List of polysubstance combinations

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A drug combination chart designed for harm reduction by TripSit Combo 2.png
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.

Contents

Table

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

Drug 1Drug 2Drug 3Drug 4Polysubstance slang, [2] [3] [4]
or brand name
Intoxication nameComment
Any dissociative Any dissociative Void flipVoid flipping
Any dissociative DMT Dime bar, angel flipDimension flipping, angel flipping
Any depressant Any stimulant Speedball, powerball, over and underPowerballing, 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 Benzodiazepine Psilocybin or Magic mushroom WarpingWhen taken recreationally, a combination of benzodiazepines and psilocybin may soothe some of the more extreme negative effects often experienced during the peak and comedown phases of a psychedelic trip. Although benzodiazepines do not counteract the hallucinogenic and euphoric sensations caused by Psilocybin (commonly found in Magic mushrooms), they are sometimes administered by medical professionals to mitigate symptoms of a "bad trip." This practice helps to gradually relieve overactive sensory responses and induces relaxation in the individual, easing their mental state.
Any deliriant or diphen­hydramine MDMA Nightmare flipNightmare 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] NexuswalkNexus (slang for 2C-B) + Robowalk (slang for walking on DXM), similar to Nexusflipping
2C-B LSD Gnome flip[ citation needed ]Gnome flipping
2C-E LSD MDMA Haychmaich flip [5] Haychmaich flipping
2C-P 2C-E Meskini TripMeskini Tripping
2C-E MDMA or any Empathogen-entactogen 2C-B or the closely related 2C-x Elias flip [5] Elias flippingThe 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 FlipAlias flippingThe 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 flipTime flipping
Alcohol Caffeine Caffeinated alcoholic drink
Alcohol Cannabis Tincture of cannabis. Herb and Al. Judgement DayCross fading, twisting, getting twisted [13] Called Judgement Day in Ghana when cannabis is added to the drink
Alcohol Cocaine Snow-coneSnow-coningEthanol is metabolized into cocaethylene [14]
Alcohol MDMA Tipsy flipTipsy flippingIt 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]
Amphetamine Cannabis LSD Hippie heart attack [ citation needed ]
Amphetamine Cocaine Snow seals
Amphetamine Heroin Bombido [15]
Amphetamine Xanax Orange Dream BlossomCloud RushThe combination is crushed together and insufflated
Belladonna Hashish Alamout black hash [5] Mixed
Caffeine Cannabis Hippie-speedball [16] [17] Hippie-speedballing
Caffeine Diphen­hydramine Sleep walkSleepwalking
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 flipStoner flipping
Cannabis Ketamine Stoner Kitty
Cannabis Ketamine Cocaine SimmeredGetting Simmered
Cannabis Nicotine Blunt, joint, spliff, JonkoA 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)IllingWet is cannabis dipped in PCP [26]
Cannabis PCP Nicotine Wet blunt, dust blunt, dusted blunt, Kendrick Lamar bluntIlling
Cocaine Heroin Snowball. Other names: Belushi, bombita, murder one, whiz bangSnowballing
Cocaine Heroin LSD Frisco special [5]
Cocaine Heroin Nicotine Flamethrower, primosCigarette laced with cocaine and heroin
Cocaine Ketamine CK1, Calvin Klein, Cable, Party bag, CoquetteWhile 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 stringCandy-flipping on a stringHigh risk on health
Cocaine MDMA Sugar flipSugar 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 syrupsCombination 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, outerlimitsCracid is a portmanteau of crack cocaine and acid[ citation needed ]
Crack cocaine Meth­amphetamine Fire, twisters
Crack cocaine Nicotine Coolie, crimmie, woolasA cigarette laced with crack [ citation needed ]
Crack cocaine Nicotine PCP OzonePCP and crack cigarette [ citation needed ]
Crack cocaine PCP Missile base, P-funk, space base, spaceball, space cadet, space dust, tragic magicMissile basing, space basing
Diphen­hydramine DXM OTC flip, counterflippingOTC flipping, robowalking on a string
DMT LSD Cosmo flip, Meadow flipCosmo flipping, meadow flipping
DMT LSD Psilocybin or psilocybin mushroom Super flipSuper flippingTake LSD and shrooms then at the come up smoke DMT
DMT MAOIs Pharmahuasca
DMT Psilocybin or psilocybin mushroom Terence flipTerence flipping
DMT Alcohol Spyder, Spyder spinSpyder spinning
DXM LSD LSDXM
DXM MDMA Robo flipRobo flipping
DXM Psilocybin or psilocybin mushroom Cherry-bombCherry-bombing
Fentanyl Heroin Birria, chiva loca, FacebookFacebook 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 flipGamma flipping
GHB Meth­amphetamine Cherry meth
Hashish Crack cocaine Double zero
Hashish LSD Royal temple ballThe 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 flipDolphin flipping
Ketamine MDMA Kitty flip, [27] MK-ultraKitty flipping
Ketamine Psilocybin or Psilocybin mushrooms Funky flip, chonkFunky flipping, chonkingFungus 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 [28] FlipHoffmann flippingDose 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 flipHoly Tridenting, Martin Luther King flipping, Galaxy Flipping
LSD MDMA Candy flip [9] [10] Candy flipping [29] [9] [10] Generally, the MDMA is taken approximately 4 hours after the LSD ingestion.
LSD MDMA Psilocybin or psilocybin mushroom Jedi flip, [27] twilight flipJedi flipping, twilight flipping
LSD MDMA Mushrooms Ketamine Quantum FlipQuantum FlippingSimilar 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 end result is a highly visual and euphoric experience with periods of deep dissociation.
LSD Mescaline Stella trip
LSD Nitrous oxide Gasid
LSD PCP Black acid
LSD MDMA Ketamine Swalap FlipSwalaped
LSD Psilocybin or psilocybin mushroom God's flesh, Soul Bomb, Alice, [5] Wizard flipWizard flipping
LSD MDMA Any dissociative (Optional) DMT Pixie flip, portal flipPixie flipping, portal flipping
MDMA Mescaline or psychoactive cactus Love flip, love tripLove flipping
MDMA Methadone Chocolate flipChocolate flipping
MDMA Meth­amphetamine Trailer flipTrailer flipping
MDMA DMT Shaman flip, time flipShaman flipping, time flipping
MDMA Nitrous oxide Nox
MDMA Opiates Poppy flipPoppy flipping
MDMA PCP Domex, elephant flipElephant flipping
MDMA Psilocybin or psilocybin mushroom Hippie flipHippie flipping [29]
MDMA or any Empathogen-entactogen 5-MeO-MiPT 2C-B or the closely related 2C-x Selma FlippingSelma FlipKeep 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 flipZen flipping
MDMA Ketamine Mushrooms Obama FlipObama Flipping
Meth­amphetamine Secobarbital, or other barbituratesPoor man's speedball
Methamphetamine Alpha-PVP Cartel methSo-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 [30] [31] Ingested by smoking. Popular in South Africa, elsewhere in Africa, and in India. [31]
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

Related Research Articles

<span class="mw-page-title-main">Recreational use of dextromethorphan</span> Cough suppressant drug susceptible to misuse.

Dextromethorphan, or DXM, a common active ingredient found in many over-the-counter cough suppressant cold medicines, is used as a recreational drug and entheogen for its dissociative effects. Street names include Brownies, Dextro, Drix, Gel, Groove, Lean, Mega-perls, Poor man's ecstasy, Red devils, Robo, Rojo, Rome, Skittles, Sizzurp, Sky and Velvet.

<span class="mw-page-title-main">Recreational drug use</span> Use of drugs with the primary intention to alter the state of consciousness

Recreational drug use is the use of one or more psychoactive drugs to induce an altered state of consciousness, either for pleasure or for some other casual purpose or pastime. When a psychoactive drug enters the user's body, it induces an intoxicating effect. Recreational drugs are commonly divided into three categories: depressants, stimulants, and hallucinogens.

<span class="mw-page-title-main">2C-B</span> Psychoactive drug

2C-B (4-bromo-2,5-dimethoxyphenethylamine), also known as Nexus, is a synthetic psychedelic drug of the 2C family, mainly used as a recreational drug. The substance was first synthesized by Alexander Shulgin in 1974, and gained an initial reputation for potential psychotherapeutic use, but its use has been limited to mainly recreational use. To date, there is limited scientific information regarding the drug's pharmacokinetics and pharmacological effects in humans. The existing studies primarily classify 2C-B as a stimulant and hallucinogen, and less commonly an entactogen and empathogen.

<span class="mw-page-title-main">2C-E</span> Chemical compound

2C-E is a psychedelic phenethylamine of the 2C family. It was first synthesized by Alexander Shulgin and documented in his book PiHKAL. Like the other substances in its family, it produces sensory and cognitive effects in its physical reactions with living organisms.

<span class="mw-page-title-main">Cannabinol</span> Naturally-occurring cannabinoid

Cannabinol (CBN) is a mildly psychoactive cannabinoid (e.g., cannabidiol (CBD)) that acts as a low affinity partial agonist at both CB1 and CB2 receptors. This activity at CB1 and CB2 receptors constitutes interaction of CBN with the endocannabinoid system (ECS).

<span class="mw-page-title-main">Cannabidiol</span> Phytocannabinoid discovered in 1940

Cannabidiol (CBD) is a phytocannabinoid discovered in 1940. It is one of 113 identified cannabinoids in cannabis plants, along with tetrahydrocannabinol (THC), and accounts for up to 40% of the plant's extract. As of 2022, clinical research on CBD included studies related to the treatment of anxiety, addiction, psychosis, movement disorders, and pain, but there is insufficient high-quality evidence that cannabidiol is effective for these conditions. CBD is also sold as a herbal dietary supplement promoted with unproven claims of particular therapeutic effects.

<span class="mw-page-title-main">Tetrahydrocannabivarin</span> Homologue of tetrahydrocannabinol

Tetrahydrocannabivarin is a homologue of tetrahydrocannabinol (THC) having a propyl (3-carbon) side chain instead of pentyl (5-carbon), making it non-psychoactive in lower doses. It has been shown to exhibit neuroprotective activity, appetite suppression, glycemic control and reduced side effects compared to THC, making it a potential treatment for management of obesity and diabetes. THCV was studied by Roger Adams as early as 1942.

<span class="mw-page-title-main">2C-B-FLY</span> Psychedelic designer drug

2C-BFLY is a psychedelic phenethylamine and designer drug of the 2C family. It was first synthesized in 1996 by Aaron Monte, Professor of Chemistry at UW-La Crosse.

<span class="mw-page-title-main">Polysubstance use</span> Use of multiple psychoactive substances

Polysubstance use or poly drug use refers to the use of combined psychoactive substances. Polysubstance use may be used for entheogenic, recreational, or off-label indications, with both legal and illegal substances. In many cases one drug is used as a base or primary drug, with additional drugs to leaven or compensate for the side effects, or tolerance, of the primary drug and make the experience more enjoyable with drug synergy effects, or to supplement for primary drug when supply is low.

<span class="mw-page-title-main">11-Hydroxy-THC</span> Active metabolite of Δ9-THC

11-Hydroxy-Δ9-tetrahydrocannabinol, usually referred to as 11-hydroxy-THC is the main active metabolite of tetrahydrocannabinol (THC), which is formed in the body after Δ9-THC is consumed.

<span class="mw-page-title-main">Tetrahydrocannabutol</span> Chemical compound

Δ9-Tetrahydrocannabutol is a phytocannabinoid found in cannabis that is a homologue of tetrahydrocannabinol (THC), the main active component of Cannabis. Structurally, they are only different by the pentyl side chain being replaced by a butyl side chain. THCB was studied by Roger Adams as early as 1942

<span class="mw-page-title-main">Dronabinol</span> Generic name of Δ9-THC in medicine

Dronabinol, also known under the brand names Marinol and Syndros, is a generic name for the molecule of delta-9-tetrahydrocannabinol in the pharmaceutical context. It has indications as an appetite stimulant, antiemetic, and sleep apnea reliever and is approved by the FDA as safe and effective for HIV/AIDS-induced anorexia and chemotherapy-induced nausea and vomiting only.

<span class="mw-page-title-main">Cannabis drug testing</span> Drug test methodologies for the use of cannabis

Cannabis drug testing describes various drug test methodologies for the use of cannabis in medicine, sport, and law. Cannabis use is highly detectable and can be detected by urinalysis, hair analysis, as well as saliva tests for days or weeks.

<span class="mw-page-title-main">Tetrahydrocannabinolic acid</span> THC precursor

Tetrahydrocannabinolic acid is a precursor of tetrahydrocannabinol (THC), an active component of cannabis.

<span class="mw-page-title-main">8,9-Dihydrocannabidiol</span> Chemical compound

8,9-Dihydrocannabidiol is a synthetic cannabinoid that is closely related to cannabidiol (CBD) itself. that was first synthesized by Alexander R. Todd in 1940 derived from the catalytic hydrogenation of cannabidiol.

<span class="mw-page-title-main">Δ-8-Tetrahydrocannabinol</span> Isomer of tetrahydrocannabinol

Δ-8-tetrahydrocannabinol is a psychoactive cannabinoid found in the Cannabis plant. It is an isomer of delta-9-tetrahydrocannabinol, the compound commonly known as THC, with which it co-occurs in hemp; natural quantities of ∆8-THC found in hemp are low.

<span class="mw-page-title-main">11-Hydroxy-Delta-8-THC</span> Metabolite of delta-8-THC

11-Hydroxy-Delta-8-tetrahydrocannabinol is an active metabolite of Δ8-THC, a psychoactive cannabinoid found in small amounts in cannabis. It is an isomer of 11-OH-Δ9-THC, and is produced via the same metabolic pathway. It was the first cannabinoid metabolite discovered in 1970.

<span class="mw-page-title-main">Tetrahydrocannabihexol</span> Chemical compound

Tetrahydrocannabihexol is a phytocannabinoid, the hexyl homologue of tetrahydrocannabinol (THC) which was first isolated from Cannabis plant material in 2020 along with the corresponding hexyl homologue of cannabidiol, though it had been known for several decades prior to this as an isomer of the synthetic cannabinoid parahexyl. Another isomer Δ8-THCH is also known as a synthetic cannabinoid under the code number JWH-124, though it is unclear whether this occurs naturally in Cannabis, but likely is due to Δ8-THC itself being a degraded form of Δ9-THC. THC-Hexyl can be synthesized from 4-hexylresorcinol and was studied by Roger Adams as early as 1942.

Tusi, also known as pinkcocaine, is a recreational drug most commonly found in pink-dyed powder form that contains a mixture of different psychoactive substances. The concoction is also referred to as “pink cocaine”, as it typically circulates on the illicit market in pink powder form. Tusi is believed to have originated in Latin America around 2018. Drug-checking studies in Latin America report tusi to be a concoction of ketamine, MDMA, cocaine, methamphetamine, caffeine, opioids, and other new psychoactive substances (NPS). Existing literatures suggest tuci to have no standard proportions of the constituent drugs.

Cannabidiol (CBD) can be chemically converted into tetrahydrocannabinol (THC) via a ring-closing reaction. This cyclization can be acid-catalyzed or brought about by heating.

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