Exhibit 11-3. Drug Combinations and Common Reasons for Use

Heroin plus alcoholEnhance a high; create euphoria or sedation
Heroin followed by alcoholMedicate opioid withdrawal; medicate cocaine overstimulation (e.g., anxiety, paranoia)
Heroin plus cocaine (“speedball”)Enhance or alter cocaine euphoria
Heroin followed by cocaineMedicate opioid withdrawal
Cocaine plus alcoholEnhance high; reduce cocaine overstimulation (e.g., anxiety, paranoia)
Cocaine followed by heroinReduce cocaine overstimulation (e.g., anxiety, paranoia); modulate the cocaine crash
Methadone plus alcoholCreate a high; sedate
Methadone plus cocaineReduce cocaine overstimulation (e.g., anxiety, paranoia); moderate the cocaine “crash”
Methadone plus benzodiazepinesCreate a high; sedate
Any opioid plus any nonbenzodiazepine sedativeCreate a high; sedate
Any opioid followed by any nonbenzodiazepine sedativeMedicate opioid withdrawal
Any opioid plus amphetamineCreate a high

From: Chapter 11. Treatment of Multiple Substance Use

Cover of Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs
Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs.
Treatment Improvement Protocol (TIP) Series, No. 43.
Center for Substance Abuse Treatment.

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