Speedball (drug)

Speedball, powerball, or over and under<ref>Template:Cite web</ref> is the polydrug mixture of a stimulant with a depressant, usually an opioid. The most well-known mixture used for recreational drug use is that of cocaine and heroin; however, methamphetamine mixed with morphine and/or fentanyl has also been used. A speedball may be taken intravenously or by nasal insufflation.<ref>Template:Cite book</ref>

Speedballs often give stronger effects than either drug when taken alone due to drug synergy, and are a particularly hazardous mixture that can easily cause heart attack, respiratory arrest and death.<ref>Template:Cite book</ref> When compared to single drugs, speedballs are more likely to lead to addiction,<ref name=rat/><ref>Template:Cite journal</ref> relapse<ref name=rat>Template:Cite journal</ref><ref>Template:Cite journal</ref> and overdose.<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref><ref>Template:Cite journal</ref>

History

The classic speedball is heroin and cocaine.<ref>Template:Cite web</ref> It could also mean morphine and an amphetamine.<ref>Template:Cite web</ref>

The United States Drug Enforcement Administration warned in 2019 that the rapid rise of fentanyl 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.<ref name=":0">Template:Cite web</ref>

Pink cocaine or "tusi" usually includes an unknown mix of uppers and downers and is sometimes called a speedball.<ref>Template:Cite web</ref> Cocaine mixed with ketamine is called a CK or Calvin Klein.<ref name=ck/>

Reportedly speedballs now account for most of the overdose fatalities in San Francisco. Many people are not speedballing intentionally. Rather, it has become difficult to avoid because so much of the cocaine, crack and methamphetamine supply is adulterated with fentanyl.<ref>Template:Cite web</ref> As of 2023 it is being called the "fourth wave" of the opioid epidemic.<ref>Template:Cite news</ref><ref>Template:Cite news</ref><ref>Template:Cite web</ref>

Physiological response

It is a widespread misconception that taking downers will reduce the risk of adverse cardiac effects from stimulants, or vice versa. Stimulants and opioids are more dangerous when mixed because they work in different ways. Stimulants wear off before opiates. When heart rate changes quickly, first increasing rapidly from the effect of the stimulant and then dropping quickly when the stimulant wears off and the full effects of the opiates are felt, this can cause a stroke or heart failure.<ref>Template:Cite web</ref>

Speedballs are extremely dangerous. The variations in heart rate and contraction caused by taking the mix of uppers/downers can lead to stroke or death even in young, healthy persons.<ref name=ck>Template:Cite web</ref>

Notable deaths attributed to speedball use

• Jean-Michel Basquiat (artist, d. 1988),<ref name="gate">Template:Cite web</ref><ref>Template:Cite book</ref> though other sources list his death as heroin overdose only.<ref>Template:Cite book</ref><ref>Template:Cite web</ref>
• John Belushi (comic actor, d. 1982)<ref name=gate/>
• Ken Caminiti (baseball player, d. 2004)<ref>Template:Cite web</ref>
• Chris Farley (comic actor, d. 1997)<ref name=gate/><ref>Template:Cite web</ref>
• Pete Farndon (rock musician, d. 1983)<ref>Template:Cite web</ref>
• Zac Foley (alternative rock musician of the band EMF, d. 2002)<ref>Template:Cite web</ref>
• Trevor Goddard (actor, d. 2003)<ref>Template:Cite web</ref>
• Mitch Hedberg (comedian, d. 2005)<ref>Template:Cite web</ref>
• Philip Seymour Hoffman (actor, d. 2014)<ref>Template:Cite web</ref>
• Sebastian Horsley (artist and writer, d. 2010)<ref>Template:Cite web</ref>
• Chris Kelly (rapper of the duo Kris Kross, d. 2013)<ref>Template:Cite web</ref>
• Brent Mydland (musician, d. 1990)<ref>Template:Cite web</ref>
• River Phoenix (actor, d. 1993)<ref>Template:Cite news</ref><ref>Template:Cite magazine</ref>
• DJ Rashad (musician, d. 2014)<ref>Template:Cite web</ref>
• Judee Sill (singer-songwriter, d. 1979)<ref>Template:Cite book</ref>
• Layne Staley (singer-songwriter, d. 2002)<ref>Template:Cite web</ref>
• Joey Stefano (actor, d. 1994)<ref>Template:Cite book Based on information from Charles Isherwood's Wonder Bread and Ecstasy.</ref>
• Michael K. Williams (actor, d. 2021)<ref>Template:Cite web</ref>

Notable non-fatal incidents

• In 1996, the rock musician Steven Adler had a stroke after taking a speedball, leaving him with a permanent speech impediment.<ref name="lacb">Template:Cite news</ref>
• Also in 1996, pop-music singer Dave Gahan suffered a heart attack following a speedball overdose, but survived.<ref>Template:Cite web</ref>
• According to his autobiography, the rock guitarist Slash (who had been in the same band as Adler) experienced cardiac arrest for eight minutes after taking a speedball, but was revived.<ref>Template:Cite book</ref>Template:When

See also

• Amfecloral
• Brompton cocktail
• Combined drug intoxication
• Desbutal
• Dexamyl
• D-IX
• Drug abuse
• List of deaths from drug overdose and intoxication
• List of polysubstance combinations
• Poly drug use

External links

• Template:Cite web