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

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:

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

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

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

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

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.

What are gel tabs?

Gel tabs are small squares of gelatin infused with LSD (lysergic acid diethylamide), a powerful hallucinogenic drug. They deliver the same psychoactive effects as traditional blotter paper but in a more concentrated, stable form that's harder to detect.

How do gel tabs differ from other LSD forms?

Unlike blotter paper or liquid drops, gel tabs contain LSD suspended in gelatin, making them more potent per dose, longer-lasting in storage, and less vulnerable to degradation from light or heat. This concentrated format increases overdose risk and unpredictable effects.

Are gel tabs dangerous?

Yes. Gel tabs carry serious risks including severe hallucinations, psychosis, dangerous behavior, HPPD (flashbacks), and psychological dependence. Because dosing is unregulated, users face unpredictable potency and potential contamination with other substances like fentanyl or synthetic cannabinoids.

Can you become addicted to LSD gel tabs?

While LSD is not physically addictive like opioids or alcohol, psychological dependence develops in some users. Repeated use can lead to tolerance, requiring higher doses for the same effect, and some individuals struggle to stop despite negative consequences—both signs professional treatment is needed.

How long do the effects of gel tabs last?

A single dose of LSD gel tabs typically produces effects lasting 8–12 hours, with peak intensity around 2–4 hours. However, aftereffects like mood changes, anxiety, or perceptual distortions can persist for days. Long-term users may experience chronic visual disturbances and mental health issues.

Where can I get help for LSD or hallucinogen use?

If you or a loved one is struggling with LSD, gel tabs, or other hallucinogens, Briarwood Detox Center offers medically supervised detox and withdrawal management in Austin, TX, with outpatient support in San Antonio, Houston, and Colorado Springs. Call (866) 710-7710 to speak with an admissions specialist 24/7.

If gel tabs or any other substance has taken control of your life, you don't have to face it alone. Briarwood Detox Center offers confidential assessments, 24/7 medical supervision, and a compassionate team dedicated to your safety and long-term success.

Reach out today: Call (866) 710-7710 or visit our guide to continued support after detox to learn about next steps in your recovery journey. We accept most major insurance plans and offer same-day admissions when clinically appropriate.

Related resources: How Drugs Change the Brain | Co-Occurring Disorders and Detox | What to Expect When a Loved One Is in Detox