Speedball (or powerball) is a polydrug mixture of a

stimulant Stimulants (also often referred to as psychostimulants or colloquially as uppers) is an overarching term that covers many drugs including those that increase activity of the central nervous system and the body, drugs that are pleasurable and inv ...

(most often

cocaine Cocaine (from , from , ultimately from Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly used recreationally for its euphoric effects. It is primarily obtained from the leaves of two Coca species native to South Am ...

amphetamine Amphetamine (contracted from alpha- methylphenethylamine) is a strong central nervous system (CNS) stimulant that is used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. It is also commonly used ...

) with an opioid (

heroin Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and bro ...

morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies ('' Papaver somniferum''). It is mainly used as a pain medication, and is also commonly used recreationally, or to make other illicit opioids. T ...

, and/or

fentanyl Fentanyl, also spelled fentanil, is a very potent synthetic opioid used as a pain medication. Together with other drugs, fentanyl is used for anesthesia. It is also used illicitly as a recreational drug, sometimes mixed with heroin, cocain ...

) that may be taken

intravenous Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutrie ...

ly or by nasal

insufflation In religious and magical practice, insufflation and exsufflation are ritual acts of blowing, breathing, hissing, or puffing that signify variously expulsion or renunciation of evil or of the devil (the Evil One), or infilling or blessing with go ...

. Original speedball combinations used cocaine hydrochloride mixed with morphine sulfate, while modern speedballs may also use pharmaceutical opioids,

benzodiazepines Benzodiazepines (BZD, BDZ, BZs), sometimes called "benzos", are a class of depressant drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. They are prescribed to treat conditions such as anxiety disorders, ...

, or

barbiturates Barbiturates are a class of depressant drugs that are chemically derived from barbituric acid. They are effective when used medically as anxiolytics, hypnotics, and anticonvulsants, but have physical and psychological addiction potential as we ...

along with stimulants. Speedballs often give stronger effects than either drug when taken alone due to drug synergy, and are considered a particularly hazardous mixture that can easily cause

heart attack A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which ma ...

respiratory arrest Respiratory arrest is a sickness caused by apnea (cessation of breathing) or respiratory dysfunction severe enough it will not sustain the body (such as agonal breathing). Prolonged apnea refers to a patient who has stopped breathing for a long pe ...

and death. Evidence suggests that when compared to single drugs, speedballs are more likely to lead to addiction, and users are more likely to

relapse In internal medicine, relapse or recidivism is a recurrence of a past (typically medical) condition. For example, multiple sclerosis and malaria often exhibit peaks of activity and sometimes very long periods of dormancy, followed by relapse or ...

and also to overdose.

Physiological response

Cocaine acts as a

, whereas heroin/morphine acts as a

depressant A depressant, or central depressant, is a drug that lowers neurotransmission levels, which is to depress or reduce arousal or stimulation, in various areas of the brain. Depressants are also colloquially referred to as downers as they lower the ...

. Co-administration is meant to provide an intense rush of

euphoria Euphoria ( ) is the experience (or affect) of pleasure or excitement and intense feelings of well-being and happiness. Certain natural rewards and social activities, such as aerobic exercise, laughter, listening to or making music and d ...

with a high that is supposed to combine the effects of both drugs, while hoping to reduce the negative effects, such as the

anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...

, hypertension and palpitations associated with stimulants, and

sedation Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure. Examples of drugs which can be used for sedation include isoflurane, diethyl ether, ...

/drowsiness from the depressant. While this can be somewhat effective, there is an imperfect overlap in the effects of stimulants and depressants. Some users report a higher rush and better comedown, and others report displeasure at the drugs effectively cancelling each other out. 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. Cocaine's stimulating effects also cause the body to use more oxygen, while the depressant effects of heroin slow breathing rates. This combination significantly increases the chance of experiencing

respiratory depression Hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate (''hypo'' meaning "below") to perform needed respiratory gas exchange. By definition it causes an increased concentration of carbon dioxide (hypercapni ...

respiratory failure Respiratory failure results from inadequate gas exchange by the respiratory system, meaning that the arterial oxygen, carbon dioxide, or both cannot be kept at normal levels. A drop in the oxygen carried in the blood is known as hypoxemia; a rise ...

, which may become fatal.

Super speedballs

The United States

Drug Enforcement Administration The Drug Enforcement Administration (DEA; ) is a United States federal law enforcement agency under the U.S. Department of Justice tasked with combating drug trafficking and distribution within the U.S. It is the lead agency for domestic en ...

warned in 2019 that the rapid rise of

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.

Notable deaths attributed to speedball use

Jean-Michel Basquiat Jean-Michel Basquiat (; December 22, 1960 – August 12, 1988) was an American artist who rose to success during the 1980s as part of the Neo-expressionism movement. Basquiat first achieved fame as part of the graffiti duo SAMO, alongside ...

, though other sources list his death as heroin overdose only. *

John Belushi John Adam Belushi (January 24, 1949 – March 5, 1982) was an American comedian, actor, and musician, best known for being one of the seven original cast members of the NBC sketch comedy show ''Saturday Night Live'' (''SNL''). Throughout his c ...

Ken Caminiti Kenneth Gene Caminiti (April 21, 1963 – October 10, 2004) was an American third baseman who spent 15 seasons in Major League Baseball (MLB) with the Houston Astros (1987–1994, 1999–2000), San Diego Padres (1995–1998), Texas Rangers ( ...

Chris Farley Christopher Crosby Farley (February 15, 1964 – December 18, 1997) was an American actor and comedian. Farley was known for his loud, energetic comedic style, and was a member of Chicago's Second City Theatre and later a cast member of the ...

* Pete Farndon * Zac Foley *

Trevor Goddard Trevor Joseph Goddard (14 October 1962 – 7 June 2003) was an English actor. He was best known for playing Kano in the martial arts film ''Mortal Kombat'', Lieutenant Commander Mic Brumby in the television series '' JAG'' and main villain ...

Mitch Hedberg Mitchell Lee Hedberg (February 24, 1968 – March 30, 2005) was an American stand-up comedian known for his surreal humor and deadpan delivery. His comedy typically featured short, sometimes one-line jokes mixed with absurd elements and non se ...

Philip Seymour Hoffman Philip Seymour Hoffman (July 23, 1967 – February 2, 2014) was an American actor. Known for his distinctive supporting and character roles—typically lowlifes, eccentrics, underdogs, and misfits—he acted in many films and theatrical produc ...

Sebastian Horsley Sebastian Horsley (born Marcus A. Horsley; 8 August 1962 – 17 June 2010) was an English artist and writer. Horsley's writing often revolved around his dysfunctional family, his flamboyant and eccentric behavior, his drug addictions, sex, and ...

DJ Rashad Rashad Harden (October 9, 1979 – April 26, 2014), known as DJ Rashad, was a Chicago-based electronic musician, producer and DJ known as a pioneer in the footwork genre and founder of the Teklife crew. He released his debut studio album '' ...

* Chris Kelly *

Brent Mydland Brent Mydland (October 21, 1952 – July 26, 1990) was an American keyboardist and singer. He was a member of the rock band The Grateful Dead from 1979 to 1990, a longer tenure than any other keyboardist in the band. Growing up in Concord ...

River Phoenix River Jude Phoenix (; August 23, 1970 – October 31, 1993) was an American actor, musician and activist. Phoenix grew up in an itinerant family, as the older brother of Rain Phoenix, Joaquin Phoenix, Liberty Phoenix, and Summer Phoenix. He ...

Judee Sill Judith Lynne Sill (October 7, 1944 – November 23, 1979) was an American singer and songwriter. The first artist signed to David Geffen's Asylum label, she released two albums on Asylum and partially completed a third album before dying of a d ...

Layne Staley Layne Thomas Staley (born Layne Rutherford Staley; August 22, 1967 – April 5, 2002) was an American musician, songwriter and the original lead singer of the rock band Alice in Chains, which rose to international fame in the early 1990s as part ...

* Joey Stefano, died from mixing cocaine, morphine, heroin and

ketamine Ketamine is a dissociative anesthetic used medically for induction and maintenance of anesthesia. It is also used as a recreational drug. It is one of the safest anesthetics, as, in contrast with opiates, ether, and propofol, it suppress ...

. * Michael K. Williams, died of overdose of a mixture of fentanyl-laced heroin and cocaine.

Notable incidents of use

In 1996,

Steven Adler Steven Adler (born Michael Coletti; January 22, 1965) is an American musician. He was the drummer and co-songwriter of the hard rock band Guns N' Roses, with whom he achieved worldwide success in the late 1980s. Adler was fired from Guns N' Roses ...

had a

stroke A stroke is a disease, medical condition in which poor cerebral circulation, blood flow to the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemorr ...

after taking a speedball, leaving him with a permanent speech impediment. That same year, Dave Gahan suffered a heart attack following a speedball overdose, but survived. According to his autobiography,

Slash Slash may refer to: * Slash (punctuation), the "/" character Arts and entertainment Fictional characters * Slash (Marvel Comics) * Slash (''Teenage Mutant Ninja Turtles'') Music * Harry Slash & The Slashtones, an American rock band * Nash ...

experienced cardiac arrest for eight minutes after taking a speedball, but was revived.

References

External links