What Is Speedball? Lethal Drug Combos And Its Side Effects


The term cocktail had been massively enjoyed by people worldwide. Generally meaning mixing two or more alcohol variants gives a sense of utter satisfaction. The term is no more limited to alcohol itself and has been passed on to a new generation of addiction, speedball – the concoction of drugs. 

Stating the consequences, some of the famous Hollywood stars had hit the headlines real hard. Speedball had been probably introduced back in the 1930s, but the term and its associated scenario had brought it to media and public attention in the 1980’s. In 1982, famous comedian John Belushi was discovered dead in his hotel room at Chateau Marmont, Los Angeles. Following this in 1997, another comedian Chris Farley had lost his life. In 2013 and 2014, two back to back speedball cases had caused a significant tremor in Hollywood. The deadly cocktail of drugs had victimized musician Chris Kelly (2013) and actor Philip Seymour Hoffman (2014). These are just a couple of examples to mention.

In this article, we will know everything about speedballing, its side effects, its intake in moderation, how they work and if they are dangerous. Let us dive right in!

What Is A Speedball? How Does It Work?

Speedball, also otherwise known as “Powerball” is a mixture of stimulant and depressant drugs. The most common form is mixing two opioids, cocaine and heroin or cocaine and morphine. For powerballing, the concoction of the stimulant and depressant is often injected or snorted. With the two almost opposite characteristics of opioids, the intake causes an intense euphoric rush in the bloodstream and the term that better describes the situation is known as “push-pull”.

Speedball, at its core, involves a mixture of cocaine hydrochloride and morphine sulphate. Now, drug addicts experiment with any sort of drugs from pharmaceutical opioids, barbiturates, benzodiazepines or methamphetamines available both offline and in the darknet markets.

While each of the said drugs can be lethal on its own, the drug combination, however, goes a few steps further with the interaction between the two opposite drug variants. Cocaine is a stimulant that generally causes euphoria accelerating the central nervous system (CNS) along with increased energy. On the physical part, it increases your heart rate alongside raising your blood pressure and body temperature. The effects are often instant and last somewhere between five and 90 minutes.

On the contrary, heroin is a depressant that induces euphoria similar to cocaine, but unlike cocaine, it slows your body functions. In this case, the users undergo decreased breathing with a slowed heart rate. 

When both the drugs are mixed, it provides an intense rush and a feeling of being high that is supposed to combine both the drug’s effects for developing a pleasant feeling. It works on the theory that the depressant and the stimulant will cancel out each other’s effects and thus neutralize each other’s side effects. In turn, the body and mind are overloaded with serotonin and adrenaline.

Various Forms Of Drug Combination & Lethal Opioid Concoctions

As already mentioned earlier, various types of drugs can be mixed together for the purpose of speedballing, such as:

  • Alcohol and amphetamines
  • Cocaine and alcohol
  • Cocaine and benzodiazepines
  • Cocaine and prescription opioid painkillers
  • Ecstasy (Molly) and marijuana
  • Xanax and methamphetamine

Four lethal categories of opioid concoctions have been identified viz., alcohol combos, cocaine combos, cocaine and alcohol combinations and prescription drug combinations. This segment will discuss all the lethal drug combo categories and the drugs that fall under them.

Alcohol Concoctions

Alcohol & Benzodiazepines

Benzos had been involved in more than a fifth of the opioid and alcohol-related hospital check-ins in 2009, as per the DAWN report. In most cases, respiratory failure was the prime factor. It bears added danger in a party setting as this concoction is one of the most happening pairs in the parties. The one who overdid the drug speedball may sleep it off while the rest enjoy having fun.

That’s a horrible move, says Dr Lewis-Younger: “We have a cultural mantra, I guess, in this country about letting people sleep it off. I cannot tell you how many tragedies that I have heard of in my duties that happened because of it.”

Alcohol & Prescription Painkillers

The hospital visits owing to this combo is relatively lower than mixing drinks with benzodiazepines. It has been recorded 15% of the hospital visits involve drugs and alcohol and that 21% involve anxiety drugs. However, it is predicted that it would grow in popularity in the near future. 

But it has been seen that between 2004 and 2009, the rate of emergency room trips due to hydrocodone, fentanyl, morphine, hydromorphone and oxycodone. If this trend continues, there will be a steep problem caused by these concoctions. Notably, this trend is more common amongst young women who indulge in them at parties and concerts, and the fact is that this mixture has a more substantial effect on women than men.

Cocaine Combos

Cocaine & Opiates

This mixture makes a dreadful speedball. John Belushi, Chris Farley and River Phoenix died due to this combination in the 80’s and 90’s. This mixture had probably topped the combo list. 


“So many different things—seizures, heart attacks, strokes, unregulated body temperature—can happen when you take drugs that stimulate you, like cocaine,” says Dr Lee. “And then, on the other side you have respiratory depression. If you have a combination of the two, it can make it harder for you to recognize the impact of one chemical.”

Cocaine & Ecstasy (MDMA)

Similar to mixing two depressants, concocting two stimulants can exacerbate the effects of both types of narcotics. You will hardly fall asleep and cease breathing on this narco cocktail; you might stop breathing definitely in another way. Ecstasy or MDMA on its own is highly dangerous as it can damage the cardiovascular system causing problems with body temperature regulation. Cocaine can do the same as well. Having a stroke is familiar with this combination if you are physically active at the moment of consumption (say, dancing or partying) and consuming the concoction. 

As Dr Lewis-Younger puts it, “Combining any unknown with any other unknown? It’s like Russian roulette.”

Alcohol & Cocaine

This mixture of the drugs will definitely land you in the hospital bed and is extremely bad for the health if consumed for the long term. 

“When you take cocaine and the alcohol together for a long time, there’s a combination chemical called cocaethylene that is formed that is very toxic,” says Dr Lee. “It can really damage your liver and heart and other organs.” 

Singer Whitney Houston’s death had been indirectly linked to alcohol and cocaine speedball. While this particular speedball is not the cause of death, the autopsy report states that it was present in her system. Also, the drowning had been caused by heart disease exacerbated by years and years of cocaine consumption.

Rx Combos / Prescription Opioid Combos

Narcotic Painkillers, Sleeping Pills & Benzodiazepines

It is sure to cause a disaster if you mix any central nervous system depressant like Xanax, OxyContin, heroin or alcohol with any other thing. The additive effects generally suppress breathing which you may overlook.

“Your brain has a reward system that tells you if you’re getting high, and then it has a system that controls your breathing that’s located in the brainstem, and the two centers do not necessarily talk to each other,” says Dr Lee. “Trying to gauge how much you use based on how you feel is going to be deadly.” 

Apart from the extremely addictive properties of sleeping pills, painkillers and benzos, this concoction is particularly awful due to its sheer prevalence. A study in 2010 had mentioned that in the U.S., hospitalizations due to poisoning of these three drugs had increased by 65% between 1999 and 2006.

Multiple Prescription Painkillers

It is one in the multiple-depressant category that causes respiratory failure and a high incidence of drug addiction.

“Narcotics used for pain are not very effective after about six weeks,” says Dr Lewis-Younger. “We see people adding drugs all the time, or increasing the amounts they’re taking over what’s been prescribed.”

The perception of pills prescribed by the doctors are safe sometimes provide the users with a false sense of security. Since cocaine was the leading cause of unintentional overdoses in 1999, it is not included in prescription opioids. In 2007, opioids had been involved in more overdose deaths as compared to the drug combination of cocaine and heroin.

Over-the-Counter Tylenol & Tylenol 3

Doctors often give Tylenol to the babies, which raises a sense of not being so scary. Little do people know that it contains acetaminophen, which can be tremendously toxic to the liver if introduced in the body in high doses. Tylenol with other drug combos is extremely bad, especially if you mix with an addictive opioid such as codeine. Your liver will take a beating. 

Image: Fred Meyer

As per a 2005 study carried out by the University of Washington Medical Center in Seattle, 38% of people who had developed acute liver failure due to accidentally ingesting way too much had consumed more than one kind of pill and that 63% had consumed a pill containing both an opioid and acetaminophen.

What Are The Side Effects Of Speedballing?

While you experience pleasure on the inside, giving you a head high, on the outside, both the coke and heroin can produce some intensely adverse side effects.

The stimulants like cocaine causes (or may cause) – 

  • Anxiety and Agitation
  • Fast or Irregular Heart Beat
  • High Blood Pressure
  • Raised Body Temperature

The depressants like heroin causes (or may cause) – 

  • Clouded Mental Function
  • Drowsiness
  • Slowed Breathing
  • Slowed Heart Rate

When both the stimulant and depressant functions together, you will experience the following:

  • Aneurysm
  • Blurred Vision
  • Confusion
  • Extreme Drowsiness
  • Inability To Sleep
  • Incoherence
  • Loss of Motor Skills
  • Mental Impairment
  • Paranoia
  • Respiratory Failure
  • Stupor

What Are The Risks Associated With Speedball?

Considered a rare event, the desired result is obtained, and the side effects remain suppressed. However, if the side effects are suppressed, the users can falsely trust that they are not high enough or have not reached their best tolerance. This false security alarm tends to double dosing, which further turns to overdose. Continuous overdose via speedball leads to death. There are a few factors that exceptionally make Powerball dangerous.

Image: All That’s Interesting
  • Raised Chances of Overdoses

For beginners, the most fatal overdoses are a result of using over one substance at a time. As per the 2018 National Vital Statistic Report, heroin and cocaine are in the list of top 10 most frequently used drugs involved in the United States overdose deaths. Additionally, as the effects of each of the substances might be suppressed when you engage in speedball, you might not understand that you are that high. This false sense of relative sobriety may cause frequent re-dosing, which eventually causes overdosing.

  • Failure of Respiratory System

When you speedball, you deliberately expose yourself to respiratory failure. Cocaine’s stimulating effects cause your body to consume more oxygen, while on the contrary, heroin’s depressant effects slow down your breathing rate. This combination, however, significantly increases the chances of experiencing respiratory failure or respiratory depression. Simply stating, it can fatally cause slower breathing.

  • Fentanyl Contamination

Heroin and coke are not always in their purest forms and may contain other substances mixed in them, such as fentanyl. Fentanyl is a powerful synthetic opioid. It is quite similar to morphine but is 100 times more potent than morphine. This states that a very little quantity of fentanyl can make you extremely high, which is why fentanyl is being added to specific substances to reduce costs. 

Most people associate opioids with fentanyl contamination, but slowly and steadily, it makes its way into the other substances. Centres for Disease Control and Prevention (CDC) had highlighted quite a couple of cases of unintentional fentanyl overdoses by those people who assumed that they had just been snorting coke. 

  • Other Factors

Apart from these mentioned, there are a few other risks associated with speedballing, which people mostly overlooks:

~ Cocaine heavily affects the cardiovascular system and the heart, which may increase the chance of heart attack.

~ Both the drugs bear a high potential for addiction which can lead to tolerance and withdrawal symptoms.

Safety Tips For Speedball

People generally rush to powerballing without knowing or abiding by the safety tips, which leads to overdose and eventually death. Here are some suggestions for your safety if you wish to try speedball. However, we do not recommend you indulge in speedballing or anything that could prove to be lethal and we at all cost does not support speedballing even for testing out.

  • Always Use Clean Tubes & Needles: Whenever you inject drugs into your veins, make sure you use clean and sterilized tubes and needles. You must never share needles and tubes with other speedballers. This ensures a reduction in the risk of contracting and/or transmitting HIV and other related infections. The same rule applies to things used for snorting drugs.
  • Always Test The Drugs: When you speedball, it is crucial to tent the purity and the strength of the drugs. Home test kits are readily available in the market that tells you how pure or potent are the drugs you are about to Powerball.
  • Consider Mixing Each Drug In Smallest Amount: It is the best option to keep the drug doses as low as possible. You must never re-dose even though you feel you are still not high. As already mentioned, the effects of each of the drugs used to speedball cancel out one another, which gives you a feeling of not being in that high state. But in reality, you are high.
  • Don’t Speedball All Alone: The best practice of speedballing is doing it with or in front of a friend who may help you if things go out of control. This being said, it does not necessarily mean that you would not overdose. But this will make sure you have someone to get help.
  • Spot The Signs Of Trouble: People who speedballs must know how to identify the signs of an overdose. This makes sure they take immediate steps to control the situation.
  • Take Help Of A Naloxone Kit: Naloxone, also termed as Narcan, is able to reverse the effects of an opioid overdose temporarily in case your drugs have mixed fentanyl in them. Narcan is straightforward to use and is now available without a prescription at the pharmacies in most states. Possessing Narcan and knowing the proper way of its usage can save your life or even someone else’s.

How To Identify Speedball Overdose?


Speedball is often associated with overdosing. Thus, it is crucial to recognize the signs of an emergency. You can call the cops if things go out of your knowledge. Also, below are the physical health symptoms that urgently require help:

  • anxious
  • bluish lips or fingernails
  • choking sounds or snore-like gurgling
  • inability to talk / incoherent speech
  • irregular heart rate
  • loss of consciousness
  • pale or clammy skin
  • slow, shallow, or erratic breathing
  • vomiting

If you are worried about law enforcement officials getting too involved, you can opt not to mention the drugs used for speedballing over the phone. But it is always recommended that you provide as much information as possible. But make sure to mention the specific symptoms so that an appropriate response can be sent. Additionally, till help is received, you must lay the affected on their side. Get them to bend their top knee inward, which ensures added support. This position will let their airways open if they commence vomiting.

Notable Deaths Caused Due To Speedball

Since speedballing had been introduced as one of the primary routes to get high on drugs and seek happiness, several speedballers have lost their lives in the process of overwhelming excitement caused due to drug overdose, such as:

  • Brent Mydland, keyboardist from the Grateful Dead
  • Chris Farley, comedian and actor
  • Chris Kelly, from rap duo Kriss Kross
  • Eric Show, pitcher for the Major Leagues
  • Hillel Slovak, original guitarist and founding member of the Red Hot Chili Peppers
  • Jean-Michel Basquiat, American graffiti artist
  • John Belushi, comedian, actor, and musician
  • Ken Caminiti, third baseman
  • King George V of the United Kingdom, king of England
  • Layne Staley, lead singer and co-songwriter of the band Alice in Chains
  • Mitch Hedberg stand-up comedian
  • Pete Farndon, English bassist from the band the Pretenders
  • River Phoenix, actor

Speedballing may seem pretty adventurous initially, but it is not ideal to do it. Even if you want to do it once in a blue moon, you can do it while maintaining proper safety. Else, you can risk your life and even take your life to do this. However, it is not recommended that you do speedballing. 

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