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Speedball (drug)
Combination of narcotics
Combination of narcotics
Speedball, powerball, or over and under 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.
Speedballs often give stronger effects than either drug when taken alone due to drug synergy, but are a particularly hazardous mixture that can easily cause heart attack, respiratory arrest and death. When compared to single drugs, speedballs are more likely to lead to addiction, relapse and overdose.
History
The classic speedball is heroin and cocaine. It could also mean morphine and an amphetamine.
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.
Pink cocaine or "tusi" usually includes an unknown mix of uppers and downers and is sometimes called a speedball. Cocaine mixed with ketamine is called a CK or Calvin Klein.
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. As of 2023 it is being called the "fourth wave" of the opioid epidemic.
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. Some stimulants, such as cocaine, wear off before most 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.
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.
Notable deaths attributed to speedball use
- Jean-Michel Basquiat (artist, d. 1988), though other sources list his death as heroin overdose only.
- John Belushi (comic actor, d. 1982)
- Ken Caminiti (baseball player, d. 2004)
- Chris Farley (comic actor, d. 1997)
- Pete Farndon (rock musician, d. 1983)
- Zac Foley (alternative rock musician of the band EMF, d. 2002)
- Trevor Goddard (actor, d. 2003)
- Mitch Hedberg (comedian, d. 2005)
- Philip Seymour Hoffman (actor, d. 2014)
- Sebastian Horsley (artist and writer, d. 2010)
- Chris Kelly (rapper of the duo Kris Kross, d. 2013)
- Brent Mydland (musician, d. 1990)
- River Phoenix (actor, d. 1993)
- DJ Rashad (musician, d. 2014)
- Judee Sill (singer-songwriter, d. 1979)
- Layne Staley (singer-songwriter, d. 2002)
- Joey Stefano (actor, d. 1994)
- Michael K. Williams (actor, d. 2021)
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.
- Also in 1996, pop-music singer Dave Gahan suffered a heart attack following a speedball overdose, but survived.
- 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.
References
References
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- (1992). "Buprenorphine attenuates drug craving in men with concurrent heroin and cocaine dependence". Problems of Drug Dependence.
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- "Definition of SPEEDBALL".
- (2019). "2019 National Drug Threat Assessment". [[Drug Enforcement Administration]].
- Wiginton, Keri. "Pink Cocaine: Risks, Effects, and Treatment". WebMD.
- (2023-12-11). "So-Called ‘Speedball’ Mixtures of Fentanyl and Stimulants Now Account for Most SF Overdose Deaths". SFist - San Francisco News, Restaurants, Events, & Sports.
- (July 9, 2024). "Stimulant users caught up in fatal 'fourth wave' of opioid epidemic". NPR.
- (2023-09-16). "How the fentanyl crisis' fourth wave has hit every corner of the US".
- (March 8, 2024). "Speedballing: The Current Fourth Wave of the Overdose Crisis". Psychology Today.
- (2022-06-07). "What Everyone Should Know About the Risks of Speedballs - RAYSAC".
- (2022-06-01). "Here’s What Happens When You Mix Cocaine and Ketamine". VICE.
- "Death by Drugs: Fatal Celebrity Drug and Alcohol Addictions". Gatehouse Academy.
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- Dowd, Vincent. (25 September 2017). "Jean-Michel Basquiat: The neglected genius". [[BBC News]].
- Litsky, Frank. (2 November 2004). "Report Says Overdose Killed Caminiti". [[The New York Times]].
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- Henke, James. (26 April 1984). "Chrissie Hynde Without Tears".
- Peacock, Tim. (1 October 2002). "Obituary: Zac Foley". Whisperin' and Hollerin'.
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- (27 December 2005). "Report: Mitch Hedberg died of drug overdose". [[Today (U.S. TV program).
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- (18 June 2010). "UK artist Sebastian Horsley dies of overdose". [[NineMSN]].
- Markman, Rob. (2 May 2013). "Report: Kris Kross' Chris Kelly Autopsy Complete". [[MTV]].
- (11 August 1990). "Grateful Dead Member Died of Drug Overdose". [[Los Angeles Times]].
- Mydans, Seth. (13 November 1993). "Death of River Phoenix Is Linked To Use of Cocaine and Morphine". [[The New York Times]].
- (October 17, 2013). "River Phoenix's Tragic Overdose: Dan Aykroyd Warned Him About Heroin Dependency".
- Michaels, Sean. (8 Aug 2015). "House artist DJ Rashad died of a drug overdose, post-mortem confirms". [[The Guardian]].
- Alfonso, Barry. (2002). "The Billboard Guide to Contemporary Christian Music". Billboard Books.
- (8 May 2002). "Report: Staley Died of Heroin/Cocaine Overdose".
- (23 November 2000). "Who's Who in Contemporary Gay and Lesbian History Vol.2: From World War II to the Present Day". Routledge.
- (24 September 2021). "Medical Examiner Reveals Cause of Death for Michael K. Williams".
- Himmelsbach, Eric. (8 July 2004). "Little Drummer Boy Lost". Southland Publishing.
- Davis, Johnny. (28 October 2007). "This Much I Know: Dave Gahan, singer, 45, London". [[The Observer]].
- Hudson, Saul. (2007). "Slash". HarperEntertainment.
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