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We need more scientific research about drug combos

SpiralusSancti

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Feb 2, 2023
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How often two or more drugs is significantly worse in combo then each alone?

I have a hunch that many usual drug combos are. One kinda unexpected example know rather good is alcohol + cigarettes is worse than each one alone. Why and by what extent exactly it’s hard to estimate but it’s fact/definitely statistically significantly less harmful to do just one at a time. It’s a fact that coke is worse with alcohol, even worse than ethylcocaine alone (studies on animals are quite conclusive and it’s almost sure it’s same for humans). Than, take MDMA, everyone knows how bad it’s with alcohol but do you know it’s bad with, wait for it CAFFEINE, it raises body temperature significantly, if my memory serves me good, it’s about 1 Celsius, and everyone knows fever is NOT GOOD FOR YOUR BRAIN! I kinda like this combo, used to drink a cup of coffee with M as it otherwise it can get me into melting from pleasure state from solid dose when sometimes I want that intensity but to stay active. From 125mg, nah you are good, but from 250 - 300mg of pure MDMA will render you a high, that’s most certainly too intense for most social events, but even coffee can change that. Still wouldn’t recommend it if people around you dose 125mg as amount of….ehh….entheogenic effects might be disproportional. Speed works just as good or even better, but you need just a tiny amount if you dose that high, if doing smaller dose you can mix it almost 50/50 for a waaaaay longer experience, really modified and more intense in one way and less intense in another compared to dose of MDMA alone! Kinda same for meth, except you it’s better to keep dose very low in any case. With numbers I see today and prevalence of 225 – 260mg pills I sometimes think, what the fucking fuck. First pill I took was 90 – 115 rage pill and it was it, beautiful, fucking intense, life changing roll. Took it another once a that dose and few times 1 or 1.5 and than hour latter one more pill, well fuck meeeeeeee, that was BRUTALLY intense. Real MDMA and mehDMA aside, pills are in upper strong level and heavy for some skinny girl. And guess what, loads of people will take more than one, same as with low – medium dosed pills (70 – 130), or strong pills (140 – 180) and many will pop few or more than a few during night, WTF!? That’s how you get people who combine MDMA with alcohol, downers and opiates, energy drink and some even cocaine as in monster doses it’s some kinda of monster high. Many of that doses are BAD. And look at some other trend in pills, “dirty pills” are RARE! And by dirty I mean one with caffeine, ampthetamine, meth and arguably for some even MDA. Why? Not because people like MDMA by itself best, o now. Even those who strongly consider HARM REDUCTION at least combine it with weed, psychedelics or disssos or at least use something after most of the effects are gone and that way it’s much easier to use MDMA more often as comedown is easier and Monday blues is rare for someone who’s a stoner during week. Hope you get where I’m going with this? It’s a huge problem with otc supplements and all kind of remedies as lot of people is stacking and even less chemically, pharmacologically, neurobiologically and otherwise similary impaired rarely can stack 10 usual supplements of any kind and use without disregarding for important reason why not to combine A and B or at the very least why you have to adjust dose, dosing schedule or whatever parameter to avoid some kind of damage but LUCKILY there’s not many nootropic combos that’ll lead to serotonin syndrome, paradoxical effects, potentateon in odder of magnitude and such things and when there is, meh, you might not even notice but with drugs it’s a lot more often if something like that or similar happens with some multi drug combo, you might be fucked.
 
Cocaine and ethanol together is worse than either alone. It creates cocaethylene which is more lethal (LD50 in rats is 2/3 that of cocaine), more cardiotoxic (as if coke wasn't bad enough), it's actually an SNDRI (which means if you mix certain things with your coke and alcohol you could end up getting serotonin syndrome), it has a longer elimination half-life, and apparently it gets you higher than cocaine by itself.
 
Alcohol is one that's really bad to mix IMO. Not always, like alcohol and opioids *shouldn't* be mixed by I had a 5 year overlap between the two and never OD'd. Still dangerous, though.

Alcohol and Cocaine metabolizes into cocaethylene. Cocaine is cardiotoxic in itself, but cocaethylene is several time MORE cardiotoxic. Plus because alcohol lasts so much longer than cocaine, you can feel not-that-drunk or-sedated...then the coke wears off and you're suddenly dangerous sedated. I've seen people who mixed these who only seemed a little drunk while doing a lot of coke, then 20 minutes later suddenly black out or become incoherent.

You should be super-careful mixing it with benzos or barbiturates soon.

Oh and NEVER mix alcohol and GHB unless you want a fast-pass to the afterlife.
 
Yeah, GHB and ethanol is extremely dangerous. Even more dangerous than that is 1,4-butanediol and ethanol. Reason being, 1,4-b and ethanol both get metabolized by alcohol dehydrogenase. 1,4-b metabolizes into GHB via alcohol dehydrogenase, but ethanol is metabolized first, if you should be taking both at once. So it is extremely easy to overdose, because you can be dosing 1,4-b along with alcohol, and you won't feel it until the alcohol is metabolized. Whereupon you will suddenly get a bunch of GHB dropped into your bloodstream very rapidly, and as mentioned, GHB and alcohol is very dangerous,. it's really easy to overdose.

This combo is the only time I have ever overdosed, and I have spent 12 years of my life in total addicted to opiates. Even though I knew what I just explained, I got cocky. I drank a few shots, and wasn't going to take any 1,4-b that day, but once I got a little drunk, I changed my mind, and dosed my normal dose of 1,4-b. Then stupidly though, oh, I don't feel it, I guess I must have tolerance. Dosed again, still didn't feel it. Dosed again; now I had 3 times my normal dose of 1,4-b than I would normally take to get nice and high on GHB. I went for a walk in the woods. Thankfully, I got home before it started to metabolize, although I was stumbling by the time I got home.

Last thing I remember was going into the bathroom, and I vaguely remember laying on the floor. Next thing I know, I was in an ambulance, with paramedics shouting in my face. I was incredibly confused, I didn't remember anything from that day. I couldn't even tell them what my name was, I seriously had absolutely no idea what was happening. At the emergency room, I got lectured by multiple doctors. Finally, they gave me my phone back and I called my girlfriend, and she asked me, through her tears, if I had taken GHB. Then like lightbulb went off, I remembered it all. She had called my friend, who knew I had some 1,4-b, and suggested to her that it was probably that.

What had happened was, she found me unresponsive on the bathroom floor. I was breathing really unevenly and no matter what she did, I wouldn't respond at all. She had no idea what was happening, but knew I used to be an opiate addict, so she knew I might die and had surely overdosed on something. So she called 911. They came over, gave me narcan, which did nothing, and then loaded me onto the ambulance. Apparently the cops stayed and tied to get her to tell them where I got the "heroin", and tried to get her to let them search the house (thankfully she said no, because she knows I have a massive collection of drugs). She said the paramedics were trying to get the cops to leave with them and they all did except one cop, who she said made her nervous. Finally he did leave. Then she called our friends, trying to figure out what was going on.

At the ER, they kept telling me to admit that I had shot up heroin... I was like guys, listen, I can't remember what happened but I KNOW it wasn't heroin (at the time I was still 5 years clean from opiates... unfortunately I relapsed a while after that, meh). They were like okay then, well we can't rule out brain damage, if it isn't drugs, then it's even more concerning. They gave me an MRI and some other tests, and after that was when I called my girlfriend. I tried to tell them it was GHB once I remembered, but they thought I was lying, and recorded it as a heroin/fentanyl overdose... which I told them was obviously not true, since narcan didn't do anything (they gave me 3 doses before I came to, and I came to without being in PWD and still massive fucked up). So dumb.

Anyway, I asked to leave, although they tried to get me to stay overnight. My friend came to pick me up, and I went home and felt really stupid, and grateful to be alive. My bill would have been upwards of $50,000, except I have insurance, so I paid $150 copay plus my yearly deductible which was $400.

In any case... my point is, don't combine GHB and alcohol... and especially don't combine 1,4-b and alcohol. At least if it had been actual GHB, I would have gotten fucked up as I expected and stopped before I overdosed (hopefully anyway).
 
That explains a lot. I think that’s one of reasons GHB and relatives have that bad reputation. I honestly never really gone into why exactly GHB – alcohol is a – steer away from it combo – and just though it’s a plain logic because both drugs are downers, both need to be metabolized by liver and you need gram doses of both, both even alone are known to knock out people or at least lower inhibitions to dangerous levels (alcohol way more), sweet spot for G is is narrow range etc...
Once GHB – GBL combo did knocked me out once, I passed out during sex, behind the girl I was with but I was still 3 – 4x away from any kind of dangerous dose. All other times I managed to keep it in order, and I think if it was GHB or GBL alone and not GHB – GBL combo that time, it wouldn’t happen. Latter I found out some friends had their share with G years before me, someone figured out litres of it are barging (GBL was still legal in Germany, isn’t any-more right?) and whole party of those people mixed GHB with alcohol for months and months during weekends and no one ever OD, fatally or enough to be hospitalized, honestly I thought that’s weird but though ,fuck they must have a huge alcohol tolerance so that’s why …..

Only approved treatment for G overdose as far as I know is monitoring and sustaining body functions until it clears out were approved but there was some substance in development but still in a experimental phase many years ago, idk if there were any real improvement with that.
 
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