• N&PD Moderators: Skorpio | someguyontheinternet

Combining stimulants and depresants - what is the real risk?

I'm pretty sure the only reason they're bad is because their effects seem cancelled out to users, leading them to take more than they can handle of one or the other..

...leading to eventual overdose. Exactly.

While using [Cocaine+Heroin] 'speedballs' about 345 days out of the 365 days in a year, I would notice that I could inject up to 3 grams of very, very high grade tar and 3 grams of Cocaine of the same quality within a 24 hour period (honest to god). The compulsive feeling of the need to re-dose from the Cocaine along with the feeling of the need to add the Heroin to "take the edge off" would lead to constant re-dosing, in absurd amounts.

However, on those [around] 20 days throughout that year that I did not use Cocaine, I would get by on under a gram of Heroin in a day, no problem. The only issue was that since 98% of my veins (aside from my neck, femoral and penis, which I refused to use, although I did tie them off a few times whilst sick and not able to find a vein. very, very surprisingly, logic+safety came into play and i never used them.) were collapsed from the chronic use of tar and the constricting properties of the Cocaine over the long periods of use, I would almost always have my shots 'leak'. Meaning that when I would find a vein, it was either so damaged that my shots would leak out into the areas surrounding it, or I would miss completely. On many occasions, this caused me to tolerate being sick for extended periods of time until I could secure Cocaine to add to the tar (for numbing effects), because the tar on it's own would burn *severely* without the Cocaine in it, especially when I was injecting in more painful areas like my feet, toes, hands, fingers.

So ultimately, there are many dangerous factors that come in to play when combining stimulants with depressants (primarily intravenous use of Opiates/oids with Stimulants). The main two, in my opinion, being: a) compulsion to re-dose (from the stimulant) and b) urge to take more of the depressant to "take the edge off". And the wheel just turns and turns...
 
Paramedic here, I have only seen people stop breathing from opiates when they fell asleep (or are unconscious) . Their Resp rate is usually about 7-8 Breaths a minute while awake then slows to 3-6 when sleeping. Normal RR is 12-20 while awake and 10-12 minimum while sleeping. If you take enough H to OD though you usually will black out, then stop breathing. This question asked by the OP is a good one but there is no definite answer. It depends on the drugs taken, the amounts taken, the useres tolerance, comorbidities etc. etc. A lot of people that OD on drugs have mixed them thus causing death. Cocaine and Alcohol for example is an ER docs worst nightmare treatment wise. The coke and Etoh mix and create a toxic 20 times deadlier that either drug alone. I would guess that the safest downer to mix with an upper would be a mild dose of a Benzo. They're given in the ER ll the time for various reasons. Anti seizure, Meth overdose, anxiety etc. Anyway we could talk about this all day but the best answer is the less drugs in your system, the better.
 
using a benzo prevents the acquisition of behavioral sensitization to stimulants
 
I assume you are talking about cocaethylene. Can you substantiate your 20 times 'DEADLIER' figure?

Cocaethylene toxicity.
Andrews P.

Kentucky Correctional Psychiatric Center, Louisville, USA.
Abstract
Concurrent use of cocaine and alcohol produces another psychoactive substance known as cocaethylene which has pharmacological properties similar to that of cocaine but which has a plasma half-life three to five times that of cocaine. This slow removal from the body makes it an attractive drug for abuse. However, cocaethylene has been associated with seizures, liver damage, and compromised functioning of the immune system. It also carries an 18- to 25-fold increase over cocaine alone in risk for immediate death.

PMID: 9243342 [PubMed - indexed for MEDLINE]


The risk for immediate death is a lot higher, so I'd say on acute toxicity he's on point.
 
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