List of polysubstance combinations explained

Polysubstance use or multisubstance use is the use of combinations of psychoactive substances with both legal and illegal substances. This page lists polysubstance combinations that are entheogenic, recreational, or off-label indicated use of pharmaceuticals. For example, the over-the-counter motion sickness combination drug dimenhydrinate (8-chlorotheophylline/diphenhydramine) is occasionally used in higher doses as a deliriant. The prescription medicine Adderall (dextroamphetamine sulfate/amphetamine sulfate/dextroamphetamine saccharate/amphetamine aspartate monohydrate) is also frequently used recreationally. However, using non-prescribed drugs, using non-prescribed dose regimen, can cause polysubstance dependence, or combined drug intoxication which may lead to deaths.

Table

To avoid an excessively long list, the table below only lists recreational drug combinations that are not patent medicine.

Drug 1Drug 2Drug 3Drug 4Polysubstance slang,[1] [2] [3]
or brand name
Intoxication nameComment
Any dissociativeAny dissociativeVoid flipVoid flipping
Any dissociativeDMTDime bar, angel flipDimension flipping, angel flipping
Any depressantAny stimulantSpeedball, powerball, over and underPowerballing, speedballing[4]
Any pharmaceuticalAny pharmaceuticalPolypharmacyPharming Polypharmacy is most commonly defined as the use of five or more medications daily by an individual.[5] However, the definition of polypharmacy is still debated and can vary from two to 11 concurrent medications.
Any drugCannabisAmp joint[6]
Any drugNicotineCooler
Any β-Carboline
containing plant (e.g.
Banisteriopsis caapi
or Peganum harmala)
DMTAyahuasca, ChangaAyahuasca is drunk. Changa is smoked or vaped.
Any antiretroviral drugBlack tar heroinWhoonga, Nyaope [7]
Any deliriant or diphenhydramineMDMANightmare flipNightmare flipping
2C-B or the closely related 2C-xLSD or any of the LysergamidesMDMA or any Empathogen-entactogenAli flip[8] [9] Ali flippingThis combination start as a classic Candyflip and end in a Nexus flip.The LSD is taken first, followed by the MDMA 4 hours later and then 2C-B is taken 2 hours after the MDMA (so 6 hours after the LSD).

MDMA can be replaced by 6-APB, 5-APB, 6-MAPB or 5-MAPB, in this case the Empathogen is taken 2 hours after the LSD, while 2C-B may be replaced by 2C-C, 2C-D or 2C-B-FLY.

This combination's goal is to prolong the empathogenic effects of MDMA and the psychedelic effects of LSD. The idea is to have be able to experience an enhanced "Candyflipping" with a smoother comedown. The whole experience is long-lasting and can be too intense as all of these molecules synergize and potentiate each other.

2C-BMDMANexus flipNexus flippingThe MDMA is often taken first and the 2C-B after the end of the MDMA peak (h+2/h+2.½).[10] The 2C-B is supposed to help the empathogenic effect of the MDMA last longer.
2C-BDXMNexuswalk[11] NexuswalkNexus (slang for 2C-B) + Robowalk (slang for walking on DXM), similar to Nexusflipping
2C-BLSDGnome flipGnome flipping
2C-ELSDMDMAHaychmaich flipHaychmaich flipping
2C-P2C-EMeskini TripMeskini Tripping
2C-EMDMA or any Empathogen-entactogen2C-B or the closely related 2C-xElias flipElias flippingThe Elias Flipping inspired by the Ali Flip with the use of 2C-E instead of LSD.
2C-EMDMA or any Empathogen2C-B or closely related 2C-xAlias Flip Alias flippingThe Alias flip is a very powerful mix between an Elias flip and an Ali flip. The idea is to take substances in this order to maximize the duration of 2C-E with the LSD taken one hour after 2C-E.
AlcoholBenzodiazepineTime flipTime flipping
AlcoholCaffeineCaffeinated alcoholic drink
AlcoholCannabisTincture of cannabis. Herb and Al. Judgement DayCross fading, twisting, getting twisted[12] Called Judgement Day in Ghana when cannabis is added to the drink
AlcoholCocaineSnow-coneSnow-coningEthanol is metabolized into cocaethylene[13]
AlcoholMDMATipsy flipTipsy flippingIt may be dangerous
AlcoholNicotineNicotiniA nicotini is any alcoholic drink which includes nicotine as an ingredient. Nicotine replacement therapy products such as mouth spray may be used.
AmphetamineBarbituratesInbetweens[14]
AmphetamineCannabisLSDHippie heart attack
AmphetamineCocaineSnow seals
AmphetamineHeroinBombido
AmphetamineXanaxOrange Dream BlossomCloud RushThe combination is crushed together and insufflated
BelladonnaHashishAlamout black hashMixed
CaffeineCannabisHippie-speedball[15] [16] Hippie-speedballing
CaffeineDiphenhydramineSleep walkSleepwalking
CaffeineMethamphetamineYa ba, biker's coffee, kamikaze
Cacao beanMagic mushroomAztec use of entheogens. Conventional defatted cocoa solids dissolved in fat may be used instead of whole beans.
CBDTHCLow to moderate doses of CBD might reduce some of the paranoia, anxiety,[17] and reduction of hippocampal volumes that the current high potency THC marijuana (in the last decades, THC content increased and CBD content decreased) can cause, if the CBD substitutes a part of the THC dose.[18] [19] [20] Low doses of Kanna might also help counteract the anxiety.[21] [22]
CannabisCocoa solidsCannabis-infused brownieCannabis edible
CannabisCrack cocaineCrack weed (less known: Buddha, caviar, champagne, chronic, cocktail, dirty joint, fry daddy, gimmie, gremmies, juice joint, lace, oolies, p dog, primo, thirty eight, torpedo, turbo, wollie, yeola)Cocoa puffs, splitting
CannabisCrack cocaineHeroinMajor Pronin, El Diablo
CannabisCrack cocainePCPJim Jones
CannabisDamianaDamiana and other herbs can be used as a tobacco alternative for rolling joints.[23]
CannabisDXMNicotineCandy blunt
CannabisHeroin or opiumA-bomb, Atom bomb, stuff
CannabisMDMAStoner flipStoner flipping
CannabisKetamineStoner Kitty
CannabisKetamineCocaineSimmeredGetting Simmered
CannabisNicotineBlunt, joint, spliff, JonkoA rolled cannabis cigarette usually made with rolling paper. A blunt is a cigar hollowed out and filled with cannabis. It is rolled with the tobacco-leaf "wrapper" from an inexpensive cigar. Blunts take their name from Phillies Blunt brand cigars.
CannabisOpiumDemetra
CannabisPCPWet (less known: Bionic, clickums, donk, illies, leak, love leaf, lovelies, parsley, supergrass, superweed, wet, zoom) IllingWet is cannabis dipped in PCP [24]
CannabisPCPNicotineWet blunt, dust blunt, dusted blunt, Kendrick Lamar bluntIlling
CocaineHeroinSnowball. Other names: Belushi, bombita, murder one, whiz bangSnowballing
CocaineHeroinLSDFrisco special
CocaineHeroinNicotineFlamethrower, primosCigarette laced with cocaine and heroin
CocaineKetamineCK1, Calvin Klein, Cable, Party bag, Coquette While CK1, Calvin Klein and Cable are all names for using both substances; a Party bag is in specific reference to when the substances are mixed in a single bag prior to use.
CocaineKetamineMDMAKetamollicaine
CocaineLSDMDMACandy-flip on a stringCandy-flipping on a stringHigh risk on health
CocaineMDMASugar flipSugar flipping
CocaineMorphineC & M
CocainePCPSpace, whack
CocaineWineCoca wineEthanol is metabolized into cocaethylene
CocaineQuetiapineQ-ball
CodeineGlutethimidePancakes and syrupsCombination of glutethimide and codeine cough syrup
CodeinePromethazineLean, purple drank, oil
Crack cocaineFentanylDirty fentanyl, takeover
Crack cocaineHeroinChocolate rock, dragon rock, eightball, moonrock, smoking gun, tar
Crack cocaineLSDCracid, outerlimitsCracid is a portmanteau of crack cocaine and acid
Crack cocaineMethamphetamineFire, twisters
Crack cocaineNicotineCoolie, crimmie, woolasA cigarette laced with crack
Crack cocaineNicotinePCPOzonePCP and crack cigarette
Crack cocainePCPMissile base, P-funk, space base, spaceball, space cadet, space dust, tragic magicMissile basing, space basing
DiphenhydramineDXMOTC flip, counterflippingOTC flipping, robowalking on a string
DMTLSDCosmo flip, Meadow flipCosmo flipping, meadow flipping
DMTLSDPsilocybin or psilocybin mushroomSuper flipSuper flippingTake LSD and shrooms then at the come up smoke DMT
DMTMAOIsPharmahuasca
DMTPsilocybin or psilocybin mushroomTerence flipTerence flipping
DMTAlcoholSpyder, Spyder spinSpyder spinning
DXMLSDLSDXM
DXMMDMARobo flipRobo flipping
DXMPsilocybin or psilocybin mushroomCherry-bombCherry-bombing
FentanylHeroinBirria, chiva loca, FacebookFacebook is mixed in a pill form
Fentanyl
(and/or heroin)
XylazineTranq, Tranq dope"Tranq" is sometimes used to refer to xylazine by itself, but as a drug of abuse it is invariably combined with heroin or fentanyl
GHBMDMAGamma flipGamma flipping
GHBMethamphetamineCherry meth
HashishCrack cocaineDouble zero
HashishLSDRoyal temple ballThe hashish is mixed with LSD and rolled into a ball intended for oral use, because LSD cannot be smoked.
HashishOpiumBlack hash, black Russian
HeroinMethamphetamineGoofball
HeroinMorphineNew Jack swing
HeroinPCPAlien sex fiend
KetamineLSDDolphin flipDolphin flipping
KetamineMDMAKitty flip,[25] MK-ultraKitty flipping
KetaminePsilocybin or Psilocybin mushroomsFunky flip, chonkFunky flipping, chonkingFungus and K: one confirmed option is to ingest a low (0.75g) dose of psilocybin, wait 45 minutes, snort half a moderate dose of powdered ketamine, wait 10 minutes, snort the other half
LSDCaffeineHoffmann[26] FlipHoffmann flippingDose the LSD (amount of your choice). After 30 minutes drink 250ml of coffee and keep your usual coffee drinking habit throughout the day.(Albert Hofmann x James Hoffmann)
LSDKetamineMDMAHoly Trident, Martin Luther King flip, Galaxy flipHoly Tridenting, Martin Luther King flipping, Galaxy Flipping
LSDMDMACandy flipCandy flipping[27] Generally, the MDMA is taken approximately 4 hours after the LSD ingestion.
LSDMDMAPsilocybin or psilocybin mushroomJedi flip, twilight flipJedi flipping, twilight flipping
LSDMDMAMushroomsKetamineQuantum FlipQuantum FlippingSimilar to Jedi flipping, but with a heavy dissociative effect induced by ketamine. The substances are taken in the order of LSD, Mushrooms, MDMA, then ketamine. Each substance should be taken at the peak of the previous substance to maximize the synergistic effects. Ketamine can be re-dosed as needed to extend the trip. The end result is a highly visual and euphoric experience with periods of deep dissociation.
LSDMescalineStella trip
LSDNitrous oxideGasid
LSDPCPBlack acid
LSDMDMAKetamineSwalap FlipSwalaped
LSDPsilocybin or psilocybin mushroomGod's flesh, Soul Bomb, Alice, Wizard flipWizard flipping
LSDMDMAAny dissociative(Optional) DMTPixie flip, portal flipPixie flipping, portal flipping
MDMAMescaline or psychoactive cactusLove flip, love tripLove flipping
MDMAMethadoneChocolate flipChocolate flipping
MDMAMethamphetamineTrailer flipTrailer flipping
MDMADMTShaman flip, time flipShaman flipping, time flipping
MDMANitrous oxideNox
MDMAOpiatesPoppy flipPoppy flipping
MDMAPCPDomex, elephant flipElephant flipping
MDMAPsilocybin or psilocybin mushroomHippie flipHippie flipping
MDMA or any Empathogen-entactogen5-MeO-MiPT2C-B or the closely related 2C-xSelma FlippingSelma FlipKeep the doses low, as 5-MeO-MiPT and Empathogen-entactogen can cause a Serotonin Syndrome at high doses, it's a Nexus Flip enhanced by 5-MeO-MiPT for psychedelic, entactogenic & erotic effects.
MDMAViagra (or other PDE5 inhibitors such as Cialis or Levitra)Sextacy
MDMAXanaxZen flipZen flipping
MDMAKetamineMushroomsObama FlipObama Flipping
MethamphetamineSecobarbital, or other barbituratesPoor man's speedball
MethamphetamineAlpha-PVPCartel methSo-called "cartel meth" is primarily composed of cutting agents such as isopropylbenzylamine and/or dimethylsulfone with a small proportion of methamphetamine plus the potent stimulant Alpha-PVP
MethaqualoneCannabisWhite pipe[28] [29] Ingested by smoking. Popular in South Africa, elsewhere in Africa, and in India.[30]
NicotinePCPChipping, fry cigarette
PentazocineTripelannamineT's and blues
VenlafaxineMirtazepineCalifornia rocket fuelNone of the drugs are illegal and the combination is used for medical purposes.

See also

Notes and References

  1. Web site: Erowid Drug Slang & Terminology Vault : A - B . erowid.org.
  2. Web site: Copping . Jasper. Drug slang: what police must learn A to B . 8 November 2009.
  3. Web site: Slang Terms and Code Words: A Reference for Law Enforcement Personnel . GovInfo . 2024-07-06.
  4. Web site: Erowid Drug Slang & Terminology Vault : A - B. erowid.org.
  5. Masnoon . Nashwa . Shakib . Sepehr . Kalisch-Ellett . Lisa . Caughey . Gillian E. . October 2017 . What is polypharmacy? A systematic review of definitions . BMC Geriatrics . 17 . 1 . 230 . 10.1186/s12877-017-0621-2 . 1471-2318 . 5635569 . 29017448 . free .
  6. Web site: Slang Terms for Drug Combinations . 2021-12-08 . Narconon International . en-us.
  7. Grelotti DJ, Closson EF, Smit JA, Mabude Z, Matthews LT, Safren SA, Bangsberg DR, Mimiaga MJ. Whoonga: potential recreational use of HIV antiretroviral medication in South Africa. AIDS Behav. 2014 Mar;18(3):511-8.
  8. Web site: Ali Flip : Candy Flip & Nexus Flip melted . 2024-03-29 . Chemical Collective.
  9. Web site: El Guennouni . Ali . 'Ali flip' LSD, MDMA & 2C-B use and combination in Therapy . 1 May 2023 . chemical-collective.com.
  10. Web site: Weiss . Suzannah . 2024-02-16 . Nexus Flipping: What Happens When You Combine MDMA and 2C-B . 2024-07-10 . DoubleBlind Mag . en-US.
  11. Web site: DXM & 2C-B - Erowid Exp - 'Nexuswalk - A Beautiful Mix of DXM and 2C-B' . 2023-04-18 . erowid.org.
  12. Lankenau . Stephen . Clatts . Michael . Welle . Dorinda . Goldsamt . Lloyd . Gwadz . Marya . Street careers: homelessness, drug use, and sex work among young men who have sex with men (YMSM) . International Journal of Drug Policy . January 2005 . 16 . 1 . 10–18 . 10.1016/j.drugpo.2004.07.006.
  13. Pergolizzi . Joseph . Breve . Frank . Magnusson . Peter . LeQuang . Jo Ann K. . Varrassi . Giustino . 2022-02-22 . Cocaethylene: When Cocaine and Alcohol Are Taken Together . Cureus . en . 14 . 2 . e22498 . 10.7759/cureus.22498 . free . 35345678 . 8956485 . 2168-8184.
  14. Keup . Wolfram . The Vocabulary of the Drug User and Alcoholic: A Glossary . The International Journal of the Addictions . June 1971 . 6 . 2 . 348 . 10.3109/10826087109057793 . 4950517 . 7 October 2021.
  15. Web site: Crone . Madeline . 2021-10-07 . Premiere: Singer-Songwriter Ben Chapman Defines a "Hippie Speedball" with a New Acoustic Video . 2024-07-27 . American Songwriter . en-US.
  16. Web site: Rizzo . Melanie . 2022-03-21 . Coffee Alternatives: A Modern Spin on the Hippie Speedball . 2024-07-27 . TheBluntness . en-US.
  17. Gibson LP, Karoly HC, Ellingson JM, Klawitter J, Sempio C, Squeri JE, Bryan AD, Bidwell LC, Hutchison KE . 2022 . Effects of cannabidiol in cannabis flower: Implications for harm reduction. Addiction Biology . 27 . 1 . e13092 . en . 10.1111/adb.13092 . 34467598 . 9357513 . 237372495.
  18. Stuyt . Elizabeth . 2018 . The Problem with the Current High Potency THC Marijuana from the Perspective of an Addiction Psychiatrist . Missouri Medicine . 115 . 6 . 482–486 . 0026-6620 . 6312155 . 30643324.
  19. ElSohly . Mahmoud A. . Mehmedic . Zlatko . Foster . Susan . Gon . Chandrani . Chandra . Suman . Church . James C. . 2016-04-01 . Changes in Cannabis Potency over the Last Two Decades (1995-2014) - Analysis of Current Data in the United States . Biological Psychiatry . 79 . 7 . 613–619 . 10.1016/j.biopsych.2016.01.004 . 0006-3223 . 4987131 . 26903403.
  20. Zamarripa . C. Austin . Spindle . Tory R. . Surujunarain . Renuka . Weerts . Elise M. . Bansal . Sumit . Unadkat . Jashvant D. . Paine . Mary F. . Vandrey . Ryan . 2023-02-01 . Assessment of Orally Administered Δ9-Tetrahydrocannabinol When Coadministered With Cannabidiol on Δ9-Tetrahydrocannabinol Pharmacokinetics and Pharmacodynamics in Healthy Adults: A Randomized Clinical Trial . JAMA Network Open . 6 . 2 . e2254752 . 10.1001/jamanetworkopen.2022.54752 . 2574-3805 . 9926328 . 36780161.
  21. Web site: Sumpter . Luke . 2022-12-29 . Combining Kanna with Weed or CBD: Should You Do It? . 2023-02-05 . www.zamnesia.com . en.
  22. Manganyi . Madira Coutlyne . Bezuidenhout . Cornelius Carlos . Regnier . Thierry . Ateba . Collins Njie . 2021-04-28 . A Chewable Cure "Kanna": Biological and Pharmaceutical Properties of Sceletium tortuosum . Molecules (Basel, Switzerland) . 26 . 9 . 2557 . 10.3390/molecules26092557 . 1420-3049 . 8124331 . 33924742. free .
  23. Web site: Ewe . Koh . 2021-04-19 . TikTokers Are Smoking Flowers As Weed Alternatives . 2021-12-24. www.vice.com. en.
  24. Holland . Julie A. . Nelson . Lewis . Ravikumar . P. R. . Elwood . William N. . Embalming Fluid-Soaked Marijuana: New High or New Guise for PCP? . Journal of Psychoactive Drugs . Erowid.org . 22 February 2017 . 30 . 2 . 215–219 . 10.1080/02791072.1998.10399693 . 9692385 . 30 July 2021.
  25. Web site: Nolan . James . 'Kitty flipping' and the Psychonaut Obsession with Mixing Drugs . VICE.com . 8 February 2019 . 16 July 2020.
  26. Web site: James Hoffmann . 2024-06-07 . YouTube . en.
  27. Zeifman . Richard J. . Kettner . Hannes . Pagni . Broc A. . Mallard . Austin . Roberts . Daniel E. . Erritzoe . David . Ross . Stephen . Carhart-Harris . Robin L. . 2023-08-22 . Co-use of MDMA with psilocybin/LSD may buffer against challenging experiences and enhance positive experiences . Scientific Reports . en . 13 . 1 . 13645 . 10.1038/s41598-023-40856-5 . 2045-2322. 10444769 .
  28. Web site: Mandrax. 2003. DrugAware. Reality Media. 2009-08-13.
  29. McCarthy G, Myers B, Siegfried N . Treatment for methaqualone dependence in adults . The Cochrane Database of Systematic Reviews . 2 . CD004146 . April 2005 . 15846700 . 10.1002/14651858.CD004146.pub2.
  30. McCarthy G, Myers B, Siegfried N . Treatment for methaqualone dependence in adults . The Cochrane Database of Systematic Reviews . 2 . CD004146 . April 2005 . 15846700 . 10.1002/14651858.CD004146.pub2.