Speedball (Drug Mix)

A “speedball” is the dangerous combination of a stimulant and a depressant. This guide covers modern variations, effects, and the extreme overdose risk from fentanyl.

What Is a Speedball?

A speedball is the practice of combining a stimulant drug with a depressant drug, most often taken together through injection. The user’s goal is typically to achieve the intense euphoria of the stimulant while using the depressant to reduce negative side effects like anxiety and the subsequent “crash.”

This creates a dangerous push-pull effect on the body, as the central nervous system receives competing signals to speed up and slow down simultaneously. This practice is exceptionally dangerous, highly addictive, and carries a significant risk of fatal overdose.

Slang Names for Speedballing

Speedballing has many street names, depending on the drugs used and the location. Some of the most common slang terms include:

• Belushi
• Bombita
• H & C
• Powerballing
• Snowballing
• Dynamite

Drug Breakdown Modern Speedball Variations

While the classic speedball is a specific mix, the term is now often used to describe any combination of a stimulant and a depressant.

• Classic Speedball: The original combination of cocaine (stimulant) and heroin (depressant opioid).
• Methamphetamine Variation: Replacing cocaine with methamphetamine for a longer-lasting, more intense stimulant effect.
• Prescription Speedball: Combining prescription stimulants (like Adderall or Ritalin) with prescription opioids (like Oxycodone or Vicodin).
• Benzodiazepine Mix: Combining a stimulant like cocaine with a depressant benzodiazepine, such as Xanax or Valium.

Why Speedballing Is So Dangerous The Science Explained

Speedballing is particularly dangerous because the two drugs are processed by the body at different rates. This creates a high risk for a specific type of overdose. Cocaine’s effects wear off much more quickly (in about 30 minutes) than heroin’s (4-6 hours). When the stimulant effect disappears, the full, unmasked depressant effect of the opioid overwhelms the body. This can lead to severe respiratory depression, where a person’s breathing slows down and stops completely, resulting in a fatal overdose.

Short-Term and Long-Term Effects

The effects of speedballing are severe and can cause lasting damage to the body and brain.

Short-Term Effects

Immediately after use, a person may experience a powerful rush of euphoria, but this is often accompanied by dangerous and unpredictable effects. These can include confusion, blurred vision, paranoia, incoherence, and a loss of motor control. The competing effects on the heart can cause a dangerously irregular heartbeat.

Long-Term Effects

Chronic use of speedballs can lead to devastating long-term health consequences, including permanent damage to vital organs. The most common effects include:

• Cardiovascular Damage: Increased risk of heart attack, stroke, and aneurysm.
• Respiratory Damage: Damage to the lungs and an increased risk of pneumonia.
• Brain Damage: Can be caused by strokes or by hypoxia (lack of oxygen) during non-fatal overdoses.
• Mental Health Decline: Chronic use is linked to severe anxiety, paranoia, depression, and a risk of developing long-term psychosis.

The Modern Speedball Fentanyl Contamination

Today, the greatest danger of speedballing comes from the unintentional consumption of illicitly manufactured fentanyl. The nation’s street drug supply is widely contaminated with this potent synthetic opioid. Cocaine, heroin, and counterfeit prescription pills are all frequently laced with fentanyl.

This means a person may create a speedball without ever knowing they are taking a lethal dose of fentanyl. The latest CDC data highlights this danger:

Approximately 50% of all cocaine-involved overdose deaths also involved a synthetic opioid like fentanyl. Similarly, nearly 70% of all overdose deaths involving psychostimulants like methamphetamine also involved fentanyl.

This contamination is the primary driver of the current overdose crisis and makes any form of speedballing exceptionally risky.

Signs of Speedball Use and Overdose

Recognizing the signs of speedball use and overdose is critical for loved ones and can be the key to saving a life.

Signs of Speedball Use

A person using speedballs may exhibit erratic and extreme swings in behavior. This can include periods of high energy, talkativeness, and agitation (from the stimulant) followed by periods of drowsiness, sedation, or “nodding off” (from the depressant). The presence of drug paraphernalia like needles, pipes, or rolled-up bills may also be an indicator.

Signs of an Overdose Call 911 Immediately

A speedball overdose is a medical emergency. The primary danger is that the stimulant wears off first, leaving the full depressant effect of the opioid to shut down the body’s breathing. Signs include:

• Slow, shallow, or stopped breathing
• Gurgling noises or a “death rattle”
• Blue or purple lips and fingernails
• Clammy, cold skin
• Unresponsiveness (cannot be woken up)

If you suspect an overdose, call 911 immediately and administer naloxone (Narcan) if available. Do not leave the person alone.

High-Profile Overdoses A Tragic History

The danger of speedballing is infamously associated with several tragic, high-profile deaths.

• John Belushi (1982): The famous comedian died from an overdose of cocaine and heroin.
• River Phoenix (1993): The actor died from an overdose of cocaine and morphine (a heroin metabolite).
• Chris Farley (1997): The comedian died from an overdose of cocaine and morphine.
• Philip Seymour Hoffman (2014): The actor died from an acute mixed drug intoxication, including heroin and cocaine.

It’s important to note that other celebrity deaths, like that of Heath Ledger, were due to accidental overdoses from combining multiple prescription drugs, a different but equally dangerous form of polydrug use.

Treatment Options for Speedballing

Overcoming an addiction to multiple substances requires a comprehensive, integrated approach to addiction treatment. The first and most critical step is medically supervised detoxification.

Medical Detox

Detoxing from both a stimulant and a depressant at the same time is complex and can be dangerous. Withdrawal symptoms from both drug classes can occur, requiring medical monitoring to ensure safety and manage severe discomfort. This should never be attempted alone.

Rehabilitation Programs

Following detox, an inpatient or residential rehab program is often recommended. These programs provide a safe, structured environment where a person can focus entirely on recovery. Treatment typically involves a combination of:

• Behavioral Therapies: Cognitive Behavioral Therapy (CBT) helps individuals identify and change the negative thought patterns that lead to substance use.
• Medication-Assisted Treatment (MAT): For the opioid component of a speedball, medications like buprenorphine or naltrexone can be used to reduce cravings and prevent relapse.
• Dual Diagnosis Care: Addressing any co-occurring mental health disorders is essential for lasting recovery.

Support for Families and Loved Ones

Loving someone with a substance use disorder can be a traumatic and isolating experience. It’s crucial for family members to get support for themselves. Groups like Nar-Anon and Al-Anon provide a safe space for people to share their experiences and learn from others who understand. Learning to set healthy boundaries and practicing self-care are essential parts of supporting a loved one’s recovery without losing yourself in the process. For more resources, visit our page on support for families.

Your Path to Recovery Starts Here

Overcoming an addiction to speedballing and polydrug use begins with finding the right support. To explore all your options, including online therapy and the free SAMHSA helpline, see our Find Treatment Help page.

When you are ready to connect with local care, our treatment locator can help you find a provider in your community.

Written by

Jessica Miller

Editorial Director

Jessica Miller is the Editorial Director of Addiction Help. Jessica graduated from the University of South Florida (USF) with an English degree and combines her writing expertise and passion for helping others to deliver reliable information to those impacted by addiction. Informed by her personal journey to recovery and support of loved ones in sobriety, Jessica's empathetic and authentic approach resonates deeply with the Addiction Help community.

Reviewed by

• Fact-Checked
• Editor

Kent S. Hoffman, D.O.

Co-Founder & Chief Medical Officer

Kent S. Hoffman, D.O. has been an expert in addiction medicine for more than 15 years. In addition to managing a successful family medical practice, Dr. Hoffman is board certified in addiction medicine by the American Osteopathic Academy of Addiction Medicine (AOAAM). Dr. Hoffman has successfully treated hundreds of patients battling addiction. Dr. Hoffman is the Co-Founder and Chief Medical Officer of AddictionHelp.com and ensures the website’s medical content and messaging quality.