When a person combines heroin and cocaine it is known as a ‘speedball’. The combination can be extremely dangerous or lethal because it mixes together a very strong depressant with a very strong stimulant. Heroin depresses respiration while cocaine stimulates the heart, which can lead to simultaneous cardiac and respiratory arrest. Dr. Adam Winstock, founder of the Global Drug Survey, explained in a Vice article entitled What Happens to Your Body and Brain When You Combine Different Drugs by Oliver Imhof and Charlie Brinkhurst-Cuff, “”It’s dangerous, because you combine two very potent drugs and it’s very hard to control since it’s usually taken by injection—once you’ve injected it, there’s nothing you can do.” It is very easy to take too much heroin in an attempt to mitigate the effects of cocaine, and vice versa. There is also no way to accurately gauge one’s intake because the drugs are being injected and will be felt immediately. Most fatal drug overdoses are the result of a person taking two or more substances at once. According to the Harm Reduction Coalition, “While it seems intuitive that combining a stimulant and a depressant would counterbalance the different effects, the combination does not cancel out overdose risk. Actually, people who speedball are at higher risk for overdosing than people who use heroin or cocaine alone.” The increased risk occurs for two major reasons: cocaine causes the body to use up more oxygen, while heroin reduces one’s breathing rate. The combination of these two effects is likely to lead to cardiac and respiratory depression. Also, the body has more drugs to process and “people who speedball usually inject more frequently with less time between shots than people who are using only heroin,” which could also increase risk of overdose. There is also the complication of varying durations of each drug. According to the National Institute on Drug Abuse, “Respiratory failure is particularly likely with speedballs because the effects of cocaine wear off far more quickly than the effects of heroin. Fatal slowing of the breathing can occur when the stimulating cocaine wears off and the full effects of the heroin are felt on their own.” Given that a person is more likely to inject more frequently while under the influence of both drugs, they are also much more likely to have dangerous levels of heroin in their system that will lead to respiratory depression once the effects of the cocaine wear off.
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