Polydrug Use: Mixing Cocaine & Heroin

Mixing drugs is a dangerous practice.¹ Combining drugs such as heroin and cocaine can have unforeseen and lasting consequences.¹ This page will explore polydrug misuse, and the difference between cocaine and heroin and their effects, both alone and in combination.

What Is Polydrug Misuse?

Polydrug misuse is the practice of ingesting multiple substances within a short time frame, regardless of if it’s intentional or not.¹ For example, some people may mix stimulants with depressants in an effort to balance out the undesirable effects of one with the other, while others may drink alcohol with certain drugs, like benzodiazepines and opioids.¹

Polydrug misuse can also be unintentional, such as when a person is unaware that a substance they are using is cut with another substance (such as fentanyl).¹

Regardless of how or why someone engages in polydrug misuse, combining various substances can be unpredictable and lead to a life-threatening overdose.¹

What Is Cocaine?

Cocaine is a stimulant substance that is derived from the coca plant, which is native to South America.² It is a Schedule II drug, meaning that it possesses high potential for misuse and addiction.² Healthcare providers can use it for valid medical purposes, such as local anesthesia for some surgeries, however, cocaine is otherwise an illegal substance in the United States. Despite this, approximately 4.8 million people in the United States reported using cocaine in 2021.³

Cocaine can be used as a white powder or a solid rock-like form (known as freebase or crack cocaine).² In the powder form, it can be snorted, mixed with water and injected, or rubbed on the gums.² Crack cocaine is used a bit differently, as it is generally heated and smoked, however no matter how it is consumed, cocaine can produce a variety of different effects.²

Effects of Cocaine

Cocaine use can lead to the development of dangerous side effects of cocaine, even if used only one time.² The amount taken, route of administration, and frequency of use are all factors that can affect the duration and severity of its effects.²

Some side effects of cocaine use may include, but are not limited to:²

• Increase in energy.
• Talkativeness.
• Temporary decreased need for food and sleep.
• Increase in body temperature.
• Increased heart rate.
• Elevated blood pressure.
• Aggression, anxiety, and paranoia.
• Tremors or muscle twitches.

Some of the most concerning effects of cocaine use can include those that can be life-threatening, such as heart attacks, seizures, strokes, coma, or even sudden death.²

Long-Term Effects of Cocaine Use

Cocaine has been shown to negatively impact the cardiovascular system in both the short and long-term, and long-term or regular use can increase the risk of potentially long-lasting detrimental cardiovascular effects. Inflammation of the heart muscle (myocarditis), aortic ruptures, and the inability for the heart muscle to properly contract (cardiomyopathy) are associated with long-term cocaine use.² Additionally, long-term cocaine use can also lead to obstruction of a coronary artery (myocardial infarction), heart failure, arrhythmias, and infection of the heart’s inner lining/valves (endocarditis).⁴

There are several other potential long-term effects and health risks associated with chronic cocaine use, some of which include:

• Lung tissue damage and worsening of asthma or other chronic pulmonary conditions.
• Increased risk of stroke.
• Increased risk of HIV or hepatitis.
• Increased risk of Parkinson’s diseases or other movement disorders.
• Cognitive impairments such as diminished memory, attention problems, and difficulty with motor skills.

Additionally, the changes that occur in the brain in response to chronic cocaine use can result in a cocaine addiction.² At that point, not only are there physiological adaptations that have occurred, but the individual is likely also experiencing significant negative consequences affecting all aspects of life, including social, familial, occupational, and environmental changes, too.² This can create long-term impacts not only on the individual misusing cocaine, but on those around them as well.

What Is Heroin?

Heroin is an illicit and highly addictive opioid drug derived from morphine, a naturally occurring opioid.⁵ It is available as a white or brown powder (which is often mixed with impurities like starch or sugars or cheap, synthetic opioids like fentanyl) or used as a black tar or coal-like substance.⁵ People may snort, smoke, or inject heroin to achieve its effects.⁵

Effects of Heroin

Heroin acts on the brain’s opioid receptors, causing a surge of pleasurable sensations. The intensity of this “rush” is dose dependent and related to the method of administration, which impacts how quickly the drug reaches the brain. Opioids like heroin also depress breathing and block pain messages transmitted to the central nervous system (CNS).⁵

When opioid receptors in the brain are activated, the brain’s reward system is also impacted, reinforcing drug taking behavior which can cause the person to desire and take heroin repeatedly.⁵ Heroin use also produces several side effects.⁵

There are several potential effects that can occur because of heroin use, regardless of how short or long a person has been misusing it for. Some of these side effects of heroin can include, but are not limited to, the following:⁵

• Dry mouth
• Feeling of heaviness in the limbs
• Nausea or vomiting
• Constipation
• Impaired ability to think clearly
• Slowed or irregular breathing
• Slowing of heart rate

The effects experienced by someone using heroin can vary depending on the amount used, the duration of use, and the method of administration.⁵ Some people use heroin repeatedly, which can lead to effects associated with long-term or chronic heroin use, including heroin addiction.⁵

Long-Term Effects of Heroin Use

Chronic use of heroin is associated with certain long-term effects or health risks.⁵ It is a powerful drug that can create physical and chemical changes in the brain that may last even after a person stops using heroin.⁵

Health risks or effects associated with long-term heroin use may include:⁵

• Insomnia.
• Lung disorders (such as pneumonia or tuberculosis).
• Depression.
• Scarred or collapsed veins.
• Blood infections.
• Skin or soft-tissue infections.
• Infected heart valves.
• Clogged blood vessels.
• Increased risk of HIV and hepatitis.
• Reduction in decision-making, behavioral regulation, and stress response abilities.

Heroin use can also lead to dependence and addiction. Dependence and addiction are two separate phenomena. Dependence refers to the body’s natural adaptation that leads to withdrawal symptoms when someone decreases or stops their use of an addictive substance such as heroin.⁶ Addiction, on the other hand, refers to the loss of control over consuming drugs despite the negative consequences of doing so.⁶

Risk of Overdose

In taking any drug recreationally, there is a risk of overdose. Nearly 20,000 people died from cocaine-involved overdoses in 2020, and over 13,000 from heroin-involved overdose.^2,3  Additionally, a whopping 80,000+ people died in 2021 from opioid-involved overdoses, a major increase from 2020, where 57,834 people lost their lives to the same type of overdose.¹⁰

People combining drugs may believe they can safely monitor how much they have taken within a given time frame, but combining drugs is notoriously unpredictable. When a stimulant like cocaine is combined with an opioid like heroin, the risk of overdose increases.¹ As previously mentioned, cocaine wears off much more quickly than heroin, which can more easily lead to a heroin overdose.² Additionally, certain overdose symptoms of one or both drugs may be masked by the other, leading the person to believe that they are safe to take more of either drug.¹ This impression of false safety also increases the risk of overdose.¹

Treatment Options for Polydrug Addiction

Substance use disorders can be treated. Many rehabs across the country offer specialized treatment plans for people struggling with addiction to one or multiple substances.

Desert Hope Treatment Center in Las Vegas offers treatment for cocaine and heroin use disorders alongside many other services. Our professional staff is available 24/7 to help with any questions you may have regarding types of addiction treatment, insurance coverage, handling the cost of rehab, or types of rehab.

If you or a loved one are currently struggling with a substance use disorder, you can consider getting started with medical detox and continuing your journey at Desert Hope inpatient rehab in Las Vegas. Don’t wait – if you start the admissions process today, it may save your life tomorrow.

Get started by having your insurance verified and filling out our secure online .