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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.
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 Benzodiazepine | Psilocybin or Magic mushroom | Warping | When 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 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[ citation needed ] | Gnome flipping | |||
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] | ||||
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 | 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, [27] 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 [28] 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. | ||
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 [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 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 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 Flip | Swalaped | ||
LSD | Psilocybin or psilocybin mushroom | God's flesh, Soul Bomb, Alice, [5] Wizard flip | Wizard flipping | |||
LSD | MDMA | Any dissociative | (Optional) DMT | Pixie flip, portal flip | Pixie flipping, portal 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 | 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 [29] | |||
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 [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. | |||
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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
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.
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.
Tetrahydrocannabinolic acid is a precursor of tetrahydrocannabinol (THC), an active component of cannabis.
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.
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.
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.
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.