination is unfortunately quite common. Illicit cocaine and heroin aren’t always pure. It is often mixed in with fentanyl because it is a cheaper substance and can help achieve a stronger effect.

Speedballing increases the chances of overdose. In a 2018 National Vital Statistics report, cocaine and heroin were in the top 10 addictive substances that are most frequently involved in overdose deaths in the United States. The effects of cocaine often wear off much faster than heroin. A cocaine high can last up to 20 minutes. A heroin high can last for hours longer. Therefore, users are inclined to inject the mixture more often in order to maintain the cocaine high. However, when doing so, they are taking more heroin at toxic levels. This leads to an overdose of one or both substances. Overdose symptoms include vomiting, fainting, confusion, delirium, hallucinations, seizures, heart attack and organ failure.

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Treatment for Cocaine and Heroin Addiction

Cocaine and heroin are potent drugs that can become extremely habit-forming leading to addiction. When combined, they can produce unexpected and dangerous effects. Despite the dangers of this polysubstance combination, speedballing cocaine and heroin continues to be popular among drug users. Overcoming this addiction can be extremely difficult. Professional behavioral health treatment programs such as Hotel California by the Sea provide all the resources and support clients need to recover from a polysubstance addiction. We specialize in treating cocaine use disorders, heroin use disorders and polysubstance use disorders.

Our treatment facilities offer drug detox, residential treatment and outpatient programs such as partial hospitalization programs and intensive outpatient programs. We believe in a holistic approach to drug addiction treatment. This means incorporating psychological treatments as well as physical treatments. We utilize evidence-based behavioral treatments such as CBT, DBT and EMDR therapy. Addressing every aspect of addiction gives our clients the best chance of sobriety and recovery.