Mixing Cocaine and Fentanyl

Medically Reviewed By: Dr. Patricia Sullivan MD, MPH

cocaine laced with fentanyl

Table of Contents

Mixing Uppers and Downers

Cocaine is a stimulant drug that makes users feel confident, more talkative, and more energetic. Fentanyl is a depressant drug that causes drowsiness and sedation.

The resulting effect of mixing these two drugs is a strong “push-pull” reaction that puts extra strain on the heart.

Additionally, there are many chemical forms of Fentanyl including furanyl fentanyl and acetyl fentanyl that can increase or decrease the potency of the high caused by combining cocaine and fentanyl.

The risk for overdose rises as users cannot anticipate the severity of the effects that will be caused by each dose that is taken.

Components of Cocaine

Cocaine is the second most popular drug behind marijuana. It is made from the Coca tree found in South America by crushing and processing leaves into a white powder.

The drug is most commonly snorted up the noses of users or injected directly into the body by a syringe. It affects the body by boosting dopamine levels in the brain. Dopamine is a naturally occurring chemical that makes us feel good for basic behaviors like eating.

Cocaine makes users feel happy, focused, and gives them a burst of energy because of this added Dopamine.

As with all illicit drugs, there are many names for Cocaine including:

  • Coke
  • Snow
  • Rock
  • Blow
  • Crack
  • Nose Candy
  • Dust
  • Bump

While there are some uses for cocaine in local anesthetics, the majority of cocaine use in the U.S. remains illicit.

Components of Fentanyl

Fentanyl is a lab-manufactured opioid that is prescribed as a pain reliever for patients with acute issues such as those in treatment for cancer, after major surgery, for people who are resistant to other types of opioids, and even for end-of-life care.

It is taken by injection, as an edible lozenge, or by transdermal patch and its effectiveness is up to 50 times more powerful than that of heroin. This drug works just like opioids that are made from poppy plants in that it attaches to opioid receptors in the brain that control pain.

Fentanyl’s effects are similar to the euphoria felt from taking heroin. Users report extreme feelings of pleasure, happiness, and relaxation when taking Fentanyl.

Street names for Fentanyl include:

  • Jackpot
  • Friend
  • Tango
  • Apache
  • Murder 8
  • Cash
  • Tango
  • China Girl
  • China White
  • Dance Fever
  • Goodfellas

Mixing Cocaine and Fentanyl Intentionally “Speedballing”

Combining drugs for their shared effects is nothing new in the world of drug abuse. It usually consists of mixing a stimulant drug with a depressant drug. This practice is referred to as speedballing.

Users who are looking for more and more of a high often mix more commonly abused substances like marijuana and alcohol while others choose to cross more dangerous drugs like Adderall and Xanax prescriptions.

While it’s well known that singular drug abuse can have devastating effects on a person’s life, speedballing is less studied as addiction and overdose in different types of drugs can cause similar physical reactions.

Addiction to two of more drugs requires specialized treatment care that addresses and treats all substances that are being abused.

Physical Effects of Speedballing

All drug abuse causes both a pleasurable sensation such as euphoria, relaxation, or extra energy. But those same drugs can also set off distressing negative physical and mental reactions like excessive sweating, heart rate increases, and anxiety.

Speedballing aims to increase the good effects felt by drug use while decreasing the bad ones by combining specific opposite reaction drugs.

For example, cocaine often causes irritability in users but smoking marijuana while high on cocaine can subdue feelings of irritation.

Combining stimulants and depressants can lead to an array of negative bodily responses including blurry vision, confusion, lethargy, unintelligibility, impaired motor function, and extreme sleepiness.

People who speedball drugs by injection are more likely to contract hepatitis or HIV and to develop skin infections.

Speedballing Abuse Ripples through Families

The children and families of drug users cannot usually escape the ravaging effects that speedballing has on them.

Studies show that parents who abuse two or more substances such as cocaine and fentanyl are more likely to exhibit negative or threatening behavior against their children.

These parents become anxiety-ridden over time and may develop a sense of paranoia and delusion that causes them to act violently or combative. They also become less affectionate and more likely to over scrutinize their kids.

Physical dangers to babies and small children include the risk of a roll-over or dropping accident by an overly sleepy parent. Furthermore, children of moms and das who speedball receive less attention due to a parent’s preoccupation with taking drugs and being high.

These parents can also develop more psychological issues and are twice as likely to not complete drug rehabilitation.

The Dangers of Fentanyl Laced Cocaine

There is mounting evidence that the recent rise in opioid overdose is being fueled by fentanyl in coke.

The National Institute on Drug Abuse states that “some drug dealers are mixing fentanyl with other drugs, such as heroin, cocaine, methamphetamine, and MDMA. This is because it takes very little to produce a high with fentanyl.”

Fentanyl is a cheaper, more powerful drug so it doubly benefits dealers in that it costs much less to make and it is more addictive to customers whom they want to return for more purchases.

It may also unintentionally make its way into cocaine by being produced with the same equipment that coke was made with by careless, multitasking drug pushers.

Short and Long-term Health Issues of Cocaine Abuse

The high from cocaine is felt within a few seconds of ingesting the drug and it lasts anywhere from mere minutes to a half an hour.

Repeatedly taking cocaine by smoking or injection rather than snorting it creates a more powerful high that does not last as long.

Using more cocaine in more extreme ways can cause a range of severe short and long-term side-effects including:

  • Nausea and vomiting
  • Muscle spasms and trembling
  • Elevated blood pressure and heartbeat
  • Enlarged pupils
  • Sensitivity to noises and light
  • Constant runny nose, nosebleeds, and a reduced sense of smell
  • Bowel deterioration due to slowed blood flow
  • Development of respiratory issues like severe cough, asthma, and pneumonia
  • Scarring, vein damage, and skin infections
  • Anxiety and paranoia
  • Insomnia and irritation
  • Malnutrition
  • Violent behavior

Risk of Overdose Rises with Cocaine Cut with Fentanyl

Intentional abuse of cocaine and fentanyl can cause many unpredictable reactions because users do not know what type of fentanyl they are taking or how much. In addition to the many physical consequences of cocaine use, ingesting fentanyl in coke significantly raises the risk of overdose and death.

The high from cocaine does not last long, so in taking more coke more frequently to maintain that high, users also end up talking much more fentanyl.

A report by the New York City Department of Health and Mental Hygiene stated that “The presence of fentanyl in the New York City drug supply has dramatically increased the number of overdose deaths, and fentanyl is now the most common drug involved in overdose deaths.

In 2017, 800 New Yorkers died from overdoses involving fentanyl.”

Signs of fentanyl abuse and overdose include:

  • Respiratory problems
  • Blue tinted nails and lips
  • Lightheadedness and confusion
  • Slowed heartbeat and blood pressure
  • Skin that is clammy or cold to the touch
  • Listlessness and loss of awareness
  • Coma
  • Death

Getting Treatment for Polysubstance Abuse

A tailored rehab plan is needed in all cases of addiction to ensure its effectiveness. Finding specialized rehabilitation that addresses both cocaine and fentanyl is key to recovering from this addiction.

Because detoxification from fentanyl can cause severe illness, it is recommended that users initially partake in inpatient rehabilitation so that their health and well-being can be closely monitored.

Fentanyl cannot be stopped cold turkey and users must be slowly weaned from the drug. Detox sets off withdrawal symptoms that can span across weeks.

In rare instances, people can die from opioid withdrawal symptoms; highlighting why medical intervention is essential during detox.

Process of Detox from Fentanyl in Cocaine

Within the first 30 hours of stopping drug abuse, withdrawal symptoms will begin to show. The body begins to experience a range of varying physical and mental effects that mimic the flu as a response to the chemical void that has been left by quitting drugs.

As the brain begins to attempt to produce and replace the missing dopamine that was previously provided by drugs, the body starts to become sick and worn down.

The severity of withdrawal symptoms depends on how long and in what manner that the cocaine and fentanyl were taken and medication may be prescribed to help mitigate pain and irritability.

Withdrawal symptoms may include:

  • Sweating
  • Chills
  • Nausea
  • Headache
  • Muscle pain
  • Fatigue
  • Diarrhea
  • Sleepiness
  • Mood Swings
  • Cravings
  • Depression
  • Anxiety
  • Suicidal Ideation

Talk Therapy and Rehabilitation

Most rehab treatment plans involve some type of therapy or counseling employed to address the mental aspects of addiction. Talk therapy is the most popular form of rehab that doctors recommend and there are many variations of it. This form of therapy allows patients to examine and modify their drug-driven actions so that they can learn to lead better lives.

These forms of therapy include cognitive-behavioral therapy, personal motivation incentives, family based therapy, and motivational interviewing.

After an inpatient detox and rehab stay is completed patients may move on to a short-term residential treatment facility, a recovery home, or will join a peer or community support group such as Narcotics Anonymous.

Regular communication with rehab doctors is recommended even beyond initial treatment as relapse is always a possibility and should be viewed as part of the recovery process rather than the end of it.

Addiction to Fentanyl or Cocaine Can Be Overcome

Addiction to any one substance is a scary and intimidating issue to deal with and adding in another drug dependence can make it seem nearly impossible. Addiction to cocaine cut with fentanyl has created thousands of unnecessary overdose deaths.

But millions of people have battled and won the war against drug abuse and addiction so please know that you are not alone in the fight.

We will help you to find and secure the right kind of drug treatment for yourself or a loved one. Do not hesitate; pick up the phone and dial the number below for more info.


[1] Pubmed Study
[2] Fentanyl Facts

Susana Spiegel

Susana Spiegel

Susana has experience writing about addiction, treatment, mental health, and recovery. She holds a Bachelors in Arts of Theology from GCU, and has a deep empathy for those who are struggling with addiction, as she is in recovery herself.

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