Quick Answer: A speedball is a combination of a stimulant (such as cocaine or meth) and a depressant (such as heroin or fentanyl). People describe an intense rush, but the feeling is misleading: each drug hides the other’s effects, so people take more than they realize. Because stimulants wear off faster than opioids, breathing can slow or stop once the stimulant fades. Speedballing is a leading cause of fatal overdose, and fentanyl contamination makes it even riskier.
Medical emergency: If someone who has used these drugs is unresponsive, breathing slowly or not at all, has blue or gray lips, or is having a seizure or chest pain, call 911 immediately. If you have naloxone (Narcan), give it.
Speedballing is a practice that involves taking a cocktail of drugs–usually a stimulant and a depressant. While some people may turn to this combination for the intense highs it promises, the risks are severe and often life-threatening.
In this article, we’ll explore the dangers and risks of speedballing, as well as gain an understanding of what speedballing feels like by considering first-hand accounts of Reddit users who have tried it themselves.
What is a Speedball?
A speedball is a combination of two drugs: a stimulant, typically cocaine or methamphetamine, and a depressant, usually heroin or another opioid. The stimulant provides a quick, intense high, while the depressant has a calming or sedative effect.
Speedball combinations involve at least one depressant and one stimulant. Some of the most common combinations include:
- Cocaine and heroin
- Cocaine and fentanyl
- Meth and heroin
- Meth and fentanyl
People may combine stimulants and depressants because they feel that using both substances together balances out the extreme highs and lows of each, but this combination is incredibly risky. It can mask the negative effects of one drug, leading users to take more than they normally would, increasing the likelihood of dangerous side effects or overdose.
Why Speedballing Is So Dangerous: The Timing Problem
| Stimulant (cocaine or meth) | Opioid (heroin or fentanyl) | |
|---|---|---|
| What it does | Speeds up the heart, raises blood pressure, increases alertness | Slows breathing and heart rate, causes sedation |
| How long effects last | Cocaine wears off relatively quickly; meth lasts longer | Often lasts longer than cocaine |
| Main fatal risks | Heart attack, stroke, seizures, overheating | Slowed or stopped breathing |
Here is the problem: The two drugs don’t cancel each other out. They only cancel out what you feel. A person may feel less high or less sedated, so they take more. Then the faster-fading stimulant wears off first, leaving the full effect of a large opioid dose. Breathing can slow and stop, sometimes without warning. Meanwhile the stimulant has been straining the heart the whole time.
Effects and Warning Signs of Speedballing
| Effects people commonly report | Warning signs of an emergency (call 911) |
|---|---|
| Rapid heartbeat and high blood pressure | Chest pain or pressure |
| Sweating and overheating | Very slow, shallow, or stopped breathing |
| Dizziness and loss of coordination | Blue or gray lips or fingertips |
| Nausea and vomiting | Unresponsive or can’t be woken |
| Anxiety, agitation, or paranoia | Seizures |
| Confusion | Extreme agitation with high fever |
| Drowsiness alternating with restlessness | Gurgling or choking sounds |
What Does Speedballing Feel Like According to Reddit?
Reddit users have mixed opinions about speedballing. One user, whose account has since been deleted, said, “Feel great, no other feeling beats it.” Another says, “…mixing them can make you an emotional wreck! I’m on downers an took a dexedrine the other day, I became pretty emotional over the next few days I guess til it got out of my system.”
Blueskyn01se describes their experience as “hard to remember,” but details the high, “It was like, all the euphoria of the fentanyl without the nod, mixed with the distinct head buzz of meth. I had a lot of energy and my whole body was tingling and felt really really good. I do recall nearly falling over several times, and also I was SWEATING. like, A LOT of sweat. I was so hot I had to take my shirt off despite it being pretty cold outside.”
Why the “Good” Feeling Is Deceiving
Some Reddit users describe speedballing as an intense rush. But those feelings are unreliable, and the same people often describe dangerous moments too: nearly falling, heavy sweating, memory gaps. The table shows what the experience can hide:
| What it can feel like | What may actually be happening |
|---|---|
| “I don’t feel that high, I need more.” | The drugs are masking each other, but both are still working. Taking more raises overdose risk. |
| “I feel energized and fine.” | The stimulant is covering sedation from the opioid. When it wears off, breathing can slow. |
| “I feel hot and sweaty but okay.” | Overheating and a strained heart can be dangerous even without other symptoms. |
| “I don’t remember much.” | Memory gaps can signal a toxic dose or low oxygen. |
A note on online stories: The people who describe these experiences survived to write about them. Many who mix these drugs do not. Don’t let a positive description set your expectations.
The Dangers of Speedballing
Plenty of Reddit users point out the risks of speedballing. KemWiz says, “
Ehh, I don’t care for speedballs, too much damage on the body and too risky to do. With speed it really isn’t great unless you just take a small amount of speed to keep you up til you nod even harder, which is dangerous.. or using opiates st the come down of speed, which is also pretty dangerous, i usually wake back up speeding after I sleep, which can’t be healthy. Basically what I’m saying is, with speed its not worth it.”
In the subreddit, r/explainlikeimfive, where users explain complex concepts in easy-to-understand terms, DerDudexX observes that many famous people die of overdoses after mixing cocaine and heroin, and they ask why this mixture is so dangerous.
In the replies, internetboyfriend666 explains that “The effects cancel each other out to some degree, so a person might not feel as high and thus either take more of both drugs than they would alone, or re-dose more frequently, resulting an overdose of one or both drugs. Especially, as you pointed out, the cocaine wears off faster. If a person loads up on heroin to counteract the cocaine and the cocaine wears off first, then the effects of the huge heroin dose kick in and a person can easily die from respiratory failure.
It’s important to understand that the 2 drugs don’t actually “cancel each other out,” chemically, they just cancel out the experienced effects. So even if you don’t feel as high, both drugs are still working in your body as if you had taken only one.”
Highlighting the Risks
Speedballing can have short and long-term health risks, including:
- Overdose: The combination of a stimulant and a depressant increases the risk of overdose, as the opposing effects can mask each other, leading users to take higher doses than they realize.
- Cardiovascular problems: The stimulant raises heart rate and blood pressure, while the depressant can slow heart rate and breathing, putting extreme stress on the heart and increasing the risk of heart attack or stroke.
- Respiratory failure: The depressant can slow or stop breathing, especially in high doses, leading to respiratory arrest.
- Seizures: The stimulant can increase brain activity, while the depressant affects neurotransmitter function, making seizures more likely.
- Impaired judgment and coordination: The combination can lead to risky behaviors, accidents, or poor decision-making, which can result in physical harm or dangerous situations.
- Long-term mental health issues: Repeated use can lead to severe anxiety, paranoia, depression, and other mental health problems.
- Addiction: Both substances in a speedball can be highly addictive, leading to dependency, withdrawal symptoms, and a cycle of abuse.
If you or someone you love is struggling with drug abuse, reach out to the team at Moving Mountains Recovery today to discuss your treatment options.
The Hidden Risk: Fentanyl in the Supply
Illicitly made drugs, including cocaine, meth, heroin, and counterfeit pills, can be contaminated with fentanyl, a powerful opioid that is deadly in tiny amounts. You can’t see, smell, or taste it, and it is often unevenly mixed, so one dose can contain far more than another. Someone who believes they are using only a stimulant can be exposed to a fatal amount of opioid without knowing, and in a speedball, the risk is multiplied. Fentanyl test strips can detect some fentanyl, but they are not foolproof.
What to Do if You Suspect a Speedball Overdose
- Call 911 right away. Don’t wait to see if it passes.
- Give naloxone (Narcan) if you have it. It reverses the opioid part of the overdose, which is usually what stops breathing. It will not reverse the effects of cocaine or meth, but it is safe to give and can save a life. More than one dose may be needed, especially with fentanyl.
- Stay with the person, even if they wake up. Naloxone can wear off in as little as 30-90 minutes while some opioids last longer, so the person can slip back into overdose.
- If they are unconscious but breathing, place them on their side (recovery position).
- If they stop breathing, start rescue breathing or CPR if you know how, following the 911 dispatcher’s instructions.
- Don’t leave them alone, and don’t give them anything to eat or drink.
Naloxone is available over the counter at many pharmacies and is often free through local health departments. Many states, including New Jersey, have Good Samaritan laws that offer some legal protection to people who call for help during an overdose. Check the details for your state.
Treatment for Polydrug Abuse
The National Institute on Drug Abuse highlights that treating speedball abuse can be difficult, as treatments for heroin addiction are only somewhat effective for those using speedballs.
There is no FDA-approved medication specifically for cocaine addiction, and opioid treatments don’t address the cocaine aspect of the abuse. However, addiction treatment goes beyond just medication.
Behavioral therapy plays a central role, even when medication is prescribed. For example, cognitive-behavioral therapy (CBT) is often used to help individuals explore the underlying reasons for their substance use and learn healthier ways to cope with their struggles. The Matrix Model, a therapeutic approach designed for stimulant addiction, combines relapse prevention, self-help involvement, and education about substance abuse.
With the serious risks involved in using speedballs, individuals struggling with this combination need immediate treatment. If you or someone you love needs help, don’t hesitate to contact our team at Moving Mountains Recovery today. Our admissions line is available 24 hours a day.
Withdrawal From a Speedball
Someone who uses both types of drugs may face two different withdrawals at once:
| Stimulant (cocaine or meth) withdrawal | Opioid withdrawal | |
|---|---|---|
| Typical symptoms | Fatigue, depression, anxiety, intense cravings, poor sleep, increased appetite | Muscle aches, sweating, chills, nausea, vomiting, diarrhea, restlessness, insomnia, cravings |
| Main risks | Severe depression and suicidal thoughts | Usually not life-threatening, but very uncomfortable, and relapse after withdrawal carries a high overdose risk because tolerance drops |
If you have thoughts of suicide at any point, call or text 988. For free, confidential treatment referrals, call the SAMHSA National Helpline at 1-800-662-4357 (24/7).
What Treatment for Speedball Addiction Looks Like
Treatment works best when it addresses both drugs:
- Medication for opioid use disorder (MOUD). Buprenorphine, methadone, and naltrexone are effective for the opioid part and reduce overdose risk. They don’t treat stimulant addiction, so they are combined with therapy.
- Behavioral therapy for stimulant use. Cognitive behavioral therapy (CBT), contingency management, and the Matrix Model have the strongest evidence. There is currently no FDA-approved medication for cocaine or meth addiction.
- Treatment for co-occurring conditions. Anxiety, depression, trauma, and ADHD are common and drive relapse if left untreated, which is the focus of dual-diagnosis care.
- Aftercare and relapse prevention, including peer support and naloxone on hand.
At Moving Mountains Recovery in Randolph, NJ, we help clients access detox placement when medical withdrawal support is needed, and we provide Partial Care (PHP), Intensive Outpatient (IOP), and Outpatient (OP) care. Learn more about cocaine, heroin, fentanyl, and polydrug abuse treatment. Call (973) 453-0317 or verify your insurance.
Frequently Asked Questions About Speedballing
What is a speedball?
A speedball is a combination of a stimulant, such as cocaine or methamphetamine, and a depressant, usually heroin or another opioid like fentanyl. Common combinations include cocaine with heroin, cocaine with fentanyl, meth with heroin, and meth with fentanyl. The combination is extremely dangerous and a leading cause of fatal overdose.
What does speedballing feel like?
People describe an intense rush of energy and euphoria combined with sedation, often with sweating, a racing heart, and dizziness. But the feeling is deceptive: each drug hides the other’s effects, so people may take more than they realize. Many also describe memory gaps and near-collapse, which are warning signs.
Why is speedballing so dangerous?
The stimulant and the opioid mask each other, so people feel less affected and take more. Because cocaine wears off faster than many opioids, breathing can slow or stop once the stimulant fades. The stimulant also strains the heart, raising the risk of heart attack, stroke, and seizures. Fentanyl contamination adds to the danger.
What are the signs of a speedball overdose?
Signs include very slow or stopped breathing, blue or gray lips, being unable to wake the person, chest pain, seizures, a very fast or irregular heartbeat, high fever, and severe confusion. Because the drugs have opposite effects, symptoms can look like either a stimulant or an opioid overdose. Call 911 immediately.
Is there fentanyl in speedballs?
It can be. Illicit cocaine, meth, heroin, and counterfeit pills can be contaminated with fentanyl, which is deadly in tiny amounts and can’t be seen, smelled, or tasted. Contamination is often uneven, so one dose may carry far more fentanyl than another. This is a major reason speedball overdoses are so deadly.
Does Narcan work on a speedball overdose?
Narcan (naloxone) reverses the opioid part of the overdose, which is usually what stops breathing, but it does not reverse cocaine or meth. Give it if you have it, and always call 911. Its effects can wear off in 30-90 minutes, so the person must be monitored and may need more than one dose.
Is mixing meth with opioids also called speedballing?
Yes. Speedballing refers to combining a stimulant with a depressant. While it classically meant cocaine and heroin, it now includes meth with heroin or fentanyl. Meth lasts longer than cocaine, but the same masking effect and overdose risks apply.
How is speedball addiction treated?
Treatment typically combines medication for opioid use disorder (buprenorphine, methadone, or naltrexone) with behavioral therapy, such as CBT, contingency management, and the Matrix Model, for stimulant use. It also addresses co-occurring mental health conditions and includes aftercare. Moving Mountains Recovery can help at (973) 453-0317.
References:
- Science Direct: Cocaine and speedball users: Differences in psychopathology
- National Institute of Health (NIH): Discriminative stimulus effects of a cocaine/heroin “speedball” combination in rhesus monkeys
- National Institute of Drug Abuse (NIDA): Research on Heroin
