Poly drug use

Poly drug use

Poly drug use refers to combined drug intoxication to achieve a particular effect. In many cases one drug is used as a base or primary drug, with additional drugs to leaven or compensate for the side effects of the primary drug and make the experience more enjoyable with drug synergy effects, or to supplement for primary drug when supply is low.[1]


Caffeinated alcoholic drink[edit]

Caffeinated alcoholic beverages are widespread and legal.

A caffeinated alcoholic drink is an alcoholic beverage that also contains caffeine, often in the form of an energy drink.[2] The combination can result in reduced subjective alcohol intoxication but does not reduce in lowered objective intoxication.[3]

DMT and MAOIs[edit]


Ayahuasca being prepared in the Napo region of Ecuador

Ayahuasca is a beverage that combines monoamine oxidase inhibitors (MAOIs) and N,N-Dimethyltryptamine (DMT). DMT is normally inactive when taken by mouth due to being broken down by monoamine oxidase in the stomach, but the MAOIs block the enzyme action and allow the DMT to travel to the brain where it has a psychedelic drug effect.[4]


Changa (/ˈɑːŋɡɑː/) is a DMT-infused smoking blend. Typically, extracts from DMT-containing plants are combined with a blend of different herbs and ayahuasca vine and/or leaf to create a mix that is 20–50% DMT,[5] akin to a smokeable ayahuasca.[6]


Pharmahuasca is like ayahuasca except that the DMT and MAOIs are mixed as pharmaceutical chemicals instead of plant extracts.[7]


A speedball is a mixture of cocaine and heroin. The combination is used because it is believed to provide more euphoria while having each drug balance out negative side effects from each other.[8] The combination has a higher risk of overdose than of either drug alone.[9]

Common combinations[edit]

Drug 1 Drug 2 Drug 3 Poly drug name[10][11] Intoxication name Comment
Any drug Black tar heroin Whoonga Widespread use in South Africa
Any drug Cannabis Amp joint Marihuana cigarette laced with some form of narcotic
Any drug Nicotine Cooler A cigarette laced with a drug
Any depressant Any stimulant Over and under
Any pharmaceutical Any pharmaceutical Polypharmacy. Pharming
5-MeO-DiPT GHB Flying fox
Alcohol Caffeine Caffeinated alcoholic drink
Alcohol Benzodiazepine Time flip
Alcohol Cannabis Herb and Al Cross fading
Alcohol Cocaine Snow-coning Metabolized into a cocaethylene
Amphetamine Cocaine Snow seals
Banisteriopsis caapi β-Carbolines containing plants (eg Peganum harmala) Ayahuasca, changa
Barbiturates Alcohol Used to be common, when Barbiturates were more readily available
Caffeine Cannabis Hippie-speedballing
Caffeine Methamphetamine Biker's coffee. Kamikaze, ya ba
Cannabis Cocaine paste Bazooka
Cannabis Crack-cocaine Crack weed (less known: champagne, chronic, cocktail, dirty joint, fry daddy, gimmie, gremmies, juice joint, lace, oolies, p dog, primo, splitting, thirty eight, turbo, wollie, yeola) Cocoa puffs
Cannabis Crack-cocaine PCP Jim Jones
Cannabis DXM Nicotine Candy blunt
Cannabis Heroin Atom bomb, stuff
Cannabis Heroin or opium A-bomb
Cannabis Opium Buddha
Cannabis PCP Killer weed (less known: Bionic, clickums, donk, dust blunt, illies, illing, leak, love leaf, lovelies, parsley, wet, zoom) Wet is cannabis dipped in PCP
Cannabis Nicotine Blunt, spliff Stoned A rolled marijuana cigarette usually made with rolling paper. A blunt is a cigar hollowed out and filled with marijuana. It is rolled with the tobacco-leaf "wrapper" from an inexpensive cigar. Blunts take their name from Phillies Blunt brand cigars.
Cocaine Heroin Snowball. Other names: Belushi, bombita, murder one, whiz bang Snowballing
Cocaine Heroin LSD Frisco special
Cocaine Heroin Nicotine flamethrower, primos Cigarette laced with cocaine and heroin
Cocaine Heroin or morphine Powerball, speedball Powerballing, speedballing Speedballing, powerballing is often used to describe intravenous use. The term can also be applied to use of pharmaceutical opioids, benzodiazepines or barbiturates along with stimulants.
Cocaine Ketamine CK1, Calvin Klein, cable
Cocaine LSD Cracid (or outer limits) Cracid is a portmanteau of cocaine and acid
Cocaine Morphine C & M
Cocaine PCP Space, whack
Codeine Glutethimide Pancakes and syrups Combination of glutethimide and codeine cough syrup
Codeine Promethazine Purple drank
Crack-cocaine Fentanyl Dirty fentanyl, takeover
Crack-cocaine Heroin Chocolate rock, dragon rock, eightball, moonrock, smoking gun, tar
Crack-cocaine LSD Outerlimits
Crack-cocaine Methamphetamine Fire, twisters
Crack-cocaine PCP Nicotine Ozone PCP and crack cigarette
Crack-cocaine PCP Missile basing, P-funk, space basing, spaceball, space cadet, space dust, tragic magic
Crack-cocaine Nicotine Coolie, crimmie, woolas A cigarette laced with crack
DMT MAOIs Pharmahuasca
DMT Salvia Divinorum Sally and Dimitri
DXM Psilocybin or psilocybin mushroom Cherry-bombing
Ecstasy Ketamine GHB EKG EKG is defined as Ecstasy, Ketamine, GHB
Fentanyl Heroin Birria, chiva loca, Facebook Facebook is mixed in a pill form
GHB Methamphetamine Cherry meth
Hashish Belladonna Alamout black hash[12] Mixed
Hashish LSD Royal temple ball The hashish is mixed with LSD and rolled into a ball intended for oral use, because LSD cannot be smoked.
Hashish Opium Black hash, black Russian
Heroin Methamphetamine Goofball
Heroin Morphine New Jack swing
Heroin PCP Alien sex fiend
Heroin Xylazine Anestesiade caballo Xylazine is a horse anesthetic
LSD Marijuana Amphetamine Hippie heart attack
LSD Nitrous oxide Gasid
LSD PCP Black acid
LSD PCP Datura Schizo flip
LSD Psilocybin or psilocybin mushroom God's flesh
LSD DMT Cosmo flip Cosmo flipping
MDMA 5-MeO-DiPT Foxy flip Foxy flipping
MDMA 2C-B Honey flip, nexus flip, pancake flip Honey flipping, nexus flipping, pancake flipping
MDMA 2C-E Sparkle flip Sparkle flipping
MDMA 2C-I Science flip Science flipping
MDMA 2C-T-7 Lucky flip Lucky flipping
MDMA Alcohol Tipsy flip Tipsy flipping
MDMA Cannabis Stoner flip Stoner flipping
MDMA Cocaine Sugar flip Sugar flipping
MDMA Cocaine LSD Candy-flip on a string Candy-flipping on a string
MDMA DMT Shaman flip, time flip Shaman flipping, time flipping
MDMA DXM Robo flip Robo flipping
MDMA GHB Gamma flip Gamma flipping
MDMA Ketamine Kitty flip Kitty flipping
MDMA LSD Candy flip Candy flipping
MDMA LSD Psilocybin or psilocybin mushroom Jedi flip, twilight flip Jedi flipping, twilight flipping
MDMA MDEA Adam and Eve
MDMA Mescaline or psychoactive cactus Love flip, love trip Love flipping
MDMA Methadone Chocolate flip Chocolate flipping
MDMA Methamphetamine Trailer flip Trailer flipping
MDMA Nitrous oxide Nox
MDMA Opiates Poppy flip Poppy flipping
MDMA PCP Domex, elephant flip Elephant flipping
MDMA Psilocybin or psilocybin mushroom Hippy flip, flower flip, ethno flip Hippy flipping, flower flipping, ethno flipping
MDMA Psilocybin or psilocybin mushroom Cocaine Flower flip on a string, hippie flip on a string, ethno flip on a string Flower flipping on a string, hippie flipping on a string, ethno flipping on a string
MDMA Sildenafil Sextasy (or hammerheading)
Nicotine PCP Chipping

Dangerous interactions[edit]

A chart for identify dangerous drug combinations


Tranquillizers, sleeping pills, opiates and alcohol. Opioid-related deaths often involve alcohol.

Poly drug use often carries with it more risk than use of a single drug, due to an increase in side effects, and drug synergy. The potentiating effect of one drug on another is sometimes considerable and here the licit drugs and medicines – such as alcohol, nicotine and antidepressants – have to be considered in conjunction with the controlled psychoactive substances. The risk level will depend on the dosage level of both substances. If the drugs taken are illegal, they have a chance of being mixed (also known as "cutting") with other substances which dealers are reported to do to increase the perceived quantity when selling to others to increase their returns. This is particularly common with powdered drugs such as cocaine or MDMA which can be mixed with relative ease by adding another white powdery substance to the drug. This cumulative effect can lead to further unintended harm to health dependent on what is being covertly added. Concerns also exist about a number of pharmacological pairings: alcohol and cocaine increase cardiovascular toxicity; alcohol or depressant drugs, when taken with opioids, lead to an increased risk of overdose; and opioids or cocaine taken with ecstasy or amphetamines also result in additional acute toxicity.[13] Benzodiazepines can cause death when mixed with other CNS depressants such as opioids, alcohol, or barbiturates.[14][15][16]

Close-up photo of a metal spoon filled with a viscous, clear purple fluid
A spoonful of promethazine/​codeine syrup showing the characteristic purple color that gave rise to the name purple drank.


Within the general concept of multiple drug use, several specific meanings of the term must be considered. At one extreme is planned use, where the effects of more than one drug are taken for a desired effect. Another type is when other drugs are used to counteract the negative side effects of a different drug (e.g. depressants are used to counteract anxiety and restlessness from taking stimulants). On the other hand, the use of several substances in an intensive and chaotic way, simultaneously or consecutively, in many cases each drug substituting for another according to availability.[13]


The phenomenon is the subject of established academic literature.[17]

A study among treatment admissions found that it is more common for younger people to report polydrug drug use.[18]

See also[edit]


  1. ^ http://www.emcdda.europa.eu/html.cfm/index34913EN.html
  2. ^ Nordrum, Amy. "The Caffeine-Alcohol Effect". The Atlantic. Retrieved 7 August 2018.
  3. ^ Ferré S, O'Brien MC (September 2011). "Alcohol and Caffeine: The Perfect Storm". J Caffeine Res. 1 (3): 153–162. doi:10.1089/jcr.2011.0017. PMC 3621334. PMID 24761263.
  4. ^ Malcolm BJ, Lee KC (January 2017). "Ayahuasca: An ancient sacrament for treatment of contemporary psychiatric illness?". Ment Health Clin. 7 (1): 39–45. doi:10.9740/mhc.2017.01.039. PMC 6007657. PMID 29955496.
  5. ^ St. John, Graham (2015). Mystery School in Hyperspace: A Cultural History of DMT. Berkeley, USA: Evolver Editions. ISBN 978-1583947326.
  6. ^ Cusack, Carole; Norman, Alex (2012). Handbook of New Religions and Cultural Production. Leiden, Netherlands: BRILL. ISBN 9789004221871.
  7. ^ Ott, Jonathan (Summer 1996). "Pharmahuasca: On Phenethylamines and Potentiation". Newsletter of the Multidisciplinary Association for Psychedelic Studies. 6 (3): 32–34. Retrieved 7 August 2018.
  8. ^ Negus SS, Gatch MB, Mello NK (June 1998). "Discriminative stimulus effects of a cocaine/heroin "speedball" combination in rhesus monkeys". J. Pharmacol. Exp. Ther. 285 (3): 1123–36. PMID 9618415.
  9. ^ "Mixing Drugs". Harm Reduction Coalition. Retrieved 7 August 2018.
  10. ^ Copping, Jasper (8 November 2009). "Drug slang: what police must learn A to B".
  11. ^ https://ndews.umd.edu/sites/ndews.umd.edu/files/dea-drug-slang-terms-and-code-words-july2018.pdf
  12. ^ https://erowid.org/psychoactives/slang/
  13. ^ a b EMCDDA Annual Report 2006 ch. 8
  14. ^ Serfaty M, Masterton G (1993). "Fatal poisonings attributed to benzodiazepines in Britain during the 1980s". Br J Psychiatry. 163 (3): 386–93. doi:10.1192/bjp.163.3.386. PMID 8104653.
  15. ^ Buckley NA, Dawson AH, Whyte IM, O'Connell DL (1995). "[Relative toxicity of benzodiazepines in overdose.]". BMJ. 310 (6974): 219–21. doi:10.1136/bmj.310.6974.219. PMC 2548618. PMID 7866122.
  16. ^ Drummer OH; Ranson DL (December 1996). "Sudden death and benzodiazepines". Am J Forensic Med Pathol. 17 (4): 336–42. doi:10.1097/00000433-199612000-00012. PMID 8947361.
  17. ^ Scholey AB, Parrott AC, Buchanan T, Heffernan TM, Ling J, Rodgers J (June 2004). "Increased intensity of Ecstasy and polydrug usage in the more experienced recreational Ecstasy/MDMA users: a WWW study" (PDF). Addict Behav. 29 (4): 743–52. doi:10.1016/j.addbeh.2004.02.022. PMID 15135556.
  18. ^ "Polydrug Use Among Treatment Admissions: 1998." OAS Home: Alcohol, Tobacco & Drug Abuse and Mental Health Data from SAMHSA, Office of Applied Studies. Web. 29 Sept. 2011. [1]

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