There’s a new version of the old 'speedball' that now substitutes fentanyl for heroin, and the upper/downer mix now accounts for most SF overdose deaths, though many of those victims may just not have known there was fentanyl in their product.

The Chronicle apparently just discovered the age-old hard drug term “speedball” in a new article today, a term that’s actually been around for decades to describe a mixture of cocaine and heroin that brings on a combo upper-and-downer high. It's this speedball combination (also sometimes called “goofball”) that claimed the lives of John Belushi, Chris Farley, Philip Seymour Hoffman, and Michael K. Williams.

But the Chronicle’s report covers how people are now using fentanyl to make speedballs, combining that substance with crack cocaine or meth. Though it’s important to note that many of these people may not have been intentionally doing a so-called speedball, but instead were using what they thought was pure cocaine or meth, but was instead contaminated with fentanyl.  

Either way, these combinations of the depressant fentanyl and stimulants like coke or meth now account for most SF overdose deaths. According to the Chronicle's figures, 63% of SF overdose deaths in 2022 showed this combination, and they add “Data from the first half of 2023 suggests the total number and share of fentanyl-plus-stimulant deaths will be higher than ever this year.”

And it didn’t used to be that way. Per the Chron, in 2016, “less than one-third of fatal overdoses” involved fentanyl combined with a stimulant.

But again, that doesn’t necessarily mean that people are intentionally speedballing. We’ve seen many overdose cases involving people who thought they were using cocaine or meth, and were unaware they were actually using fentanyl.

“I think you’re seeing a spike in speedball and goofball ODs now because cocaine, heroin and methamphetamine are all adulterated with fentanyl,” Salvation Army Harbor Light  clinical director Adrian Maldonado told the Chronicle. “And when coke and meth have fentanyl in them, the user gets overwhelmed with the downer."

Anecdotally, heroin users in San Francisco have used stimulants for years during times when they did not have a safe space to crash or nod off — and one fentanyl user speaks to the Chronicle about using the speedball combination with crack to keep from getting his stuff stolen, because, "That little bit of crack cuts the nods."

So to any of you who do use cocaine or meth, we will stress how important (and easy) it is to get fentanyl testing strips. They are available for free at the Community Behavioral Health Services (CBHS) Pharmacy at 1380 Howard Street (hours here), and the above map shows establishments where Fentcheck has free testing strips available. Fentcheck also sells the testing strips online in sets bowls of 20 for parties or public venues, or an envelope of 40 for personal use.

Related: Five Hospitalized For ODs on Christmas After Reportedly Doing Contaminated Cocaine at Japantown Residence [SFist]

Image: SFPD via Twitter