Cocaine and heroin are used together in what is known as a speedball.

The stimulant effect of cocaine combined with the depressant effect of heroin makes for a potentially deadly drug combination. Speedball addiction, though not as common as heroin or cocaine addiction, does occur and is a highly dangerous pattern.

The high from a heroin cocaine speedball is very addictive. The elevated risks presented by both drugs make it especially difficult for speedball users to survive long periods of time using these two drugs together.

The Breakdown: Cocaine and Heroin

Cocaine is one of the most addictive drugs available to chronic drug abusers. Once a person tries the drug and experiences its euphoric effects, which may last only a few short minutes, the focus soon becomes entirely how to obtain more of the substance.

Cocaine may appear as a loose white powder or, as crack cocaine which are small light brownish colored rocks. Cocaine is consumed by sniffing or snorting it through the nasal passages, by injecting it intravenously or smoking it via a pipe.

Crack cocaine is generally smoked. If someone is regularly snorting cocaine, they might carry the drug folded up paper, plastic bags or small plastic or glass viles. A razor blade may also be present as cocaine paraphernalia as well as a rolled up dollar bill, both of which can be used to portion out the drug and snort it.

Crack cocaine users often carry crack pipes with them. These can vary widely, but some are made with aluminum foil or soda cans. Crack is processed from cocaine into the rock form that can be smoked.

The way in which the drug is consumed (by snorting, smoking or injecting) may determine the intensity and/or duration of the cocaine high. Generally speaking, a high achieved intravenously or by smoking crack cocaine tends to be shorter and more intense than one achieved by snorting the substance. Further, the euphoria and peaked energy/emotion temporarily produced by a cocaine high classifies it as a powerful stimulant drug.

If you suspect someone you know may be using cocaine, look for some of the following warning signs:

•    Dilated (large) pupils
•    Increased temperature
•    Increase in heart rate
•    Increase in blood pressure
•    Hyperstimulation (or being overly excited)
•    Nervousness
•    Anxiety
•    Sweating
•    Paranoia
•    Restlessness
•    Aggressive Behavior
•    Depression

Unlike cocaine, heroin is a central nervous system stimulant drug. The intense high caused by ingesting (by smoking or intravenously injecting) heroin can cause drowsiness, nodding off, slowed breathing and heavy extremeties. Fatal heroin overdose can occur relatively easily as a result of too great an amount of the drug hitting the system, shutting down respiratory function altogether.

The Risk of Speedballing

When heroin and cocaine are consumed together (whether in one syringe in the same arm, or two separate syringes in two arms) presents serious risks. Theoretically, the user seeks to experience both the stimulant effects of cocaine at the same time as the depressant effects of heroin.

Because the two drugs can offset the effects of one another (or negate them entirely), this can make it easy for the user to believe he/she needs more of one or both of the drugs. What is believed to be a higher tolerance may actually end up as a fatal misjudgment, causing death by overdose.

In other words, the presence of cocaine as a stimulant can give a speedball user the false sensation that he/she is able to tolerate excessive amounts of heroin. Once the cocaine has worn off, however, the excessive amount of opioids can prove to be fatal. It is believed by most experts that this delayed opioid overdose is the most common mechanism at work in speedball overdoses.