Speedballs often give stronger effects than either drug when taken alone due to
drug synergy, and are a particularly hazardous mixture that can easily cause
heart attack,
respiratory arrest and death.[3] When compared to single drugs, speedballs are more likely to lead to addiction,[4][5] and users are more likely to
relapse[4][6] and also to overdose.[7][8][9]
History
Original speedball combinations used
methamphetamine mixed with heroin,[10] or cocaine hydrochloride mixed with morphine sulfate.[11]
Physiological response
Cocaine acts as a
stimulant, whereas heroin/morphine acts as a
depressant. Co-administration is meant to provide an intense
rush of
euphoria with a high that is supposed to combine the effects of both drugs, while hoping to reduce the negative effects, such as the
anxiety, hypertension and palpitations associated with stimulants, and
sedation/drowsiness from the depressant.
By suppressing the typical negative side effects of the two drugs, the user may falsely believe they have a higher tolerance, or that they are less intoxicated than they actually are. This can cause users to misjudge the intake of one or both of the drugs, resulting in a fatal overdose.
Super speedballs
The United States
Drug Enforcement Administration warned in 2019 that the rapid rise of
fentanyl supply in the country has led to combinations of both fentanyl and heroin with cocaine ("super speedballs"). In addition, the cross-contamination of powdered fentanyl into cocaine supplies has led to reports of cocaine users unknowingly consuming a speedball-like combination.[10]
Michael K. Williams, died of overdose of a mixture of fentanyl-laced heroin and cocaine.[31]
Notable incidents of use
In 1996,
Steven Adler had a
stroke after taking a speedball, leaving him with a permanent speech impediment.[32] That same year,
Dave Gahan suffered a heart attack following a speedball overdose, but survived.[33] According to his autobiography,
Slash experienced cardiac arrest for eight minutes after taking a speedball, but was revived.[34][when?]
^Hunt, Dana E.; Lipton, Douglas S; Goldsmith, Douglas; Strug, David (1984). "Street pharmacology: Uses of cocaine and heroin in the treatment of addiction". Drug and Alcohol Dependence. 13 (4): 377.
doi:
10.1016/0376-8716(84)90005-X.
PMID6479016.
^Wapler, M; Mendelson, J. H.; Teoj, S. K.; Mello, N. K.; Kuehnle, J. C.; Weiss, R. D.; Sholar, S. W.; Hanjra, B; Rhoades, E (1992). "Buprenorphine attenuates drug craving in men with concurrent heroin and cocaine dependence". Problems of Drug Dependence: 339.