▪ Many people heard the story about the kids who took VIAGRA and ECSTASY at the same time. They had sex with girls for so long that they got gangrene on their dicks and had to get them amputated. I never knew if that was true. But, either way, it makes sense. Do not take drugs that will enable you and make you desire to use your dick for 5 hours straight. It’s not natural.

▪ Apparently you are not supposed to take TYLENOL if you are already on COCAINE. The last time I was in the emergency room visiting a friend, who had snorted too much cocaine, they were holding her there overnight to check Tylenol content in her body. It’s a very dangerous mix. On the other hand, they weren’t concerned that she had also taken Valium and Ambien that evening.

▪ Sorry to be vague on this one, but you shouldn’t be on ANY MEDICATION or drinking ALCOHOL while experimenting with SPECIAL K (KETAMINE). SPECIAL K is too dangerous by itself. It’s very good at killing people.

SPEEDBALL; HEROIN and COCAINE mixed together. Speedball overdoses now occur more often then straight Heroin overdoses in Emergency Rooms. The coke speeds up the heart beat. The heroin slows it down. The coke wears off before the heroin though and the extreme change in heart rate, from the effect of the coke to the effect of the heroin alone, can cause a delayed overdose. These days, the term “speedballing” is also used to refer to the simultaneous use of any opiate with any stimulant. The second most common combo in a speedball is heroin and methamphetamine.

HEROIN and ALCOHOL is a deadly combination. They both suppress the impulse to breathe. If you do enough of both at once, there’s a good chance you’ll stop breathing. Much like the deaths caused by Percocet and Alcohol. Heroin is an opioid.

▪ Other OPIOIDS that would mix badly with ALCOHOL include the following… OPIUM, CODEINE, MORPHINE, VICODIN, DEMEROL, PERCOCET, OXYCONTIN. I guess that week of mine on vicodin and alcohol was a bad idea. Of course, heroin is much stronger than vicodin. Point is, when you are doing any of these drugs, you are relaxed enough and do not need a few beers to take the edge off.

▪ Do not drink ALCOHOL while on PERCOCET!

▪ Most Oxycontin related deaths are attributed to a combination of the Oxycodone (found in the Oxycontin) and Alcohol or Benzodiazepines. Or any other drugs that are considered depressants in the central nervous system. Some common Benzo’s are Xanax, Klonapin, Valium, Rohypnol, Librium, etc…

▪ The dehydration factor in both ECSTASY and ALCOHOL makes them a bad mix. People have died from this combo, as stupid as that seems. When taking Ecstasy always drink enough water. You don’t want to drink too much water either. And it’s definitely better to just be lounging around as opposed to dancing all night. You should look up Ecstasy in the chapter “What Certain Drugs Do.” It provides good detail.

▪ You can die from smoking CIGARETTES if at the same time you are wearing a NICOTINE PATCH or chewing on NICOTINE GUM. This can cause a nicotine overdose, which can result in death. Smoking cigarettes alone CANNOT lead to a Nicotine overdose. Just diseases later on. Watch the film Thank you for smoking for a loose example of this.

▪ People with BI-POLAR DISORDER find that CIGARETTES help them to relax. People with ADHD (Attention Deficit Hyperactivity Disorder) say that SMOKING CIGARETTES helps them focus.

▪ The combined effect of ZOLOFT, LEXAPRO and METHADONE is what killed Anna Nicole Smith’s 20-year-old son. People don’t know why he was on the Methadone. See? It can be as innocent as you not telling one doctor that you were prescribed something else from another doctor, and Poof! You’re Dead. It doesn’t need to be from a drug dealer. Technically, I should tell you that at the moment the death certificate still reads something like, “unknown reason of death.” Zoloft and Lexapro together were apparently okay. It’s the addition of the Methadone that did it. However, you shouldn’t be taking 2 antidepressants (like Zoloft and Lexapro) at the same time anyway.

FENTANYL combined with either HEROIN or COCAINE is believed to be severely lethal. If you know that your H or Coke is being cut with Fentanyl, do not do it. If possible, it’s best to know what your drugs are cut with.

The sudden death potential of COCAINE increases by about 20 times when you drink alcohol with it. Alcohol seems to magnify the high of coke and lessens the crash. It also prolongs the entire effect of the cocaine. ALCOHOL and COCAINE is the second most lethal drug combination. Much safer to do cocaine by itself.

▪ Sorry, I know driving is not a drug, but I had to list this one. DRIVING while DRUNK. That is the most dangerous thing you can mix with drinking. This probably kills more people than anything else on this list.

ECSTASY mixed with drugs that act on SEROTONIN can cause Serotonin Syndrome, which can cause death to occur very rapidly. Anti-depressants such as Zoloft, Prozac, Lexapro, Celexa, Paxil and others act on Serotonin.

BENZODIAZEPINE and METHADONE is quite lethal if not taken precisely as directed. A commonly abused BENZODIAZEPINE is Valium.

ALCOHOL and BARBITURATES is the combination that the Heaven’s Gate Cult took in order to act out its MASS SUICIDE. Barbiturates and Benzodiazepines are the two classes of Sedatives-Hypnotics. Some well known Barbiturates are Seconal and Nembutal.

ALCOHOL and as low as 7 grams of TYLENOL can result in death. The mix causes serious damage to the liver.

(Tylenol seems to be coming up too much here. If you have a headache after a night of fun, take Advil. Or you could not take anything for the pain that night, suck it up, and plan to stop taking these drugs that are giving you the headaches in the first place!)

The following is a list of the most commonly found drugs in the corpses of 163 people who took combinations of drugs in order to commit suicide…Different mixtures of these substances were found in different victims.

Ethanol, Acetaminophen, Amitriptyline, Doxepin, Alprazolam, Propoxypene, Heroin/Morphine, Codeine, Phenobarbital, and Diazepam.

To give you a more general overview of the drugs above, they belong to the following families…or we know them more commonly as, or you can look them up in this book as…

Alcohol, Tylenol, Antidepressants, Benzodiazepines, Narcotic analgesics, Opioid derivatives and Barbiturates.

This seems like a pretty solid summary of the examples I’ve given in this chapter.

To avoid confusion, because both have come up here and they intertwine a bit, opiates and opioids are not exactly the same thing. Though both are narcotic analgesics which are attracted to opioid receptor subtypes, opiates contain the fundamental morphine or thebaine structure while opioids do not. Put more simply, opiates come from a natural source (the opium poppy) and opioids do not. Opioids are either semi or fully synthetic. What can get confusing is that the term “opioid” is used to refer to the entire family of both opioids and opiates. This family includes, but is not limited to morphine, codeine, heroin, oxycodone, fentanyl, methadone and hydrocodone.

Habitually smoking at least 2 of the following 3 substances on a regular basis (as opposed to smoking only one of them) will raise the chance of a person getting cancer. TOBACCO, MARIJUANA, CRACK COCAINE. You might want to think about only doing one of these if you have to do any.

STEROIDS and COCAINE used at the same time can cause lethal strokes. Apparently, cocaine accentuates the bad qualities of testosterone and diminishes the good ones. Personally, I would say that doing blow is safer than using steroids, but it’s more likely that you are a person who is already on steroids who may decide to try cocaine as opposed to visa-versa.

METHAMPHETAMINE and GHB combined creates a much greater risk of seizure than being on only GHB.

TOO MUCH PURE HEROIN. The explanation here actually involves more of a lack of a combination, or rather, the type of mistake a common combination can lead to. Here’s what happens. A heroin addict’s tolerance is growing and growing. He needs more each time in order to achieve the same high. The H he is normally buying is mixed with a cutting agent that represents a substantial portion of the combined substance. Lets say the addict now needs 5 bags in a sitting to get high. He’ll buy from anyone who is selling. Someone sells him his usual amount, but this heroin is actually much “better” (meaning, not mixed with other stuff) than the usual stuff the addict buys. He injects himself, taking about twice as much actual heroin than usual. This severe jump in content kills him.

- I may have touched on this already, but it’s a very important point. It is one thing if a kid is knowingly mixing drugs and doesn’t care. But the idea that a single drug may not be what it appears to be just doesn’t seem to cross peoples’ minds often enough. There are countless examples of people getting into trouble because they thought they were about to try something else. The person who snorts heroin thinking it’s cocaine. The person who smokes pot that is laced with PCP. The person who drinks a beer that has roofies in it. No matter how relaxed and chill the drug scene seems to be, you have to remember that you are not in a grocery store. There are no real labels. No ingredient lists. No complaint window. And no returning goods and getting a refund as long as you have a receipt. No one in this business is worried about getting sued. Even if someone is your friend, where is he getting the drugs? Let’s face it, drug dealers are not the most ethical people. There is an inherent risk in trying unidentified substances that people need to start thinking about.

Taking SSRI’s (selective serotonin reuptake inhibitors) and MAOI’s (monoamine oxidase inhibitors) within a few weeks of each other or at the same time can cause fatal reactions. The same is true for MAOI’s and MDMA (ECSTASY). Common MAOIs are: Nardil, Parnate, and Marplan.

You also should not combine an amphetamine with an MAOI. Again, wait a few weeks before stopping one and starting the other.

The Choking Game”: kids choking themselves or others in order to experience a temporary high. The high is caused by a lack of oxygen and blood to the brain. It can result in accidental asphyxia. Apparently a lot of kids are dying playing this game, especially when they play alone because there is no one there to revive them once they go unconscious. By “play alone,” I mean that a kid actually chokes himself to feel the high. Don’t play this game.

A friend of mine had a serious problem when he ate mushrooms, not knowing that he had Mono (Infectious Mononucleosis). Because he had Mono the mushrooms stayed in his system for a few days. You can imagine the physical effect this had on him, which of course, then led to a bit of a nervous breakdown. A disease or illness can drastically change the effect that a drug will have on the body.

Birth Control Pills and certain Antibiotics: last week a girl I know told a number of her friends that she had become pregnant while on “the pill.” She wanted to inform a few of us obviously so that we could take the appropriate precautions for ourselves. A discussion began… one friend proclaimed that the pill works 100%! I did some research and found that a common effect of many antibiotics is that they lower the success rate of oral contraceptives. Always talk to your doctor about EVERYTHING YOU ARE TAKING! A baby is a pretty serious result from a drug combination.

If a male or a female is on Acutane (severe acne medication) at the time that either of them participates in the conception of a child, there is a good chance that the child will be deformed. There are a million things that can negatively affect an upcoming baby. Once you are pregnant, you should be that much more careful. The Acutane fact is scary because the negative outcome can result even if only the guy is on the drug. That is the last thing I’ll say about babies.

So, I think that there are a number of different ideas to be drawn from the info above, one obvious one being that you might want to consider cutting down on any combination above that you would normally find yourself taking. As we’ve discussed, this data really only skims the surface of the potential problems out there. These are the obvious, simpler ones. This is why I hope that this is just the beginning of a conversation that could continue on my website. Point is, by reading this chapter and a few of the others, I think you get a good overview of some blatant dos and don’ts. Briefly mentioned in the start of this chapter was the fact that the majority of overdoses and deaths result from taking at least 2 drugs at once. So ignoring all the specific examples for the moment, I want you to realize how much safer it is to simply do one drug at a time. And realize that these drugs taken by themselves are fun enough. Even within the screwed up drug market, people are not selling these combinations. The Ecstasy dealer is not also selling you Paxil. Just as the doctor writing you a script for Paxil is not selling you Ecstasy.

Mixing drugs is similar to the stupidity of snorting prescription pills that weren’t meant to be snorted. As opposed to cocaine, which is meant to be snorted. Mixing substances, any of which could be dangerous alone, is just a more extreme example of that stupidity. So trip on acid, take E, get drunk, get high if you must. But do these things separately from one another. While still dangerous, your chance of living through each one of these experiences will be much greater.

Many other commonly used combinations are referenced in the “Lingo” chapter under their correct terminology. They were not in this chapter because their effects, whether positive or negative, have not been well documented and are relatively unpredictable.