Most people have, at some point in their lives, experimented with illicit drugs. Commonly mixed drugs include alcohol and cannabis, heroin and fentanyl and amphetamines and benzodiazepines. Some drug cocktails can potentiate the effects of their individual components, causing a higher high or a more intense sedation. Other combinations attempt to blunt the worst effects of their constituent drugs, such as mixing “uppers” and “downers” to create a supposedly cleaner high.
That some proportion of people choose to combine the psychoactive effects of recreational substances at all is unsurprising to most observers. What may instead surprise you is that most people who use illicit drugs mix two or more of them together, according to our survey of 2000 self-described drug users. To put this into perspective, not everyone who initially responded to the survey described themselves as someone who used drugs. But among those who did, over two thirds of respondents copped to drug mixing.
The most commonly mixed drug is alcohol and the most common combinations are alcohol and cannabis and alcohol and cocaine, with over 80% of respondents claiming to have tried either combination. Alcohol increases absorption of THC, the main active ingredient in cannabis. There is precious little documented research on the effects of THC on the absorption and elimination of alcohol, however, although perhaps it can delay the subjective feeling of drunkenness.
Alcohol and cocaine have the opposite effects on the body on their own, however, and combining them can intensify the high of cocaine and is believed by some drug users to reduce some of the side effects of cocaine. Another commonly mixed drug with alcohol is heroin. Both alcohol and heroin increase the potency of the other, and the combination of the two can result in slurred speech, blurred vision and slowed reaction times. In other words, both a stronger drunkenness effect and a stronger sedative effect at the same time.
Less commonly mixed with alcohol were LSD and methamphetamine, with less than a quarter of respondents claiming to have taken either substance together with alcohol.
The second most commonly mixed drug is cannabis. But there is some discontinuity among users of cannabis. Some people are purists and refuse to mix it with anything else, even tobacco. Many others use it as a mixing drug due to its versatility and wide range of strains. After all, it is the second most commonly mixed drug for a reason. With drug use and drug mixing comes drug tolerance and a simple curiosity about exploring new and interesting combinations.
Most heavy drug users do in fact mix cannabis, and not always with the same other drugs. Here then are our findings on which drugs heavy drug users most frequently mix with cannabis. Unsurprisingly, over 80% of respondents claimed to mix alcohol and cannabis, as reported in the earlier figure as well. Also of note is that over half of respondents claimed to mix cannabis and LSD, most probably due to the hallucinogenic effects of each substance individually.
Some people mix drugs specifically to blunt the more onerous side effects of their favorite substances. These attempts can be, however, unpredictable. Some people will first check to see the predicted effects of drug mixing before attempting a specific combination. This can be an excellent practice since polydrug use is associated with more frequent and stronger dependency. The side effects can be more serious as well, especially since they can be masked by drugs that have opposite effects on their own and may only become evident over time.
Here are our findings from a population of 2000 self-described drug users about their willingness to mix drugs based on the results of a search about their potential side effects when used in combination. Overall, only a small portion of respondents, about an eighth, claimed to have done research into drug combination safety before attempting a drug cocktail themselves. One hopes that, when mixing drugs at all, more people will research the potential side effects in the future so they can make an informed decision and use as safely as possible.
Even when armed with the best available information, some people view the mixing of specific drugs as a bridge too far. Some people prefer to keep specific drugs to themselves so as to not adulterate the high they are attempting to achieve. Others, meanwhile, prefer to stay far abreast of the feared side effects of some other combinations. Polydrug use as a concept is relatively poorly defined, with the interactions of pairs or even more numbers of drugs largely the subject of specialized academic research, so caution is understandable.
When we asked our sample of 2000 self-described drug users, here is what they had to say about the drugs they wouldn’t mix under any circumstances. The most commonly reported drug our respondents said they would never mix was LSD, with over half of them saying they would only take it on its own. This is a surprising finding because it was the most commonly mixed drug with cannabis, implying the presence of two populations of drug users, one who actively seek out hallucinogen potentiation and another, larger group who actively avoid it.
In the worst-case scenario, mixing drugs can lead to someone, either the mixer or someone they know, ending up in the hospital. Perhaps the most feared consequence of polydrug use from a medical perspective is the potentiation of the sedative effects of heroin or heroin derivatives. A polydrug user’s breathing can fall so fast so quickly that it can be difficult or impossible to resuscitate them. From a psychological perspective, hospitalizations can occur when someone takes too many hallucinogens, which can happen if the interactive effects of cannabis and LSD, for example, are poorly anticipated by the user.
Fortunately, in our sample over 60% of respondents reported never having been hospitalized due to taking two or more drugs together. More worryingly, over a third reported having been taken to the hospital for the same.
We surveyed 2258 people who use drugs. These people chose to participate in the survey openly. The only qualifier was that the people surveyed had to have taken an illicit drug in the past 365 days. 102 of the respondents were taken out due to incomplete responses.
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