Speedballing (alternatively known as snowballing or powerballing) is a term commonly referring to the intravenous use of heroin/morphine and cocaine together in the same needle. The combination is also known as moonrocks when smoked. This is a potentially lethal concoction: the cocaine acts as a stimulant, raising the pulse, but its effects wear off more quickly than those of either heroin or morphine, which in turn slow the heart down. As a result, it is possible to experience a delayed "overdose" (technically, severe respiratory depression) when the stimulant wears off and the full effects of the morphine are felt in isolation.
The invention of the speedball is variously attributed to Harry K. Thaw circa 1900, followers of Sigmund Freud in the late 19th Century, Beatniks in the 1950s, an obscure and long-forgotten pharmacist or battlefield medic as long as 150 years ago, or American soldiers returning from the Vietnam War.
Stimulants are used clinically to combat somnolence created by large and/or rapidly increasing doses of opioid analgesics and/or potentiate the effect of the opioid, with Methylphenidate being the most commonly used. In the past, pharmaceuticals containing both cocaine and morphine or heroin were on the market, such as Trivalin, specifically the product distributed under that name up until the 1930s or shortly thereafter which contained the valerate salts of morphine, cocaine, and caffeine.
Sometimes, other combinations of stimulants and depressants are referred to as speedballs, such as the use of amphetamines in conjunction with other opiates like hydromorphone, dihydrocodeine, oxycodone and others, benzodiazepines or barbiturates. Methylphenidate and hydrocodone is known as "kiddy speedball". Vodka Red Bull is sometimes referred to as a "speedball cocktail" since it contains the alcohol depressant and the caffeine stimulant. Marijuana and coffee is called a "hippies speedball", or a "Seattle speedball". Combining the prescription drug OxyContin (extended-release oxycodone) and cocaine is known as a "California Heart-Stopper" and is usually insufflated or injected. An oral or by Insufflation, combination of depressants or opiates and stimulants is more properly called a "set up."