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The Fourth Wave: How Speedballing Is Creating a New Kind of Drug Crisis

Speedballing—the practice of combining a stimulant like cocaine or methamphetamine with an opioid such as heroin or fentanyl—has evolved from a niche subculture to a widespread public health crisis. The practice stems from the early 1900s, when World War I soldiers were often treated with a combination of cocaine and morphine. Once associated with high-profile figures like John Belushi, River Phoenix and Chris Farley, this dangerous polysubstance use has become a leading cause of overdose death

The first non-opoid painkiller

In the nineteenth century, the invention of anesthesia was considered a gift from God. But post-operative pain relief has continued to rely on opioids, derivatives of opium, the addictive substance employed since ancient times. Although no other drug has managed to match the rapid, potent, and broadly effective relief delivered by opioids, their side effects have led to decades of addiction and overdose, leaving researchers keen to find a better solution. This all changed in January 2025, when