In the discussion of addiction, the focus is often on singular substance use. Rather than referring to those who are chemically dependent as addicts, more specific identifiers like alcoholic or cocaine addict are often used. The limitation of these terms is that many individuals are not only abusing a single primary substance.
In fact, studies have specifically shown that as individuals begin abusing harder and more dangerous drugs, they become increasingly likely to exhibit polydrug abuse, or the abuse of multiple drugs simultaneously.1 In many cases, the purpose of polydrug use is to amplify the intensity of intoxication.
However, many substance users underestimate the immense danger they’re putting themselves in by abusing multiple substances simultaneously.
To be clear, there’s no such thing as a chemical intoxicant that’s not dangerous. Every drug — whether it’s seemingly innocuous like marijuana or a narcotic like heroin — has its own risks and dangers. These risks are compounded when multiple substances are abused simultaneously. Therefore, it’s quite important for people to be aware of which particular chemical combinations have proven to be lethal.
Benzodiazepines and Alcohol
Two of the most desirable pharmaceuticals are opioid painkillers and benzodiazepines, but the latter represents a far greater number of annual prescriptions in the U.S. than opioids. It’s estimated that approximately 11 percent of all Americans have prescription benzodiazepines in their medicine cabinets.2
Additionally, alcohol is the most abused substance in the world, so it should come as little surprise that the first lethal combination of this list is benzodiazepines and alcohol. In fact, a 2011 study of people in addiction treatment for benzodiazepine addiction found that 98 percent of benzodiazepine addicts are polydrug users, and for one in four of those individuals the additional substance was alcohol.3
What makes this combination so dangerous is that benzodiazepine drugs and alcohol are both very powerful depressants, even acting on some of the same areas of the brain. As such, they have very similar effects, particularly when they’re being consumed in dangerous amounts. For instance, benzodiazepines and alcohol both cause drowsiness, a decline in coordination, impaired judgment, and a number of other pronounced cognitive impairments. When used simultaneously, they cause profound depression of the respiratory, circulatory and nervous systems, which can lead to unconsciousness, coma or even death.
Benzodiazepines and Opioids
The danger inherent in mixing benzodiazepines and opioids is comparable to that of mixing benzodiazepines with alcohol since opioids are also depressants. However, opioids are considered a much more powerful — and, therefore, desirable — substance than benzodiazepines for many people.
Many opioid addicts will use benzodiazepines as well, but the intent is to amplify the effects of the opioids by abusing benzodiazepines simultaneously. This is such a common practice that at least 30 percent of annual overdose deaths in the U.S. are caused by the simultaneous abuse of benzodiazepines and opioids, according to recent statistics.4 Additionally, more than half of opioid overdose deaths also involve benzodiazepine abuse.
Cocaine and Heroin
Here’s a lethal combination that may be familiar to some due to the countless celebrities who have died from “speedballing”—when a person creates a mixture of heroin and cocaine for taking at the same time. While the combinations mentioned so far have been mixtures of depressant drugs, a speedball is made from a depressant and a stimulant, which are on completely opposite ends of the drug spectrum.
There have been very few studies conducted on speedballing, so there’s little empirical knowledge about what could possibly make the experience of taking such a contradictory drug combination appealing. When a person takes the speedball mixture, the brain is awash in an extremely high level of dopamine that cannot be recycled and due to the sedative effects of the heroin, and the user risks losing consciousness.
With cocaine and heroin being so powerful individually, the damage the brain incurs from a person’s speedballing is greater and accumulates even faster than if either substance was used alone. Speedballing could be considered similar to trying to pull the user’s body in opposite directions at the same time.
Alcohol and Opioids
While it’s true that there are more annual prescriptions for benzodiazepines in the U.S. than there are prescriptions for opioid painkillers, the latter represents a far greater portion of the nation’s prescription drug problem. And much like with benzodiazepines, many people who abuse opioids will frequently combine alcohol as a way to boost the effects of the painkillers, resulting in a more intense level of intoxication.
As the opioid and alcohol intoxication sets in, users experience euphoria, pronounced drowsiness, numbness throughout the body and significantly depressed breathing among some other effects.5 However, this can quickly become dangerous since opioids and alcohol are both depressant drugs. Users are very likely to lose consciousness, during which time the respiratory depression may cause them to stop breathing altogether.
As well, the intoxication caused by these substances makes users much more likely to overdose since they’re less and less apt to remember how much of each substance they’ve consumed.
At the start of one’s substance abuse journey, a person will likely still have a certain level of fear of drugs and, more specifically, of overdosing. With the passage of time, that fear subsides with the individual may begin to feel as though his or her using experience will prevent an overdose. Unfortunately, there are close to 50,000 overdose deaths each year, which shows that there’s no such thing as invincibility when it comes to alcohol and drugs.
To make matters worse, each and every overdose death is preventable with an effective combination of addiction treatment and support.
By Dane O’ Leary, Contributing Writer
1Wish, E.D. et al. (2006). Evidence for Significant Polydrug Use Among Ecstasy-Using College Students. Journal of American College Health. 55 (2), 99-104.
2Olfson, M., King, M. & Schoenbaum, M. (2015). Benzodiazepine Use in the U.S. Journal of American Psychiatry. 72 (2), 136-142.
3Dangers of Mixing Alcohol and Benzodiazepines. Retrieved from https://www.foundationsrecoverynetwork.com/dangers-mixing-alcohol-benzodiazepines/
4Fiore, K. (2013, February 19). Prescription Drugs Leading Cause of Fatal Overdoses. Retrieved from https://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/37438
5Dangers of Mixing Opiates and Alcohol. (2014, April 2). Retrieved from https://www.foundationsrecoverynetwork.com/dangers-mixing-opiates-alcohol/