Method Why is the speedball method not talked about more?

[KillingPain267]

Speedball: a mix of strong opioids like fentanyl or heroin or even oxy, plus a stimulant like cocaine or meth.

A big part of the so-called massive "opioid OD crisis" is due to people mixing (by accident or purpose) a CNS depressant with a stimulant, not by opioids alone.

This is rarely mentioned by the media. But it's how River Phoenix, Philip Seymour Hoffman and many others died.

Why is this combination not discussed more often?

 

[d3ad]

I feel like it is too risky. If it fails, you would be in a very horrible position.

 

[Forveleth]

For most people, these drugs are not accessible, despite what police and the media portray. I live in a large U.S. city in a region of the country that is considered an opioid crisis area and yet I would have no idea how to get my hands on anything.

 

[KillingPain267]

For most people, these drugs are not accessible, despite what police and the media portray. I live in a large U.S. city in a region of the country that is considered an opioid crisis area and yet I would have no idea how to get my hands on anything.

It's not that hard, but even if so there is still the alternative like adhd meds combined with a prescribed opioid like oxy or morphine. A high dose of both yields a similar deadly cocktail also called a speedball.

 

[Pale_Rider]

Ill say cause its easier to just concentrate on the opiate, and that is in here.

 

[gothbird]

One reason it's not talked about more especially in pro choice or suicide planning spaces is that it's unpredictable by design. The combination of a CNS depressant with a stimulant pushes the body into extreme, competing states. Heart rate, blood pressure, and respiratory function are pulled in opposite directions, which can lead to sudden cardiac arrest, arrhythmias, or respiratory failure.

The lack of consistency is part of why it's used more in impulsive or substance facilitated attempts than in planned, controlled exits. It's not a reliable method for someone seeking peace, certainty, or minimal trauma to others. There's also the high potential for surviving with severe damage (brain injury, heart failure, etc.) if intervention happens even slightly too early.

That said, its omission from mainstream discourse is also political. Media coverage of the "opioid crisis" often erases polysubstance use entirely, to fit a narrative that blames opioids alone rather than addressing the broader issues—poverty, chronic pain, inaccessible mental healthcare, or the criminalisation of drug use. It's cleaner to say "opioid overdose" than to unpack the layers of pain and instability that lead someone to mix heroin with meth or fentanyl with cocaine.

So it's not that this combination isn't known—it's that it's inconvenient to talk about. Both in media, where it complicates the narrative, and in suicide discourse, where it doesn't fit the criteria of a clean, reliable, low intervention method.

The "best" ones I know of are Fentanyl + Methamphetamine, Heroin + Cocaine, Fentanyl + Cocaine, Oxycodone + Amphetamines, Morphine + MDMA.

They're just unpredictable and stimulants wear off faster than depressants, causing delayed respiratory collapse. There's a high risk of non fatal use which leads to brain damage, seizures, or locked in syndrome. And, well...It's intervention sensitive as I said. Some do use it intentionally, and successfully, but it's not a method that lends itself well to planning.

 

[KillingPain267]

One reason it's not talked about more especially in pro choice or suicide planning spaces is that it's unpredictable by design. The combination of a CNS depressant with a stimulant pushes the body into extreme, competing states. Heart rate, blood pressure, and respiratory function are pulled in opposite directions, which can lead to sudden cardiac arrest, arrhythmias, or respiratory failure.

The lack of consistency is part of why it's used more in impulsive or substance facilitated attempts than in planned, controlled exits. It's not a reliable method for someone seeking peace, certainty, or minimal trauma to others. There's also the high potential for surviving with severe damage (brain injury, heart failure, etc.) if intervention happens even slightly too early.

That said, its omission from mainstream discourse is also political. Media coverage of the "opioid crisis" often erases polysubstance use entirely, to fit a narrative that blames opioids alone rather than addressing the broader issues—poverty, chronic pain, inaccessible mental healthcare, or the criminalisation of drug use. It's cleaner to say "opioid overdose" than to unpack the layers of pain and instability that lead someone to mix heroin with meth or fentanyl with cocaine.

So it's not that this combination isn't known—it's that it's inconvenient to talk about. Both in media, where it complicates the narrative, and in suicide discourse, where it doesn't fit the criteria of a clean, reliable, low intervention method.

The "best" ones I know of are Fentanyl + Methamphetamine, Heroin + Cocaine, Fentanyl + Cocaine, Oxycodone + Amphetamines, Morphine + MDMA.

They're just unpredictable and stimulants wear off faster than depressants, causing delayed respiratory collapse. There's a high risk of non fatal use which leads to brain damage, seizures, or locked in syndrome. And, well...It's intervention sensitive as I said. Some do use it intentionally, and successfully, but it's not a method that lends itself well to planning.

Makes sense. Also the political stuff. But what would you say is the difference between a speedball and methods like Amitriptyline and Chloroquine mentioned in the Peaceful Pill Handbook, since they also use cardiac arrest mixed with sedatives?

 

[gothbird]

Makes sense. Also the political stuff. But what would you say is the difference between a speedball and methods like Amitriptyline and Chloroquine mentioned in the Peaceful Pill Handbook, since they also use cardiac arrest mixed with sedatives?

Both speedballs and combinations like amitriptyline + chloroquine (or SN + benzos, etc.) work by creating internal conflict right. So the body's systems are pushed in opposing directions, often overwhelming cardiac or respiratory function.

Speedballs (so opioid + stimulant) are unpredictable. The exact dose response curve varies wildly by person, batch purity, tolerance, and timing. You're relying on a chaotic crash between two drugs that are already crazy alone. There's a high risk of partial survival, seizures, cardiac trauma etc. It's also not peaceful. Many accidental ODs from speedballs involve convulsions, gasping, or long periods of distress before collapse.

The PPH protocols are designed to be as controlled and physiologically predictable as possible. Amitriptyline + chloroquine causes deliberate QT prolongation, usually leading to arrhythmia, while sedation blunts awareness. The goal is a cleaner trajectory: unconsciousness followed by cardiac arrest, without panic, without the stimulant pulled tension. SN is similar because it induces methaemoglobinaemia, essentially cutting off oxygen from the inside, with sleepiness and unconsciousness within 30–60 minutes.

So while both methods result in death via organ failure, the difference is control. PPH methods are used because they maximise predictability, reduce suffering, and lower the chance of traumatic survival. Speedballs don't offer that. They can kill but not reliably, and not gently.

That's the main divide: intentional design vs chaotic overload.

 

[wiggy]

I believe availability of opioids has dropped significantly in recent years as illicit use has been rightfully recognized as a health emergency. Additionally, as others have mentioned, it's not that reliable and failing can have gruesome consequences.

 

[Forveleth]

It's not that hard, but even if so there is still the alternative like adhd meds combined with a prescribed opioid like oxy or morphine. A high dose of both yields a similar deadly cocktail also called a speedball.

Ok, so now we are into prescription drugs which means I need to go to the doctor and try to fake having ADHD and enough pain to get medication. At this pont, I am using something that does not require me to hint down a dealer or pay $100's in doctor visits.

Not trying to argue, but Ihave seen more than a few threads on this forum from people asking how to get a hold of any sort of opioid medication or drugs. That tells you that they are not as popular and easily accessible as some people might think. Methods that take a lot of time, planning, and effort are not popular.

 

[KillingPain267]

Ok, so now we are into prescription drugs which means I need to go to the doctor and try to fake having ADHD and enough pain to get medication. At this pont, I am using something that does not require me to hint down a dealer or pay $100's in doctor visits.

Not trying to argue, but Ihave seen more than a few threads on this forum from people asking how to get a hold of any sort of opioid medication or drugs. That tells you that they are not as popular and easily accessible as some people might think. Methods that take a lot of time, planning, and effort are not popular.

I know. I meant for those who may already have adhd medication and maybe have a some unused opioid pills laying around from a past surgery. But I get that it's not so common anymore.