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The Dangers Of Mixing Opiates And Amphetamines

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

January 29, 2019

Opiates and stimulants are some of the most commonly prescribed and abused drugs in the United States. Opiates depress the central nervous system (CNS), while amphetamines cause the CNS to speed up. When taken together, a person’s breathing, blood pressure, heart rate, and temperature are simultaneously being instructed to rise and fall. This leaves the cardiovascular and respiratory systems dangerously vulnerable to overdose and other adverse health effects.

The Basics: Understanding The Difference Between Depressants And Stimulants

Your central nervous system regulates basic functions within your body which are responsible for life support. These functions include blood pressure, breathing, heart, and temperature rates. Certain drugs have a profound capacity for derailing your CNS system when abused. When this occurs these critical life support functions begin to go haywire.


Stimulants, or “uppers,” do as their name suggests; that is, they speed up and activate these systems. Stimulants have a high potential for abuse due to the way they create the following states. These drugs make a person more:

  • Alert
  • Energetic
  • Physically active
  • Wakeful

Stimulants are known for the way they suppress appetite, decrease the perceived need for sleep, and boost mood and a general sense of well-being.

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Depressants, or “downers,” exert an opposite effect on your CNS. This occurs due to the way activity is slowed within your brain. As this happens, a person’s breathing, blood pressure, heart, and temperature rates begin to drop. If a person is taking larger quantities of these drugs and/or frequent doses (as within abuse and addiction), these effects are experienced in a capacity which can lead to overdose or death.

What Is An Opiate?

An opiate drug is one which is derived from the opium poppy. These include the illicit drug heroin, opium, and the prescription medications codeine and morphine. An opioid is a term used to describe drugs which create an opiate effect, but may also be used to refer to both. The opioid classification contains the following prescription painkillers:

  • Fentanyl (Duragesic)
  • Hydrocodone (Vicodin)
  • Hydromorphone (Dilaudid)
  • Meperidine (Demerol)
  • Methadone
  • Oxycodone (OxyContin)
  • Oxymorphone (Opana)

While opioids can produce a sedated and relaxed state, they are most known for their ability to produce an analgesic (pain relieving) effect. They also produce a euphoric state. Both of these characteristics draw people into the world of drug abuse. But another attribute common to these drugs can be deadly.

Opioid drugs depress your CNS and produce respiratory depression. This means your breathing rate begins to slow or even becomes irregular. When abused, this impact is more heavily felt in a way which can lead to overdose, coma, and death.

Drug abusers administer opioids multiple ways, depending on the drug of abuse. Heroin may be injected, snorted, or smoked. Certain prescription opioids may have their form altered and be used these ways. Or an individual may swallow or chew large amounts of painkillers in the hopes they’ll produce an intense pleasurable state.

What Are Amphetamines?

The Center for Substance Abuse Research writes that “Amphetamines are a group of synthetic psychoactive drugs called central nervous system (CNS) stimulants.” They continue, informing us that amphetamines contain the following drug types:

  • Amphetamine
  • Dextroamphetamine
  • Methamphetamine

An illicit form of methamphetamine referred to as crystal meth or crank produces hallmark CNS stimulation, similar to prescription amphetamine medications.

Prescription amphetamines are used to treat attention-deficit hyperactivity disorder (ADHD), narcolepsy, binge eating disorder, and in more rare cases, depression. Examples of commonly abused medications with an amphetamine effect include:

  • Adderall
  • Benzedrine
  • Concerta
  • Desoxyn
  • Dexedrine
  • Ritalin
  • Vyvanse

Prescription stimulants have a high rate of diversion and misuse, due to their extreme potential for abuse. These medications may be taken orally, crushed and snorted, injected, or smoked. Breathing irregularities, cardiac arrhythmia, convulsions, coma, and death might accompany an overdose from these drugs.

Why Would People Use These Drugs Together?

Recreational drug abusers use drugs for a variety of reasons. When a person is addicted they’re no longer thinking about the toll the drug takes on their body and brain, but only of their next high. According to the journal Pharmacology Biochemistry and Behavior, here’s the three most common reasons why a person might mix an opioid and stimulant:

  1. To produce a greater than additive effect versus when either drug is taken alone.
  2. To reduce the side effects of one (reducing the agitation from the amphetamine or the sedation from the opiate).
  3. Because “the combination produces unique subjective effects desired by the user.”

Regardless of what your mission is, once you take these drugs you’re no longer in control. What follows can be uncomfortable in the least and deadly in the most severe of instances.

What Happens When You Mix Opioids And Amphetamines?

When you combine an opioid, whether it be heroin or a prescription painkiller, with an amphetamine, the results can be very unpredictable and dangerous. You’re also facing an increased risk for serious addiction.

As each drug creates opposite effects, one may mask the side effects of the other when both are taken together. This can lead an individual to take more of one or both drugs. Even if you don’t feel the effects as acutely, your body is still struggling under the weight of the drugs. This doesn’t just mask the high or rush, it can actually cover up certain side effects of overdose as well.

When you take any combination of an opioid and amphetamine together your body, brain, and organs are pulled in opposing directions. As the brain tries to decipher these clashing messages, the user may suffer severe cognitive impairment. This could cause them to endanger themselves or others around them. Your body may become severely dehydrated or malnourished, which limits the functioning of every organ in your body.

This dangerous cocktail of drugs can also cause damage to your heart, leading to cardiac arrest, heart attack, or heart failure. Beyond these risks, you could have a stroke or struggle to breathe. Critical life support functions may begin shutting down, leading to:

  • Seizure
  • Coma
  • Overdose
  • Death

If you’re tempted to speedball, please consider these risks before you inject. Any form of drug abuse or addiction is a serious matter. But if you’re addicted to one drug and abusing another on the side, or if you’re addicted to both, you’re in dire need of life-saving care.

Getting Treatment For Polydrug Abuse

An inpatient drug rehab center is best equipped to handle polydrug abuse. Many facilities have a medical detox on site. This is a great benefit for those who are addicted to opioids, which often require this medical intervention.

Inpatient treatment protects you from outside temptations and gives you constant access to highly-trained addiction specialists. Once on site, you’ll be immersed in transformative behavioral therapies, counseling sessions, and other diverse modalities which will help you to overcome the addictive mindset.

Don’t Get Caught In The Middle

Your body and brain are too important to cause further damage to. But if you continue to abuse opiates and amphetamines, the toll will be great. The good news is that life-changing treatment is only a phone call away. Contact our knowledgeable staff at today.

CESAR: Center for Substance Abuse Research - Amphetamines

U.S. National Library of Medicine - Powerful Behavioral Interactions Between Methamphetamine and Morphine

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