Mixing Cocaine and Heroin: Effects and Dangers

Taking different drugs, such as cocaine and heroin, at the same time or within a short period of another, can cause unexpected or dangerous effects.¹ In this article, you’ll learn about polysubstance use, the effects of cocaine and heroin, the dangers of speedballing, and treatment for substance use disorder.

What Is Polysubstance Use?

Polysubstance use is the practice of using more than one drug (or drug/s combined with alcohol), at the same time.¹ It may be done intentionally or unknowingly (for example, when a drug is laced with another unknown drug).¹ People may engage in polysubstance use to try to enhance or reduce the effects of a particular drug.¹ Other reasons may be to experience the combination–but the effects are unpredictable.¹ Studies have shown that between 30–80% of heroin users reported also using cocaine.² Deaths involving cocaine and opioids, such as heroin, rose from around 10,000 in 2017 to nearly 40,000 in 2021.³

Unregulated drugs purchased on the street are often mixed with undetectable substances like fentanyl.¹ People purchasing these drugs are at risk of unknown polysubstance use and the associated dangers such as overdose.¹ Whether or not an individual is aware of it, combining drugs (including some over the counter and prescription drugs) is never safe.¹ In fact, 50% of overdose deaths in 2019 involved multiple drugs.¹

Effects of Cocaine Use

Cocaine is a stimulant drug with incredibly addictive effects.⁴ The short-term effects may be desirable for some, but may also include some dangerous or unwanted symptoms.⁴ Short-term effects of cocaine use may include:⁴

Effects of Heroin Use

Heroin is an illegally formulated opioid derivative that is sold on the street as a brown or white powder, or a sticky substance (black tar heroin).⁵ Heroin acts quickly in the brain and body and produces desirable and undesirable effects, including:⁵

What Is Speedballing?

Speedballing is the practice of intentionally mixing heroin with cocaine.⁵ Both drugs can be injected or smoked at the same time, which produces rapid effects.^4,5 While some may believe that the combination of a stimulant and depressant may balance out their effects, that is not the case.¹ Certain effects of each drug may be masked by the other, which ultimately increases the risk of dangerous side effects.¹

Dangers of Speedballing

As with any polysubstance use, speedballing is extremely dangerous.¹ The combination of the two drugs can mask each other’s effects, which may lead a person to believe they are less affected by one or both drugs.¹

Also, cocaine is metabolized by the body quicker than heroin, which may lead to taking another combined dose before the heroin wears off.⁴ Either of these experiences can quickly lead to overdose.⁴

Long-Term Effects of Cocaine and Heroin

In addition to the short-term risks, cocaine and heroin both have long-term effects on a person’s health.^4,5 As highly addictive drugs, both may lead to physical dependence and taken stopped or cut down, withdrawal symptoms can occur.^4,5

Long-term effects of cocaine use partially depend on the method of administration, but may include:⁴

Depending on the method of administration, long-term effects of heroin use may include:⁵

Cocaine and Heroin Addiction Treatment Programs

There are many treatment options for people who find themselves struggling to control cocaine or heroin misuse. Substance use disorder treatment centers provide an initial evaluation to determine which course of treatment would benefit the individual. During the treatment process, a person seeking help may partake in one or more of the following stages of recovery:

• Detox—During detox, the body is cleared of the drug/s, but patients may experience several unpleasant side effects (withdrawal) as they adapt to functioning without the drug.⁶ Medication can be used during detox to minimize the withdrawal symptoms and help patients recover safely.⁶
• Inpatient care—Inpatient care consists of 24/7 support and treatment in a controlled and drug-free environment.⁶ An individual’s length of stay in inpatient care may vary, but consists of highly structured time and connection to therapy and resources that can help a person create healthy habits and heal from chronic drug use.⁶
• Outpatient care—Outpatient treatment allows a person to live at home while undergoing treatment. Programs vary in intensity and time commitment. Some may be comparable to inpatient treatment, while others require minimal weekly meetings.⁶
• Aftercare—Aftercare is ongoing support a person may receive after a more formal treatment plan.⁴ It may consist of mutual support groups, ongoing therapy, addiction medication, or other methods.⁴

Upon admission into a treatment program, each person is evaluated to establish a diagnosis and any co-occurring disorders.⁶ The type and length of treatment program is determined on an individual basis based on the needs of the patient.⁶ However, most programs incorporate various forms of behavioral therapy.⁶

Cocaine and heroin can both present with extremely uncomfortable withdrawal symptoms, so medication may be used during detox.⁶ To maximize relapse prevention and enhance therapeutic outcomes in people who have used heroin, medication is often available throughout treatment.⁶

To discover the best path to recovery, it is best to consult a doctor or mental health professional. Contact American Addiction Center’s helpful admissions navigators at for a free, private consultation today on cocaine and/or heroin addiction treatment programs.

Finding a Rehab to Treat Polysubstance Use

If you or a loved one are struggling with polysubstance use, help is available. Programs are available across the United States. When choosing a treatment center, one might consider:

• Accreditation status: Are the staff and facility accredited or certified to treat substance use disorders?
• Location: Do you want a local program? Would you rather travel/get away?
• Levels of treatment: Are detox, inpatient care, and outpatient care all available?
• Availability of medication: Do you need addiction medication for recovery or other medical conditions during treatment?
• Insurance acceptance: Is your health insurance accepted there?
• Other amenities: Are you seeking a specific form of therapy or have personal needs outside of treatment?

The treatment directory tool on Rehabs.com can help you find polysubstance rehabs that fit your needs. The search can be done online, but helpful admissions navigators are also available by phone to assist you at any time. Start on your path to recovery today. Call for a free, confidential consultation at .

You can also look at the facilities listed below to see if they provide the program you are looking for:

• California: Laguna Treatment Center
• Florida: Recovery First Treatment Center
• Florida: River Oaks Treatment Center
• Nevada: Desert Hope Treatment Center
• Mississippi: Oxford Treatment Center
• Texas: Greenhouse Treatment Center

Verify Your Insurance Benefits to Cover Polysubstance Treatment

Using health insurance can be incredibly helpful in paying for substance use disorder treatment. Many insurance plans provide some coverage for treatment, but every plan is different. Some insurance plans may require that you be treated by certain providers, have varying co-pays or deductibles, or maximum out-of-pocket costs. You can explore your coverage by calling your insurance company or using our online tool to verify your insurance.

Coverage may vary depending on your needs and insurance plan. To find out if your policy covers rehab, click here, or fill out the form below. Your information is kept 100% confidential.

If your plan does not cover treatment, does not cover enough to be affordable, or you do not have insurance, other forms of payment are available. Paying without insurance may involve attending a publicly funded rehab, arranging sliding scale payments, or applying for reduced-cost treatment with programs that offer it. Be sure to consider all your options before you rule out rehab because of cost.

You can also click here to find a rehab near me.

If you would like more information about cocaine and/or heroin addiction treatment options available in your area, contact American Addiction Center’s professional and compassionate admissions navigators at for a free, private consultation today. We’re here for you 24/7.