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Mixing Heroin With Other Drugs

Mixing Heroin With Other Drugs

Heroin is an opiate drug that comes from alkaloid substances in the opium plant. While people often take heroin on its own by injecting, smoking, or snorting it, many people also combine heroin with other drugs.

When abused on its own, heroin can lead to a number of health problems. Adding other drugs to the mix can significantly worsen these risks. While poly-substance combinations are never advisable, there are specific drugs that can be particularly dangerous when mixed with heroin.

Dangers of Heroin

Dangers of Heroin addiction
Heroin is dangerous and its use can lead to many health issues including:

  • Infectious diseases resulting from non-sterile injections.
  • Infections at the site of injection.
  • Breathing problems.
  • Dependence and addiction.
  • Overdose resulting in respiratory failure and death.
  • Extremely unpleasant withdrawal symptoms – including diarrhea, throwing up, and widespread body aches and pains – in people who stop using the drug.

Even when it isn’t intentionally mixed with other drugs, heroin purchased on the street often has been mixed with harmful substances. Depending on the substances used, these additives can result in a range of complications – from increased sedation to serious organ damage. Other drugs may also interact adversely with heroin.

Why People Mix Heroin With Other Drugs

One popularly abused combination is that of heroin and cocaine, which together form what’s commonly referred to as a “speedball.” Although the appeal of this poly-drug use among people who engage in it isn’t entirely understood, concurrent cocaine use may result in an especially rewarding surge of euphoria and might otherwise serve to alleviate some of the withdrawal symptoms associated with heroin use. The rate of poly-drug use has increased due to a number of factors, such as:

  • “Normalization” of illicit drug abuse.
  • Widespread availability of illicit substances.
  • Ignorance or willful disbelief of the potential risks.

People mix heroin with other drugs for a variety of reasons, but by doing so they raise their risk for a number of consequences. Concurrent drug use can increase the risk of overdose.

One study speculated that individuals may decrease heroin use and begin mixing heroin with other drugs after about 10 years of using the opioid because of the hardships associated with abuse. As the relative amount of heroin use declines for these individuals, they might begin to increase their use of other drugs. This phenomenon might explain how some cases of concurrent heroin and other drug use begin.

If you or someone you know is struggling with an addiction to heroin or you’re concerned about the health risks you might face from combining heroin and other drugs, there are inpatient or outpatient addiction treatment centers available to help you. Don’t wait to get help – the effects of heroin can quickly prove very damaging to your health and may even result in a deadly overdose. Please call 1-888-744-0789 Who Answers? today to talk to a rehab placement specialist who can help you find the right treatment center for you.

Why Mixing Heroin With Other Drugs Is Dangerous

Two drugs commonly associated with overdose when used with heroin are benzodiazepines and alcohol. Benzodiazepines are typically prescribed to treat sleep and anxiety disorders.

Heroin, alcohol, and benzodiazepines are central nervous system depressants. These drugs possess the ability to slow brain activity, heart rate, and respiratory rate. When heroin is combined with other central nervous system depressants, there is an increased risk of:

  • Respiratory depression.
  • Respiratory arrest.
  • Cardiac arrest.
  • Coma.
  • Death.

More than half of all fatal heroin overdoses involve alcohol.

Heroin Mixed With Cocaine

Mixing heroin and cocaine symptoms
Heroin is often combined with cocaine to avoid or decrease the unwanted side effects of either drug. This is a markedly risky combination of substances, and it can easily have fatal consequences.

Cocaine’s stimulant effects might temporarily prop up an otherwise depressed heart and breathing rate when abused simultaneously with heroin. However, these effects of cocaine wear off far sooner than those of heroin, which means that once the user experiences heroin’s full depressant effects, respiratory failure may occur. This overdose can easily happen if the individual takes more heroin than intended due to cocaine’s ability to mask heroin’s effects.

Combining heroin with cocaine may also increase the chances of experiencing psychotic symptoms such as delusions and paranoia. Evidence suggests that dependence developed in association with speedball use is more profound than that of either substance individually.

Heroin and cocaine tend to mask the negative side effects of each other and increase the euphoria experienced. The combined withdrawal effects that emerge may be more severe than withdrawal symptoms of heroin or cocaine alone.

This combination allows users to take cocaine for longer periods of time, but doing so can increase the risk of overdose or adverse effects. Some of the potential signs and symptoms of concurrent heroin and cocaine use include:

  • Anxiety.
  • Drowsiness.
  • Confusion.
  • Blurred vision.
  • Stupor.
  • Lack of coordination.
  • Nausea or vomiting.
  • Seizures.
  • Irregular heartbeat.
  • High blood pressure.
  • Chest pain.
  • Heart attack.
  • Stroke.
  • Respiratory distress.
  • Coma.

The combination of heroin and cocaine can negatively impact both heart rate and rhythm.  At extreme levels, this can result in death.

Speedballing might be more likely to result in injection-site problems than other forms of intravenous drug use because of a higher frequency of injection. Concurrent heroin and cocaine users tend to inject more frequently than other kinds of intravenous heroin users do, sometimes injecting as many as 16 times in a day.

Speedball users might “miss their hits” because of the numbing properties of cocaine, and this mistake can increase complications such as vein damage. Other speedballing complications include:

  • Human immunodeficiency virus (HIV).
  • Systemic bacterial infections.
  • Abscesses and other skin infection.
  • Soft tissue damage.
  • Deep vein thrombosis.
  • Pulmonary embolism.
  • Stroke.

An individual who develops an addiction to heroin and cocaine is said to have poly-substance or poly-drug dependence. Cases of poly-substance abuse might complicate an individual’s recovery trajectory. However, many treatment programs recognize these patterns of drug use and can adequately address the unique issues that arise with poly-drug addiction.

Heroin and Alcohol

The Drug Abuse Warning Network estimated that nearly 45,000 emergency department visits in 2009 involved a combination of alcohol and heroin. Heroin and alcohol produce similar sedative effects and act synergistically when combined – meaning each drug heightens the effect of the other. The negative effects of concurrent alcohol and heroin use may include:

  • Loss of coordination.
  • Slow movements and slow thinking.
  • Drowsiness.
  • Slurred speech.
  • Memory or concentration problems.
  • Behavioral or psychological changes.
  • Suicidal ideation or behavior.
  • Blackouts.
  • Respiratory distress.
  • Coma.

People who suffer from concurrent addictions to heroin and alcohol may require a more comprehensive and integrated treatment approach than people suffering from one addiction. If combined alcohol and heroin use is affecting you or someone you love, call 1-888-744-0789 Who Answers? to find the best rehab facilities with experience in treating poly-drug addictions.

Because both heroin and cocaine are central nervous system depressants, the combined effects of using them together can be too much for the body to handle. Together heroin and alcohol can affect a person’s breathing and heart rate, slowing both to dangerously low levels. These drug combinations can result in coma and death.

Mixing Heroin With Other Drugs

A number of other drugs can have negative effects when used with heroin. For example:

  • Methamphetamines (meth) and 3,4-methylenedioxymethamphetamine (MDMA or Ecstasy). Someone who takes heroin with meth or Ecstasy runs the risk of an overdose. These two drugs have many effects that counter those of heroin, potentially masking some of its effects. Often, this combination might lead to increased heroin dosing in an effort to feel the effects that are lessened by the simultaneous use of other drugs.
  • Gamma-hydroxybutyric acid (GHB). Taking GHB with heroin can result in profound nervous system depression to the point that it can cause death.
  • Fentanyl. Fentanyl or any other opioid painkiller (such as hydrocodone and oxycodone) can amplify the opioid effects in a person’s system. This combination can strengthen the severity of a number of opioid side effects, including nausea, confusion, and respiratory depression, hastening the onset of breathing problems and putting the user at risk of slipping into a coma.

Treatment for Addiction to Heroin and Other Drugs

Inpatient therapy for Heroin addictionPeople who are researching treatment centers should look for a facility with certified mental health professionals and experience in treating poly-drug addictions. There are many recovery options when looking to get sober, and what works best for one person might not be best for another. It all depends on individual needs. Different types of treatment programs include:

  • Inpatient treatment. This is also known as traditional rehab. Individuals live at the facility during the treatment program, which typically lasts between 30 and 90 days, although it can be extended if necessary.
  • Luxury inpatient. Like people in more standard rehabs, individuals in luxury inpatient addiction rehab programs reside at the treatment center throughout the inpatient stay. However, luxury facilities have added amenities and services that resemble those of a resort. Some facilities include private rooms, spa treatments, horseback riding, massage therapy, and gourmet meals.
  • Outpatient treatment. This type of treatment allows the individual to live at home while fulfilling family, work, or school responsibilities while recovering from poly-drug addiction.
  • Sober-living homes. These homes are often part of an aftercare program in which the individual lives in an entirely sober community. Residents typically have the freedom to come and go as they please, but they will most likely undergo periodic drug testing while residing there. These locations allow residents to separate themselves from the stressful, drug-using environments they might encounter if they were to return home.

People looking for drug rehab treatment centers may also want to make sure that the facilities they are considering offer medically monitored detoxification (detox) and care. While the acute opioid withdrawal syndrome associated with heroin cessation is seldom life-threatening, poly-substance withdrawal can prove more complicated, and in some cases dangerous.

Medically assisted detox can help control and lessen heroin’s unpleasant withdrawal symptoms and other dangerous symptoms that can arise during poly-substance withdrawal. Depending on the specific detox protocol of the treatment center, medications such as buprenorphine, buprenorphine, naloxone and naltrexone may be used to medically manage opioid dependence.

It’s also important to ask if the rehab center offers intake evaluations in order to assess for co-occurring mental health disorders and if it provides thorough psychiatric care as part of a dual-diagnosis program if a person requires it.

Getting Help for Mixing Heroin With Other Drugs

If you or a loved one is mixing heroin with other drugs, recovery is possible. It’s never too late to find help for heroin or poly-drug addiction.

You don’t have to hit rock bottom before seeking treatment for concurrent drug abuse. Our treatment placement representatives are available 24 hours a day to take your call and help you find the best recovery program for you. Please call 1-888-744-0789 Who Answers? today.


  1. Leri, Francesco, Julie Bruneau, and Jane Stewart. “Understanding Polydrug Use: Review of Heroin and Cocaine Co-use.” Addiction1 (2003): 7-22. Web. 29 Feb. 2016.
  2. Ives, Richard, and Preeti Ghelani. “Polydrug Use (the Use of Drugs in Combination): A Brief Review.” Drugs: Education, Prevention and Policy3 (2006): 225-32. Web. 29 Feb. 2016.
  3. Darke, S. “Heroin Overdose: Research and Evidence-Based Intervention.” Journal of Urban Health: Bulletin of the New York Academy of Medicine2 (2003): 189-200. Web. 29 Feb. 2016.
  4. Lipman, Jonathan J. “Recent Forensic Pharmacological Developments in Drug Use: The Growth and Problems of Speedballing.” The Forensic Examiner. 1997. Web. 29 Feb. 2016. <http://www.jurispro.com/uploadArticles/Lipman-problems.pdf>.
  5. “Real Teens Ask About Speedballs.” NIDA for Teens. 2013. Web. 01 Mar. 2016.
  6. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, D.C.: American Psychiatric Association, 2013. Print.
  7. Pates, Richard, and Diane M. Riley. Harm Reduction in Substance Use and High-risk Behaviour: International Policy and Practice. Chichester, West Sussex: Wiley-Blackwell, 2012. Print.
  8. “Drug-Related Hospital Emergency Room Visits.” DrugFacts. May 2011. Web. 01 Mar. 2016.

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