Drug overdose is an ongoing epidemic in the United States. From 2002 to 2015, the country experienced over a two-fold increase in fatal drug overdoses and each year, the numbers continue to rise— We know this. We also know that it is the young adult population, ages 20 to 34, that are the most affected.

Heroin, a highly-addictive opiate drug, is the number one driver of overdose deaths in the United States today. The illicit stimulant cocaine, as TIME discloses in a recent article, is the second most deadly drug in our nation. Now imagine these two drugs combined. Imagine the overwhelming power of cocaine and heroin when taken, and when working, together.

Generally, it is the heroin overdoses we most often hear about in the news. Heroin is a central nervous system depressant that can actually stop a user’s respiratory function if he or she takes too much. And as opiate abuse becomes rampant in the country, so does the number of heroin-related overdose deaths. According to the National Institute on Drug Abuse, the number of overdose deaths involving heroin increased 6.2-fold between 2002 and 2015.

Overdose deaths involving heroin. Heroin-related overdose deaths. Experts use this language all the time, but are too many of us forgetting to read between the lines? The media blames heroin. But are these rising overdose deaths involving more than just the one opiate drug, after all?

Just last month, the NIDA published a news release detailing a recent surge in heroin and cocaine-related overdose deaths. According to the news update, it all began with a startling spike in cocaine-related overdose deaths, which before 2010, had fallen in frequency. Now, they are up more than two-fold despite nationwide declines in cocaine abuse.

It was no mystery to scientists who soon determined that this dramatic increase of cocaine-related deaths could not be attributed solely to cocaine abuse, but rather to a much more dangerous drug cocktail: a cocaine and heroin mix. Overdose deaths involving both cocaine and opiates have more than doubled in recent years. And when taking opiate drugs like heroin out of the picture, cocaine overdose deaths only increased by about nine percent.

To break it down, CDC data shows that 6,784 people died of a cocaine-related overdose in 2015. 63 percent of these deaths involved an opiate drug—heroin, fentanyl, prescription painkillers. Of these cases, about 2,565 involved both cocaine and heroin.

What this means it that the opiate epidemic is not only fueling abuse, addiction, and overdose, but also driving an alarming propensity in users to mix deadly drug combinations. And to what extent is this happening? Are users mixing cocaine and heroin (street name: “speedball”) intentionally? Or are they unknowingly falling victim to synthetic, tainted products bought off the street?

Cocaine abuse on its own can result in overdose. Heroin, even more risky, can cause sudden death in its users. But all too often, the two drugs are intentionally mixed together to create the famous “speedball” – in which the individual effects of each drug are heightened and the risk of overdose is worsened.

Snorted or injected, speedball releases an intense rush of energy and euphoria in users (common in cocaine abuse) followed by a relaxation period (an effect of the CNS depressant heroin). The combination, users say, is meant to reduce the negative effects of “coming down” from either drug.

While this appears effective to speedball users, the actual drug interaction occurring in their bodies is very conflicting. Cocaine, as a stimulant drug, activates the sympathetic nervous system while heroin, the CNS depressant, triggers the parasympathetic nervous system – causing opposite effects on the body. Not only this, but cocaine can also mask any symptoms of overdose in a user. If a person goes into respiratory failure from heroin intake, he or she may not know it until the cocaine effects wear off.

Speedball use is more common among longer-term heroin and cocaine users, a group that is also very susceptible to overdose. But the cocaine and heroin mix is not always unintentional—All users, both new and seasoned, run the risk of unknowingly purchasing laced drugs: cocaine laced with heroin, heroin laced with cocaine, cocaine laced with fentanyl, heroin mixed with toxic chemicals, chemicals that can be fatal even when taken in small amounts.

If you or someone you love is abusing cocaine, heroin, opiates, or a poly-drug addiction, it is vital to seek help as soon as possible. The effects of cocaine and heroin abuse can leave irrevocable damage, and your loved one may be at risk. Through long-term, inpatient, gender-specific drug treatment, a change can be made. A sober lifestyle – a healthy future – can be achieved. Call Turnbridge today at 877-581-1793 to learn about our drug treatment programs for young adults.