List of polysubstance combinations

Not to be confused with Lacing (drugs) § Commonly laced substances.

A drug combination chart designed for harm reduction by TripSit

Polysubstance use or multisubstance use is the use of combinations of psychoactive substances with both legal and illegal substances. This page lists polysubstance combinations that are entheogenic, recreational, or off-label indicated use of pharmaceuticals. For example, the over-the-counter motion sickness combination drug dimenhydrinate (8-chlorotheophylline/diphenhydramine) is occasionally used in higher doses as a deliriant. The prescription medicine Adderall (dextroamphetamine sulfate/amphetamine sulfate/dextroamphetamine saccharate/amphetamine aspartate monohydrate) is also frequently used recreationally. However, using non-prescribed drugs, using non-prescribed dose regimen, can cause polysubstance dependence, or combined drug intoxication which may lead to deaths.

Table

To avoid an excessively long list, the table below only lists recreational drug combinations that are not patent medicine.

Drug 1	Drug 2	Drug 3	Drug 4	Polysubstance slang, [2] [3] [4] or brand name	Intoxication name	Comment
Any dissociative	Any dissociative			Void flip	Void flipping
Any dissociative	DMT			Dime bar, angel flip	Dimension flipping, angel flipping
Any depressant	Any stimulant			Speedball, powerball, over and under	Powerballing, speedballing [5]
Any pharmaceutical	Any pharmaceutical			Polypharmacy	Pharming [ citation needed ]	Polypharmacy is most commonly defined as the use of five or more medications daily by an individual. [6] However, the definition of polypharmacy is still debated and can vary from two to 11 concurrent medications. [6]
Any drug	Cannabis			Amp joint [7]
Any drug	Nicotine			Cooler [5]
Any β-Carboline containing plant (e.g. Banisteriopsis caapi or Peganum harmala )	DMT			Ayahuasca, Changa		Ayahuasca is drunk. Changa is smoked or vaped.
Any antiretroviral drug	Black tar heroin			Whoonga, Nyaope [8]		Widespread use in South Africa. Whoonga is classically reputed to be a combination of heroin with antiretroviral drugs such as ritonavir and/or efavirenz, often combined with additional drugs such as cannabis or hashish, methamphetamine and/or methaqualone
Any deliriant or diphen­hydramine	MDMA			Nightmare flip	Nightmare flipping
2C-B or the closely related 2C-x	LSD or any of the Lysergamides	MDMA or any Empathogen-entactogen		Ali flip [9] [10]	Ali flipping [9] [10]	This combination start as a classic Candyflip and end in a Nexus flip. The LSD is taken first, followed by the MDMA 4 hours later and then 2C-B is taken 2 hours after the MDMA ( so 6 hours after the LSD ). MDMA can be replaced by 6-APB, 5-APB, 6-MAPB or 5-MAPB, in this case the Empathogen is taken 2 hours after the LSD, while 2C-B may be replaced by 2C-C, 2C-D or 2C-B-FLY. This combination's goal is to prolong the empathogenic effects of MDMA and the psychedelic effects of LSD. The idea is to have be able to experience an enhanced "Candyflipping" with a smoother comedown. The whole experience is long-lasting and can be too intense as all of these molecules synergize and potentiate each other.
2C-B	MDMA			Nexus flip [9] [10]	Nexus flipping [9] [10]	The MDMA is often taken first and the 2C-B after the end of the MDMA peak (h+2/h+2.½). [11] The 2C-B is supposed to help the empathogenic effect of the MDMA last longer.
2C-B	DXM			Nexuswalk [12]	Nexuswalk	Nexus (slang for 2C-B) + Robowalk (slang for walking on DXM), similar to Nexusflipping
2C-B	LSD			Gnome flip
2C-E	LSD	MDMA		Haychmaich flip [5]	Haychmaich flipping
2C-P	2C-E			Meskini Trip	Meskini Tripping
2C-E	MDMA or any Empathogen-entactogen	2C-B or the closely related 2C-x		Elias flip [5]	Elias flipping	The Elias Flipping inspired by the Ali Flip with the use of 2C-E instead of LSD.
2C-E	LSD or closely related Lysergamides	MDMA or any Empathogen	2C-B or closely related 2C-x	Alias Flip	Alias flipping	The Alias flip is a very powerful mix between an Elias flip and an Ali flip. The idea is to take substances in this order to maximize the duration of 2C-E with the LSD taken one hour after 2C-E.
Alcohol	Benzodiazepine			Time flip	Time flipping
Alcohol	Caffeine			Caffeinated alcoholic drink
Alcohol	Cannabis			Tincture of cannabis. Herb and Al. Judgement Day	Cross fading, twisting, getting twisted [13]	Called Judgement Day in Ghana when cannabis is added to the drink
Alcohol	Cocaine			Snow-cone	Snow-coning	Ethanol is metabolized into cocaethylene [14]
Alcohol	MDMA			Tipsy flip	Tipsy flipping	It may be dangerous
Alcohol	Nicotine			Nicotini		A nicotini is any alcoholic drink which includes nicotine as an ingredient. Nicotine replacement therapy products such as mouth spray may be used.
Amphetamine	Barbiturates			Inbetweens [15] Bam
Amphetamine	Cannabis	LSD		Hippie heart attack [ citation needed ]
Amphetamine	Cocaine			Snow seals
Amphetamine	Heroin			Bombido [15]
Amphetamine	Xanax			Orange Dream Blossom	Cloud Rush	The combination is crushed together and insufflated
Belladonna	Hashish			Alamout black hash [5]		Mixed
Caffeine	Cannabis			Hippie-speedball [16] [17]	Hippie-speedballing
Caffeine	Diphen­hydramine			Sleep walk	Sleepwalking
Caffeine	Meth­amphetamine			Ya ba, biker's coffee, kamikaze
Cacao bean	Magic mushroom					Aztec use of entheogens. Conventional defatted cocoa solids dissolved in fat may be used instead of whole beans.
CBD	THC					Low to moderate doses of CBD might reduce some of the paranoia, anxiety, [18] and reduction of hippocampal volumes that the current high potency THC marijuana (in the last decades, THC content increased and CBD content decreased) can cause, if the CBD substitutes a part of the THC dose. [19] [20] [21] Low doses of Kanna might also help counteract the anxiety. [22] [23]
Cannabis	Cocoa solids			Cannabis-infused brownie		Cannabis edible
Cannabis	Crack cocaine			Crack weed (less known: Buddha, caviar, champagne, chronic, cocktail, dirty joint, fry daddy, gimmie, gremmies, juice joint, lace, oolies, p dog, primo, thirty eight, torpedo, turbo, wollie, yeola) [24]	Cocoa puffs, splitting
Cannabis	Crack cocaine	Heroin		Major Pronin, El Diablo
Cannabis	Crack cocaine	PCP		Jim Jones
Cannabis	Damiana					Damiana and other herbs can be used as a tobacco alternative for rolling joints. [25]
Cannabis	DXM	Nicotine		Candy blunt
Cannabis	Heroin or opium			A-bomb, Atom bomb, stuff [5]
Cannabis	MDMA			Stoner flip	Stoner flipping
Cannabis	Ketamine			Stoner Kitty
Cannabis	Ketamine	Cocaine		Simmered	Getting Simmered
Cannabis	Nicotine			Blunt, joint, spliff, Jonko		A rolled cannabis cigarette usually made with rolling paper. A blunt is a cigar hollowed out and filled with cannabis. It is rolled with the tobacco-leaf "wrapper" from an inexpensive cigar. Blunts take their name from Phillies Blunt brand cigars.
Cannabis	Opium			Demetra
Cannabis	PCP			Wet (less known: Bionic, clickums, donk, illies, leak, love leaf, lovelies, parsley, supergrass, superweed, wet, zoom)	Illing	Wet is cannabis dipped in PCP [26]
Cannabis	PCP	Nicotine		Wet blunt, dust blunt, dusted blunt, Kendrick Lamar blunt	Illing
Cocaine	Heroin			Snowball. Other names: Belushi, bombita, murder one, whiz bang	Snowballing
Cocaine	Heroin	LSD		Frisco special [5]
Cocaine	Heroin	Nicotine		Flamethrower, primos		Cigarette laced with cocaine and heroin
Cocaine	Ketamine			CK1, Calvin Klein, Cable, Party bag, Coquette		While CK1, Calvin Klein and Cable are all names for using both substances; a Party bag is in specific reference to when the substances are mixed in a single bag prior to use.
Cocaine	Ketamine	MDMA		Ketamollicaine
Cocaine	LSD	MDMA		Candy-flip on a string	Candy-flipping on a string	High risk on health
Cocaine	MDMA			Sugar flip	Sugar flipping
Cocaine	Morphine			C & M
Cocaine	PCP			Space, whack
Cocaine	Wine			Coca wine		Ethanol is metabolized into cocaethylene
Cocaine	Quetiapine			Q-ball
Codeine	Glutethimide			Pancakes and syrups		Combination of glutethimide and codeine cough syrup
Codeine	Promethazine			Lean, purple drank, oil
Crack cocaine	Fentanyl			Dirty fentanyl, takeover [ citation needed ]
Crack cocaine	Heroin			Chocolate rock, dragon rock, eightball, moonrock, smoking gun, tar
Crack cocaine	LSD			Cracid, outerlimits		Cracid is a portmanteau of crack cocaine and acid[ citation needed ]
Crack cocaine	Meth­amphetamine			Fire, twisters
Crack cocaine	Nicotine			Coolie, crimmie, woolas		A cigarette laced with crack [ citation needed ]
Crack cocaine	Nicotine	PCP		Ozone		PCP and crack cigarette [ citation needed ]
Crack cocaine	PCP			Missile base, P-funk, space base, spaceball, space cadet, space dust, tragic magic	Missile basing, space basing
Diphen­hydramine	DXM			OTC flip, counterflipping	OTC flipping, robowalking on a string
DMT	LSD			Cosmo flip, Meadow flip	Cosmo flipping, meadow flipping
DMT	LSD	Psilocybin or psilocybin mushroom		Super flip	Super flipping	Take LSD and shrooms then at the come up smoke DMT
DMT	MAOIs			Pharmahuasca
DMT	Psilocybin or psilocybin mushroom			Terence flip	Terence flipping
DMT	Nitrous oxide			Dimension flip	Dimension flipping	Nitrous oxide can, allegedly, briefly multiply the effects of psychedelics like DMT or NB-DMT [27]
DMT	Alcohol			Spyder, Spyder spin	Spyder spinning
DXM	LSD			LSDXM
DXM	MDMA			Robo flip	Robo flipping
DXM	Psilocybin or psilocybin mushroom			Cherry-bomb	Cherry-bombing
Fentanyl	Heroin			Birria, chiva loca, Facebook		Facebook is mixed in a pill form [ citation needed ]
Fentanyl (and/or heroin)	Xylazine			Tranq, Tranq dope		"Tranq" is sometimes used to refer to xylazine by itself, but as a drug of abuse it is invariably combined with heroin or fentanyl
GHB	MDMA			Gamma flip	Gamma flipping
GHB	Meth­amphetamine			Cherry meth
Hashish	Crack cocaine			Double zero
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 [5]
Ketamine	LSD			Dolphin flip	Dolphin flipping
Ketamine	MDMA			Kitty flip, [28] MK-ultra	Kitty flipping
Ketamine	Psilocybin or Psilocybin mushrooms			Funky flip, chonk	Funky flipping, chonking	Fungus and K: one confirmed option is to ingest a low (0.75g) dose of psilocybin, wait 45 minutes, snort half a moderate dose of powdered ketamine, wait 10 minutes, snort the other half
LSD	Caffeine			Hoffmann [29] Flip	Hoffmann flipping	Dose the LSD (amount of your choice). After 30 minutes drink 250ml of coffee and keep your usual coffee drinking habit throughout the day. (Albert Hofmann x James Hoffmann)
LSD	Ketamine	MDMA		Holy Trident, Martin Luther King flip, Galaxy flip	Holy Tridenting, Martin Luther King flipping, Galaxy Flipping
LSD	MDMA			Candy flip [9] [10]	Candy flipping [30] [9] [10]	Generally, the MDMA is taken approximately 4 hours after the LSD ingestion.
LSD	MDMA	Psilocybin or psilocybin mushroom		Jedi flip, [28] twilight flip	Jedi flipping, twilight flipping
LSD	MDMA	Mushrooms	Ketamine	Quantum Flip	Quantum Flipping	Similar to Jedi flipping, but with a heavy dissociative effect induced by ketamine. The substances are taken in the order of LSD, Mushrooms, MDMA, then ketamine. Each substance should be taken at the peak of the previous substance to maximize the synergistic effects. Ketamine can be re-dosed as needed to extend the trip. The result is a highly visual and euphoric experience with periods of deep dissociation.
LSD	Mescaline			Stella trip
LSD	Nitrous oxide			Gasid		Nitrous oxide can, allegedly, briefly multiply the effects of psychedelics like LSD. [27]
LSD	PCP			Black acid
LSD	MDMA	Ketamine		Swalap Flip	Swalaped
LSD	Psilocybin or psilocybin mushroom			God's flesh, Soul Bomb, Alice, [5] Wizard flip	Wizard flipping
LSD	Dissociatives, especially long-lasting ones such as DMXE and/or DCK.	MDMA		Pixie flip	Pixie flipping
LSD	Dissociatives, especially long-lasting ones such as DMXE and/or DCK.	MDMA	DMT	Behind the curtain, portal flip	Climbing behind the curtain, portal flipping	DMT is taken last.
LSD	Metocin (4-HO-MET)			Neon Bomb, Diamond Bomb	Neon Bombing, Diamond Bombing	Metocin is taken last, usually around onset of LSD. Similar to a Soul Bomb, but because of the lower headspace and body high and higher visual effects of Metocin, the trip is more visual and stimulating.
MDMA	Mescaline or psychoactive cactus			Love flip, love trip	Love flipping
MDMA	Methadone			Chocolate flip	Chocolate flipping
MDMA	Meth­amphetamine			Trailer flip	Trailer flipping
MDMA	DMT			Shaman flip, time flip	Shaman flipping, time flipping
MDMA	Nitrous oxide			Nox
MDMA	Opiates			Poppy flip	Poppy flipping
MDMA	PCP			Domex, elephant flip	Elephant flipping
MDMA	Psilocybin or psilocybin mushroom			Hippie flip	Hippie flipping [30]
MDMA or any Empathogen-entactogen	5-MeO-MiPT	2C-B or the closely related 2C-x		Selma Flipping	Selma Flip	Keep the doses low, as 5-MeO-MiPT and Empathogen-entactogen can cause a Serotonin Syndrome at high doses, it's a Nexus Flip enhanced by 5-MeO-MiPT for psychedelic, entactogenic & erotic effects.
MDMA	Viagra (or other PDE5 inhibitors such as Cialis or Levitra)			Sextacy
MDMA	Xanax			Zen flip	Zen flipping
MDMA	Ketamine	Mushrooms		Obama Flip	Obama Flipping
Meth­amphetamine	Secobarbital, or other barbiturates			Poor man's speedball
Methamphetamine	Alpha-PVP			Cartel meth		So-called "cartel meth" is primarily composed of cutting agents such as isopropylbenzylamine and/or dimethylsulfone with a small proportion of methamphetamine plus the potent stimulant Alpha-PVP
Methaqualone	Cannabis			White pipe [31] [32]		Ingested by smoking. Popular in South Africa, elsewhere in Africa, and in India. [32]
Nicotine	PCP			Chipping, fry cigarette
Pentazocine	Tripelannamine			T's and blues
Venlafaxine	Mirtazepine			California rocket fuel		None of the drugs are illegal and the combination is used for medical purposes.

See also

• ACE mixture
• Brompton cocktail
• D-IX
• Desbutal
• Dexamyl
• Gray death
• Homebake (slang)
• Neuroleptanalgesic
• Rodent cocktail
• Tuinal
• Twilight sleep
• List of plants used for smoking

References

1. "Drug Combinations". combo.tripsit.me.
2. "Erowid Drug Slang & Terminology Vault : A - B". erowid.org.
3. Copping, Jasper (8 November 2009). "Drug slang: what police must learn A to B".
4. "Slang Terms and Code Words: A Reference for Law Enforcement Personnel". GovInfo. Retrieved 2024-07-06.
5. "Erowid Drug Slang & Terminology Vault : A - B". erowid.org.
6. Masnoon, Nashwa; Shakib, Sepehr; Kalisch-Ellett, Lisa; Caughey, Gillian E. (October 2017). "What is polypharmacy? A systematic review of definitions". BMC Geriatrics. 17 (1): 230. doi: 10.1186/s12877-017-0621-2 . ISSN   1471-2318. PMC   5635569 . PMID   29017448.
7. "Slang Terms for Drug Combinations". Narconon International. Retrieved 2021-12-08.
8. Grelotti DJ, Closson EF, Smit JA, Mabude Z, Matthews LT, Safren SA, Bangsberg DR, Mimiaga MJ. Whoonga: potential recreational use of HIV antiretroviral medication in South Africa. AIDS Behav. 2014 Mar;18(3):511-8. doi : 10.1007/s10461-013-0575-0 PMID   23955659
9. "Ali Flip : Candy Flip & Nexus Flip melted". Chemical Collective. 29 March 2024. Retrieved 2024-03-29.
10. El Guennouni, Ali (12 March 2023). "'Ali flip' LSD , MDMA & 2C-B use and combination in Therapy". chemical-collective.com. Retrieved 1 May 2023.
11. Weiss, Suzannah (2024-02-16). "Nexus Flipping: What Happens When You Combine MDMA and 2C-B". DoubleBlind Mag. Retrieved 2024-07-10.
12. "DXM & 2C-B - Erowid Exp - 'Nexuswalk - A Beautiful Mix of DXM and 2C-B'". erowid.org. Retrieved 2023-04-18.
13. Lankenau, Stephen; Clatts, Michael; Welle, Dorinda; Goldsamt, Lloyd; Gwadz, Marya (January 2005). "Street careers: homelessness, drug use, and sex work among young men who have sex with men (YMSM)". International Journal of Drug Policy. 16 (1): 10–18. doi:10.1016/j.drugpo.2004.07.006.
14. Pergolizzi, Joseph; Breve, Frank; Magnusson, Peter; LeQuang, Jo Ann K.; Varrassi, Giustino (2022-02-22). "Cocaethylene: When Cocaine and Alcohol Are Taken Together". Cureus. 14 (2): e22498. doi: 10.7759/cureus.22498 . ISSN   2168-8184. PMC   8956485 . PMID   35345678.
15. Keup, Wolfram (June 1971). "The Vocabulary of the Drug User and Alcoholic: A Glossary". The International Journal of the Addictions. 6 (2): 348. doi:10.3109/10826087109057793. PMID   4950517 . Retrieved 7 October 2021.
16. Crone, Madeline (2021-10-07). "Premiere: Singer-Songwriter Ben Chapman Defines a "Hippie Speedball" with a New Acoustic Video". American Songwriter. Retrieved 2024-07-27.
17. Rizzo, Melanie (2022-03-21). "Coffee Alternatives: A Modern Spin on the Hippie Speedball". TheBluntness. Retrieved 2024-07-27.
18. Gibson LP, Karoly HC, Ellingson JM, Klawitter J, Sempio C, Squeri JE, Bryan AD, Bidwell LC, Hutchison KE (2022). "Effects of cannabidiol in cannabis flower: Implications for harm reduction". Addiction Biology. 27 (1): e13092. doi:10.1111/adb.13092. PMC   9357513 . PMID   34467598. S2CID   237372495.
19. Stuyt, Elizabeth (2018). "The Problem with the Current High Potency THC Marijuana from the Perspective of an Addiction Psychiatrist". Missouri Medicine. 115 (6): 482–486. ISSN   0026-6620. PMC   6312155 . PMID   30643324.
20. ElSohly, Mahmoud A.; Mehmedic, Zlatko; Foster, Susan; Gon, Chandrani; Chandra, Suman; Church, James C. (2016-04-01). "Changes in Cannabis Potency over the Last Two Decades (1995-2014) - Analysis of Current Data in the United States". Biological Psychiatry. 79 (7): 613–619. doi:10.1016/j.biopsych.2016.01.004. ISSN   0006-3223. PMC   4987131 . PMID   26903403.
21. Zamarripa, C. Austin; Spindle, Tory R.; Surujunarain, Renuka; Weerts, Elise M.; Bansal, Sumit; Unadkat, Jashvant D.; Paine, Mary F.; Vandrey, Ryan (2023-02-01). "Assessment of Orally Administered Δ9-Tetrahydrocannabinol When Coadministered With Cannabidiol on Δ9-Tetrahydrocannabinol Pharmacokinetics and Pharmacodynamics in Healthy Adults: A Randomized Clinical Trial". JAMA Network Open. 6 (2): e2254752. doi:10.1001/jamanetworkopen.2022.54752. ISSN   2574-3805. PMC   9926328 . PMID   36780161.
22. Sumpter, Luke (2022-12-29). "Combining Kanna with Weed or CBD: Should You Do It?". www.zamnesia.com. Retrieved 2023-02-05.
23. Manganyi, Madira Coutlyne; Bezuidenhout, Cornelius Carlos; Regnier, Thierry; Ateba, Collins Njie (2021-04-28). "A Chewable Cure "Kanna": Biological and Pharmaceutical Properties of Sceletium tortuosum". Molecules (Basel, Switzerland). 26 (9): 2557. doi: 10.3390/molecules26092557 . ISSN   1420-3049. PMC   8124331 . PMID   33924742.
24. Tom Dalzell (2009), The Routledge Dictionary of Modern American Slang and Unconventional English, Routledge, ISBN   978-0-415-37182-7
25. Ewe, Koh (2021-04-19). "TikTokers Are Smoking Flowers As Weed Alternatives". www.vice.com. Retrieved 2021-12-24.
26. 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. 30 (2): 215–219. doi:10.1080/02791072.1998.10399693. PMID   9692385 . Retrieved 30 July 2021– via Erowid.org.
27. "Nitrous Oxide". Drug Science. Retrieved 2024-10-03.
28. Nolan, James (8 February 2019). "'Kitty flipping' and the Psychonaut Obsession with Mixing Drugs". VICE.com. Retrieved 16 July 2020.
29. "James Hoffmann". YouTube. Retrieved 2024-06-07.
30. Zeifman, Richard J.; Kettner, Hannes; Pagni, Broc A.; Mallard, Austin; Roberts, Daniel E.; Erritzoe, David; Ross, Stephen; Carhart-Harris, Robin L. (2023-08-22). "Co-use of MDMA with psilocybin/LSD may buffer against challenging experiences and enhance positive experiences". Scientific Reports. 13 (1): 13645. doi:10.1038/s41598-023-40856-5. ISSN   2045-2322. PMC   10444769 . PMID   37608057.
31. "Mandrax". DrugAware. Reality Media. 2003. Retrieved 2009-08-13.
32. McCarthy G, Myers B, Siegfried N (April 2005). "Treatment for methaqualone dependence in adults". The Cochrane Database of Systematic Reviews (2): CD004146. doi:10.1002/14651858.CD004146.pub2. PMID   15846700.