Here's What Mixing Drugs Does to Your Body and Brain

February 2nd 2016

Most drug users don't stick to a single substance. Using multiple drugs, or polysubstance abuse, is popular both among drug users chasing new highs and those hoping to counteract the effects of one drug with another.

“For us it was basically, you know, brandy, cigarettes, pot and coke," Fleetwood Mac singer Stevie Nicks said on 60 Minutes, "And that was just the wicked little circle, rat’s wheel I call it, that everybody was on, you know, you…you’d do some coke and you were nervous and then you’d smoke some pot to calm down, you were too stoned and you’d, you know, do some more coke to wake up and then you’d have a drink ‘cause you were too nervous and uh…it was just, you know, it was just a nightmare.”

The "wicked little circle" doesn't just reinforce bad habits. Using multiple drugs also can amplify the dangerous health effects of individual substances and make you more likely to overdose.

"There are different boxes of substances, stimulants, sedatives, hallucinogens, dissociatives. Combining more than one from each of those boxes can increase your risk," Dr. Owen Bowden-Jones, founder of the CNWL Drug Club Clinic, told VICE.

Here's what happens to your body and brain during popular drug combinations.

A Crack Cocaine and Heroin Speedball

Mixtures of crack cocaine and heroin have led to many celebrity overdoses, including Lamar Odom's in October 2015. Odom allegedly collapsed in a Las Vegas brothel after injecting speedballs and ranting about how the Kardashians ruined his life.


Beyond tabloid fodder, this combination is dangerous because both drugs distort the user's judgment. Using a dangerous amount of crack makes you more likely to ingest a dangerous amount of heroin and vice versa. These mixtures create a dangerous cycle of drug abuse, and the perceived effects of stimulants make you more likely to overdose on heroin, according to Scientific American.

"Getting Crossfaded" on Weed and Alcohol

Alcohol in your bloodstream can make you absorb THC faster, heightening the effects of marijuana and making you more likely to "black out." This can also lead to increased nausea and dizziness, which makes driving particularly dangerous.

Marijuana can also make it more difficult to vomit, which can even lead to alcohol poisoning if you drink too much.

MDMA and Acid "Candy flipping"

MDMA and LSD combine to intensify auditory and visual hallucinations, making the combination most popular at raves and music festivals.

Many people don't know that LSD has stimulant as well as psychoactive hallucinatory properties, often elevating blood pressure. For this reason, Dr. Bowden-Jones, founder of the CNWL Drug Club Clinic, says that combining ecstasy pressed pills or molly capsules can be both an unpleasant combination and a dangerous one.

Many drug users don't share his feelings, but if you plan on "candy flipping," or eating an LSD tab and an MDMA pill or capsule at the same time, it is wise to test both drugs for purity. "Combining two drugs of unknown contents has potential to end tragically, or at worse fatally." And as DrugsForum Poster Chug Chug Chug advises:

"There are so many research chemicals out there these days, it's worth it to spend some extra money to make sure you know what you're taking."

MDMA purity is a big problem bemoaned by both drug users and anti-drug groups. In 2014, Drug Policy Alliance reported that analyzed 250 samples sold as "molly" and found that 40 contained MDMA and adulterants and 124 contained no MDMA at all.

Coke and Alcohol

Coke and alcohol combinations are practically ubiquitous among casual cocaine users because of the unpleasant sensation that drips down your throat from cocaine. Mixing alcohol or other downers with the drug can make the diminishing effects of the upper more pleasant, but it can also strain your heart.

Ingesting booze and coke in tandem produces cocaethylene, a byproduct that can counteract the effects of a nasty coke crash but also may endanger users. Studies show that cocaethylene may be equally or more cardiotoxic than cocaine itself.

"They do it to increase the effects of cocaine, but we have found cases where young people are getting heart palpitations and then going and playing Sunday football," The Guardian observed. "Increasing cocaine use among the young may explain heightened concerns about the effects of cocaethylene."

MDMA and Alcohol

Mixing alcohol and MDMA can be risky because both substances can cause your body to become dehydrated, putting pressure on your kidneys and liver.

If you're rolling, it's wiser to stick to water, juice, and other non-alcoholic beverages.

Ketamine and MDMA

Ketamine and MDMA is a popular combination among ravers, who often take MDMA at the beginning of a party and use K to come down or simply to experience something different.

"We know that ketamine can be a sedative and MDMA a stimulant, but judging the right balance of the two is incredibly difficult," Bowden-Jones says.

These combinations can be dangerous because there is little research on how the drugs interact, and it's easy to overdo the sensitive ratio on either end. Ketamine highs often amplify throughout the night, and users who are already high on MDMA may be unable to notice K's effects early on and find themselves in a "K-hole."

"Doing it at your peak is intense, I like to describe it as a 'rave mode' - lights and colours are intense, slight hallucinations, time is dilated; you're completely relaxed but you're incredibly stimulated." One Redditor writes, warning, "start slow with the ketamine, small amounts until you're at your desired point. Be incredibly careful doing Ketamine in a club like I've suggested above, don't go overboard."

MDMA and Weed

Weed is often used to come down off MDMA, but this can also cause anxiety or paranoia for some users. While there aren't any wildly detrimental health effects to visiting Mama Ganj when you come down from a pill, if weed tends to make you anxious or paranoid, this combination can be an unpleasant one. You also might be advised to stick to indica rather than sativa strains, as indicas usually lead to a "body high" rather than mental stimulation.

Ketamine and Alcohol

Dr. Adam Winstock, founder of the Global Drug Survey said that the organization found ketamine and alcohol the most dangerous popular drug combination.

"Alcohol hugely increases the bladder problems triggered by ketamine because of the dehydration," Winstock said. "Also, it gets you sedated and you lose your balance, which increases the risk of getting into a K-hole."

Correction: This article previously referred to a Drug Policy Alliance analysis. This was incorrect. The analysis was provided by

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