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HandWiki. Poly Drug Use. Encyclopedia. Available online: (accessed on 13 April 2024).
HandWiki. Poly Drug Use. Encyclopedia. Available at: Accessed April 13, 2024.
HandWiki. "Poly Drug Use" Encyclopedia, (accessed April 13, 2024).
HandWiki. (2022, November 17). Poly Drug Use. In Encyclopedia.
HandWiki. "Poly Drug Use." Encyclopedia. Web. 17 November, 2022.
Poly Drug Use

Poly drug use or polysubstance use refers to the use of combined psychoactive substances for recreational purposes. 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.

polysubstance use poly drug synergy

1. Combinations

Drug 1 Drug 2 Drug 3 Poly drug name[1][2] Intoxication name Comment
Any drug Black tar heroin   Whoonga   Widespread use in South Africa
Any drug Cannabis   Amp joint    
Any drug Nicotine   Cooler[3]    
Any depressant Any stimulant   Over and under    
Any pharmaceutical Any pharmaceutical   Polypharmacy. Pharming    
2C-B MDMA   Nexus Flip[4][5] Nexus Flipping  
2C-T-7 MDMA   Lucky Flip[3]    
Alcohol Caffeine   Caffeinated alcoholic drink    
Alcohol Benzodiazepine   Time flip    
Alcohol Cannabis   Herb and Al. Judgement Day Cross fading Called Judgement Day in Ghana when cannabis is added to the drink
Alcohol Cocaine   Snow-coning   Metabolized into cocaethylene
Amphetamine barbiturates   inbetweens[6]    
Amphetamine Cocaine   Snow seals    
Amphetamine Heroin   bombido[7]    
Amphetamine Xanax   Orange Dream Blossom Cloud Rush The combination is crushed together and insufflated
DMT β-Carbolines containing plants (e.g. Banisteriopsis caapi or Peganum harmala)   Ayahuasca, Changa   Ayahuasca is drunk. Changa is smoked or vaped.
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 Heroin Major Pronin    
Cannabis Crack-cocaine PCP Jim Jones    
Cannabis DXM Nicotine Candy blunt    
Cannabis Heroin   Atom bomb, stuff[3]    
Cannabis Heroin or opium   A-bomb    
Cannabis Opium   Buddha    
Cannabis PCP   Wet (less known: Bionic, clickums, donk, dust blunt, illies, illing, leak, love leaf, lovelies, parsley, wet, zoom)   Wet is cannabis dipped in PCP [8]
Cannabis Nicotine   Blunt, joint, spliff   A rolled cannabis cigarette usually made with rolling paper. A blunt is a cigar hollowed out and filled with cannabisa. 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[3]    
Cocaine Heroin Nicotine flamethrower, primos   Cigarette laced with cocaine and heroin
Cocaine Heroin or morphine   Powerball, speedball Powerballing, speedballing[3]> 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    
Cocaine Quetiapine   Q-ball    
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    
DXM Psilocybin or psilocybin mushroom   Cherry-bombing    
Any Dissociative Any Dissociative   Void flip    
Fentanyl Heroin   Birria, chiva loca, Facebook   Facebook is mixed in a pill form
GHB Methamphetamine   Cherry meth    
Hashish Belladonna   Alamout black hash[3]   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[3]    
Heroin Xylazine   Anestesiade caballo   Xylazine is a horse anesthetic
LSD Cannabis Amphetamine Hippie heart attack    
LSD MDMA 2C-B Ali Flip    
LSD Nitrous oxide   Gasid    
LSD Ketamine   Dolphin flip    
LSD PCP   Black acid    
LSD Psilocybin or psilocybin mushroom   God's flesh, Soul Bomb, Alice[3]    
Psilocybin or psilocybin mushroom DMT   Terence flip    
LSD DMT   Cosmo flip Cosmo flipping  
MDMA 2C-B   Nexus Flip Honey Flip[3] The MDMA is often taken first and the 2C-B after the end of the MDMA peak.
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[4] Kitty flipping  
MDMA LSD   Candy flip Candy flipping[3]  
MDMA LSD Ketamine Holy Trident Holy Tridenting  
MDMA LSD Psilocybin or psilocybin mushroom Jedi flip,[4] twilight flip Jedi flipping, twilight flipping  
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,[4] Hippy flipping [9]  
MDMA Diphenhydramine or Any deliriant   Nightmare flip Nightmare flipping  
Nicotine PCP   Chipping    
Pentazocine Tripelannamine   T's and blues    
DXM Diphenhydramine   Otc flip Robowalking on a string  
Diphenhydramine Caffeine   Sleep walking Sleep walking  
LSD Psilocybin or psilocybin mushroom DMT Super flip Super flipping Take LSD and shrooms then at the come up smoke DMT
MDMA Xanax   Zen flip Zen flipping  

2. Combined Drug Intoxication

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

Combined drug intoxication 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.[10] Benzodiazepines can cause death when mixed with other CNS depressants such as opioids, alcohol, or barbiturates.[11][12][13]

A spoonful of promethazine/​codeine syrup showing the characteristic purple color that gave rise to the name purple drank.

3. Scheduling

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.[10]

4. Research

The phenomenon is the subject of established academic literature.[14]

A study among treatment admissions found that it is more common for younger people to report poly drug use.[15]


  1. Copping, Jasper (8 November 2009). "Drug slang: what police must learn A to B". 
  3. "Erowid Drug Slang & Terminology Vault : A - B". 
  4. Nolan, James. "'Kitty Flipping' and the Psychonaut Obsession with Mixing Drugs". 
  5. "What is 2C-B? The Complete and Honest Explainer". 
  6. Keup, Wolfram (June 1971). "The Vocabulary of the Drug User and Alcoholic: A Glossary". The International Journal of the Addictions: 348. doi:10.3109/10826087109057793. Retrieved 7 October 2021. 
  7. Keup, Wolfram (June 1971). "The Vocabulary of the Drug User and Alcoholic: A Glossary". The International Journal of the Addictions: 348. doi:10.3109/10826087109057793. Retrieved 7 October 2021. 
  8. Holland, Julie A.; Nelson, Lewis; Ravikumar, P. R.; Elwood, William N. (22 February 2017). "Embalming Fluid-Soaked Marijuana: New High or New Guise for PCP?". Journal of Psychoactive Drugs. doi:10.1080/02791072.1998.10399693. Retrieved 30 July 2021. 
  9. Dalzell, Tom; Victor, Terry (2008). Vice Slang. Routledge. p. 91. ISBN 978-0415371810. 
  10. "EMCDDA Annual Report 2006 ch. 8". 
  11. "Fatal poisonings attributed to benzodiazepines in Britain during the 1980s". Br J Psychiatry 163 (3): 386–93. 1993. doi:10.1192/bjp.163.3.386. PMID 8104653.
  12. "[Relative toxicity of benzodiazepines in overdose."]. BMJ 310 (6974): 219–21. 1995. doi:10.1136/bmj.310.6974.219. PMID 7866122.
  13. 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.
  14. "Increased intensity of Ecstasy and polydrug usage in the more experienced recreational Ecstasy/MDMA users: a WWW study". Addict Behav 29 (4): 743–52. June 2004. doi:10.1016/j.addbeh.2004.02.022. PMID 15135556. 
  15. "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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