What makes the effect of two drugs taken together greater than the effect of either substance alone?

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Synonym(s)

Synergism, Synergy

An interaction between two or more drugs that causes the total effect of the drugs to be greater than the sum of the individual effects of each drug. A synergistic effect can be beneficial or harmful.

Related Term(s)

Drug Antagonism

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People who abuse drugs frequently combine different drugs to get enhanced effects of one or both substances. Often, this involves combining two drugs of the same type to strengthen the main effect of both drugs. However, in some cases, two drugs with different actions are combined because the combination can create a different effect, amplify the actions of both drugs, or counteract the negative effects of one substance.

One of these potent combinations occurs when mixing an opiate drug like heroin with a stimulant like methamphetamine (meth). While this combination is said to produce a significant high, it can also result in dangers and long-term health circumstances that pose relatively high risk for the person who decides to use them.

Heroin and Meth: A Potent Combination

Combining sedative and stimulant drugs has been attractive to people using drugs for a long time. In particular, mixing an opiate with a stimulant – commonly referred to as a “speedball” – is a popular method of getting an intense high. In the past, cocaine has been used with heroin or other opiates to create the combination. However, according to research from Pharmacology Biochemistry Behavior, methamphetamine has started to be used in the same capacity.

This research, along with other studies, shows that combining meth with morphine or heroin produces a more potent effect than either drug alone, based on the dosages of each.

This is a powerful high that provides both a strong attraction to those who have felt it or heard about it, and also poses a potent danger to those who attempt it.

Specific Dangers and Risks

As implied by an article from the Miami New Times, one of the major risks of taking a stimulant with an opiate is the potential that the stimulant masks the negative effects of the depressant, making it hard to tell when an overdose point has been reached.

For example, while the opiate may slow breathing, the stimulant might accelerate it, making one feel like breathing is normal. This can make it harder to tell when the dose of heroin that is tolerated might have been exceeded, which can then lead to other overdose effects and result in death.

In addition, the meth high generally lasts longer than the heroin high, causing the person to move from a slowed heart and respiration rate to a dramatically increased one. As with normal meth use, this can lead to a sudden heart arrhythmia, increased blood pressure, and potential heart issues, such as stroke or heart failure.

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Physical and Mental Effects of Mixing Heroin with Meth

Based on the interactions of these two drugs with one another, there are some specific physical and mental effects that occur when mixing them. For example, generally, when a stimulant drug is added to an opioid analgesic, the painkilling effect can be enhanced while the individual will not feel quite as much fatigue as would occur with the painkiller alone. Effects include but are not limited to:

  • Intense euphoria rush
  • Normal to increased respiratory rate
  • Increased heart rate
  • Relaxation and release of inhibitions

The fact that the two types of drugs cancel out each other’s uncomfortable symptoms makes it more possible for individuals to experience the high produced by each drug at a purer level.
In addition, the fact that the meth high lasts longer than the heroin high helps the individual end the high on a stimulated, energetic note.

Effects of Meth Alone

Methamphetamine use normally results in the following physical and mental effects, as described by the National Institute on Drug Abuse:

  • Decreased appetite
  • Hallucinations
  • Accelerated respiration and heart rate
  • Intense focus
  • Wakefulness or insomnia
  • Heightened awareness and energy

These effects can, if repeated regularly, lead to heart and lung damage, as well as damage to other organs. Malnutrition can result from chronic meth use, as can severe dental disease and skin problems due to the sense that something is “crawling” under the skin.

Effects of Heroin Alone

Also per the National Institute on Drug Abuse, heroin has many of the opposite actions of meth, including:

  • Slowed breathing and heart rate
  • Increased appetite
  • Slowed reflexes
  • Decreased pain
  • Inability to concentrate
  • Relaxation or drowsiness

Effects of Using Meth and Heroin Together

Because many of these symptoms are the opposite of those for meth use, they seem to cancel each other out in many ways, leaving the individual to experience what feels like a particularly intense high. The combination is deceptively comfortable, cancelling out some of the sensations that feel most uncomfortable when using either drug while amplifying the euphoria that both drugs induce, making for a very intense high.

The issue comes in when the fact that meth cancels out and outlasts heroin’s dangerous physical effects results in the individual taking higher doses of heroin than might otherwise be used in order to feel a more intense high. These higher doses can result in serious physical issues that result in a heroin overdose due to the person potentially taking more of the drug than might otherwise be consumed. This effect can lead to the person experiencing dangerous physical damage without feeling the discomfort, resulting in organ damage, brain damage, or death.

Treating Polydrug Abuse of Meth and Heroin

Treating polydrug abuse is already a challenge even for reputable treatment programs. When individuals indulge in multiple drug types, the treatment plan has to account for the effects of each type of drug being used to manage withdrawal and prevent relapse. With the combination of meth and heroin, it is important for treatment providers to understand the physical effects of both drugs and the body’s response to withdrawal in determining treatment.

As explained in an article from Medscape, people who use more than one drug at a time are more likely to develop physical and mental health conditions that interfere with substance abuse treatment. In addition, these individuals are often more likely to have cognitive challenges that make therapeutic treatment difficult. In this case, it is important to take into account the physical and mental effects of both drugs during treatment to provide the best possible chance for individuals to avoid relapse and move into recovery from abuse of both heroin and methamphetamine.

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    What is when an effect of two or more drugs is greater than when either is used alone?

    In medicine, describes the interaction of two or more drugs when their combined effect is greater than the sum of the effects seen when each drug is given alone.

    What does it mean if two drugs have synergistic effects?

    Two or more drugs that individually produce overtly similar effects will sometimes display greatly enhanced effects when given in combination. When the combined effect is greater than that predicted by their individual potencies, the combination is said to be synergistic.

    When 2 drugs act synergistically their combined effect is equal to the sum of each drug taken alone?

    Additive effect in pharmacology describes the situation when the combining effects of two drugs equal the sum of the effects of the two drugs acting independently. The concept of additive effect is derived from the concept of synergy.

    What is combined effect of drug?

    A combination of drugs is synergistic when the combined effect is larger than the additive effect of each individual drug. Similarly, the combination is antagonistic when its combined effect is smaller than the additive effect of each individual drug.

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