What is a Speedball? Side Effects, Risks, and Overdose

drugs to make speedball
What is a Speedball?
A “speedball” is a mixture of stimulant and depressant drugs, most commonly heroin and cocaine. The mixture is typically injected into the veins but may also be snorted simultaneously. Known for the intense high it produces, this drug combination is especially dangerous and can cause serious side effects, overdose, or death.

What is a Speedball?

A speedball is a slang term that is used to describe a combination of stimulant and depressant drugs. Most often, the term speedball refers to the mixture of heroin and cocaine injected intravenously, although some people may attempt to concoct their own speedball by mixing other drugs such as:

When a person uses a speedball, they experience an intense, fast, euphoric rush and high. The speedball is a popular drug combination because it provides an intense high and many people believe using heroin and cocaine together will cancel out the negative side effects of both drugs, keeping them awake and reducing any paranoia and agitation caused by the cocaine. However, this is a common misconception.

Using cocaine and heroin together can actually amplify the negative side effects of both drugs and cause severe or even fatal side effects.1 The combination of a stimulant and a depressant in the body at the same time forces the body to process two different types of drugs at once and creates a “push-pull” effect on the body and brain. In addition, one study found that cocaine and heroin are both more potent when administered together than when they are administered alone, which increases the user’s risk for overdose.2

The Fentanyl Speedball

Speedballing is an older drug use trend (popular in the 1970s and 80s), but it is making a resurgence among drug abusers today as heroin abuse increases. However, the speedballs of today may be “fentanyl speedballs” and are arguably more potent and dangerous as much of America’s heroin is contaminated with the deadly drug fentanyl.3

Fentanyl is a manmade drug that can be 50 (or more) times more potent than heroin and it is extremely difficult to determine when a drug is contaminated with it. As fentanyl trafficking and distribution increase, so do fatal overdoses, according to the DEA.4

Heroin vs. Cocaine

A big part of understanding the dangers of speedballing is knowing how heroin and cocaine each affect the body.

  • Heroin is an illegal opioid drug. When it is used on its own, it binds to opioid receptors in the brain and causes a powerful, relaxing high. It works by depressing the central nervous system and slowing down the body’s functions, including respiration. Heroin users typically feel a rush of euphoria which is then followed by a heavy feeling in the arms and legs, reduced blood pressure, and depressed breathing. Heroin users may also frequently lose consciousness while they are high.5
  • Cocaine is an illegal stimulant drug. When it is used alone, it stimulates the central nervous system and floods the user’s brain with dopamine, causing intense feelings of euphoria, energy, and happiness. Many cocaine users have trouble sleeping and experience increased blood pressure, heart rate, emotional stimulation, agitation, and anxiety while they are high. Cocaine users can sometimes act irrationally, behave in violent or hostile ways, or may experience paranoia while they are under the influence of the drug.6

Side Effects of a Speedball

As you can imagine, the side effects of a speedball are quite severe and dangerous. Instead of canceling out the negative side effects of cocaine and heroin, the mixture of the two drugs causes extremely harmful or fatal side effects.

Common side effects of a speedball include:

  • Blurred vision
  • Confusion
  • Drowsiness
  • Paranoia
  • Mental impairment
  • Stupor
  • Incoherence
  • Inability to sleep
  • Loss of motor skills
  • Risk of death from stroke, heart attack, aneurysm, or respiratory failure1

Speedball Overdose

A speedball can quickly cause an overdose, especially because people who take cocaine and heroin together are more likely to inject them more often than those who take each drug on their own.7 Additionally, cocaine causes side effects that require the body to utilize more oxygen while heroin suppresses breathing, making it more difficult for drug users to get the oxygen they need. Respiratory failure and death can occur as a result.

Most fatal overdoses are caused by mixing drugs and speedballing is no exception.7 There have been several notable deaths caused by a speedball overdose, including the deaths of John Belushi, Chris Farley, and Trevor Goddard, among others. Several other well-known drug users have also experimented with speedballs, despite the risks, including Kurt Cobain, Miles Davis, Jerry Garcia, Craig Ferguson, and Steven Adler.8

Additional Speedball Risks

According to the National Institute on Drug Abuse (NIDA), scientifically, very little is known about the effects and interactions of cocaine and heroin on the body and brain. However, injecting both drugs at the same time is known to pose several additional risks for drug users, including:

  • Increased negative side effects of drug abuse
  • More severe psychiatric disorders
  • Higher incidence of failure in addiction treatment
  • Increased risk of contracting HIV9

How to Tell if Someone is “Speedballing”

If someone is speedballing, he or she may show some of the signs and symptoms of heroin or cocaine abuse on their own. Signs of speedball abuse may include:

  • Being very drowsy
  • Acting paranoid
  • Showing signs of anxiety
  • Showing signs of extreme confusion
  • Displaying uncontrolled or uncoordinated motor skills
  • Speaking incoherently
  • Suddenly losing consciousness

If you think someone is overdosing due to speedball abuse, call 911 right away or seek out immediate medical care.

Cocaine and Heroin Addiction: Speedball Abuse and Recovery

Speedballing isn’t just dangerous; it’s a major contributing factor in the rise of opioid abuse in America. Regardless, many people find themselves addicted to cocaine and heroin and can’t see a way out.

Fortunately, there is help available to those who need it most. At Briarwood Detox Center, we provide drug detox and stabilization services for polydrug abuse. Speedballing can often result in complex or unpredictable withdrawal symptoms, which can be just as dangerous and deadly as the drug use itself, but polydrug detox is a safe and effective way to quit.

Our staff of medical and clinical professionals is prepared to diagnose and treat the uncomfortable symptoms of drug withdrawal so clients can be safe and rest comfortably throughout the duration of detox treatment.

Quitting cocaine and heroin cold turkey isn’t the only option and medical detox is much safer, more effective, and comfortable for those who are ready to get sober. Call (888) 857-0557 for more information or to start your detox program today. We accept many different insurance providers.


  1. https://teens.drugabuse.gov/blog/post/real-teens-ask-about-speedballs
  2. https://www.ncbi.nlm.nih.gov/pubmed/9618415
  3. https://www.vice.com/en_us/article/597bwb/fentanyl-speedballs-are-the-latest-disturbing-trend-in-americas-opioid-crisis
  4. https://www.dea.gov/sites/default/files/sites/getsmartaboutdrugs.com/files/publications/DoA_2017Ed_Updated_6.16.17.pdf#page=40
  5. https://www.dea.gov/factsheets/heroin
  6. https://www.dea.gov/factsheets/cocaine
  7. https://harmreduction.org/issues/overdose-prevention/overview/overdose-basics/opioid-od-risks-prevention/mixing-drugs/
  8. https://en.wikipedia.org/wiki/Speedball_(drug)
  9. https://archives.drugabuse.gov/news-events/nida-notes/2002/10/combining-medications-may-be-effective-treatment-speedball-abuse

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