The best way to reduce your risk from mixing chems is to not mix chems at all. However, if you do, here are some things to think about when you mix them - to maximise the pleasure and minimise the harm. 

Sometimes when drugs and sex are involved you may use more than one kind of drug (including alcohol) at any one session. It is important to be aware of the contraindications (problems) that mixing drugs can cause.

Mixing Cocaine

Cocaine and alcohol are two substances that are often mixed together. However, mixing cocaine and alcohol can be particularly harmful, as once they mix together in the body they produce a toxic chemical called cocaethylene.

Cocaethylene stays in the body much longer than cocaine or alcohol alone and can cause the effects of the drug to last longer. This also increases the damage done to the heart and liver.

Mixing Crystal Meth

Mixing crystal meth comes with a number of risks including:

  • With erectile drugs like Viagra, crystal meth can have a negative effect on your blood pressure. Using both together can make it more likely for you to suffer a stroke.
  • If you are on antidepressants, crystal meth can affect the therapeutic benefits making it more likely for you to suffer increased depressive episodes. 
  • If you are on heart or blood pressure meds, crystal meth can increase the pressure on your heart.
  • If you are mixing crystal meth with other drugs, like ecstasy and coke, it can lead you to an increased chance of your body overheating and having a stroke. 
  • If you are using downers like GHB with crystal meth, it can lead to extra pressure on your vital organs and can increase the likelihood of stroke or heart attack.
  • If you are mixing crystal meth with alcohol, the stimulant effects of crystal meth and the depressive effects of alcohol interact unpredictably, which can increase the risk of harm or even death.
Mixing GHB/GBL

If you are mixing GHB/GBL with other drugs, there is a significant risk of harm, in particular when mixed with other sedatives, depressants or 'downers':

  • If you are using benzodiazepines like diazepam or valium
  • If you are using an opiate such as tramadol, GHB can increase your risk of respiratory depression (dangerously slowing down your breathing) and 'dropping' or 'going under'.
  • If you are using 'uppers' like coke or ecstasy, GHB can make you feel more awake so you may take more GHB than you normally would; increasing the risk of overdose.
  • If you are using 'downers' like alcohol or ketamine, GHB increases your risk of respiratory depression  (dangerously slowing down your breathing), delaying the effect of GHB and overdose. This can be fatal.
  • If you are on antihistamines, GHB increases your risk of 'dropping' or 'going under' (in other words, becoming unconscious/overdosing). 

If you have high or low blood pressure, epilepsy, convulsions, heart or breathing problems, depression or panic attacks - you should avoid using GHB with other drugs. 

If you see someone ‘dropping' or 'going under' on GHB, in particular, if other drugs (including alcohol) have been used, you should: 

  • Place them in the recovery position to prevent them from choking
  • Seek medical help by calling an ambulance on 999
  • Don’t take any more drugs (including alcohol)
  • If you know what they have taken, be truthful and tell the medics
  • Stay with the person until assistance arrives
Mixing Mephedrone

If you are mixing mephedrone with other drugs (including alcohol), you should be aware of the following risks:

  • If you are using alcohol or other 'downers', mephedrone increases the risk of respiratory depression (slowing down your breathing) and increase the effects of the drug. 
  • If you are on antidepressants, using mephedrone increases your risk of seizures and heart problems.
  • if you are using 'uppers' or stimulants such as ecstasy, amphetamines and coke, mephedrone causes dehydration and overheating in your body and, can be fatal. 
  • If you are using Viagra with mephedrone, it can increase the pressure on your heart leading to heart problems. 
Mixing Ecstasy

If you are mixing ecstasy with other drugs (including alcohol), be aware of the following risks:

  • If you are using alcohol or other 'downers', this will dampen the effects of ecstasy and increase the likelihood that you will use more to get high. It will also increase dehydration in the body, overheating and the risk damage to your vital organs such as your kidneys. This combination of drugs can also increase the risk of stroke or heart attack by putting a strain on your heart. 
  • If you are using antidepressants, using ecstasy carries a risk of worsening existing mental health issues such as depression or causing psychological distress. If this happens to you, or a friend, you should seek urgent medical assistance. 
  • If you are using Viagra, mixing with ecstasy can cause you to have a hard-on that doesn't go away. If this happens, and it hasn’t subsided for over 4 hours, then you will need to seek medical attention to avoid permanent damage to your penis.
Mixing Ketamine

If you are mixing ketamine with other drugs (including alcohol), be aware of the following risks:

  • If you are using 'downers' like GHB, benzodiazepines or opiates, ketamine can cause respiratory depression (in other words, slowing down or stopping your breathing). If you stop breathing or it slows down, this can be fatal.
  • If you are using 'uppers' like amphetamines, using ketamine can cause your blood pressure to rise to dangerous levels.
  • If you are using alcohol with ketamine, this can make you feel nauseous and vertigo (where you feel like the world is spinning).