So you think you know your combos?

February 18, 2026

Does this really go with that? Or should you leave the mixing to the DJ? Do you know your stuff when it comes to combining drugs?

1. What are the effects of mixing cannabis and alcohol?
A. Increased risk of greening out
B. You feel less aware of how drunk you are
C. It’s harder to think
D. All of the above
E. None of the above

2. What drug combination does candyflipping refer to?
A. M&Ms and an acrobatics course
B. MDMA and cocaine
C. LSD and shrooms
D. LSD and MDMA

3. If you’re mixing two drugs, how much of each should you take?
A. The same amount that you usually do
B. More than you usually do, in case they cancel out
C. About half your usual dose of each drug
D. About ¼ of your usual dose for one drug, and a full dose of the other

4. What does mixing stimulants increase your risk of?
A. Serotonin syndrome
B. Overamping
C. An EPIC time
D. There is no additional risk to mixing stimulants

5. What mixture of drugs does tusi/ pink cocaine commonly refer to?
A. Methamphetamine, MDMA and caffeine
B. Cocaine, ketamine and ritalin
C. MDMA, ketamine, and caffeine
D. Cocaine, MDMA, and cathinones

6. What does mixing antidepressants and MDMA increase your risk of?
A. Serotonin syndrome
B. Hypothermia
C. Psychosis
D. Seizures

7. What does this symbol mean on our mixing chart?

A. Low risk and no amplification – these two drugs are a (relatively) low risk combination that doesn’t amplify the effects of each drug
B. High risk of physical toxicity – we highly recommend not combining these two substances
C. Approach with caution – although these might not put you in hospital you may not have a pleasant time combining these substances
D. Dangerous – this combination is likely to have dangerous and unpleasant effects

8. What psychoactive cutting agent is commonly found in ecstacy pills alongside MDMA?
A. Creatine
B. Caffeine
C. Ketamine
D. Guanine

9. Why are most substances dangerous to mix with tramadol?
A. Because tramadol is a potent opioid like fentanyl, mixing it with anything else increases your risk of overdose
B. Because tramadol increases risk of overamping
C. Because drugs are bad, mmmkay?
D. Because tramadol increases the risk of both serotonin syndrome and seizures

10. What is the slang name for mixing ketamine and cocaine?
A. Coketamine
B. Calvin Klein
C. Candy Krush
D. Carol King

11. Which legal drugs mix poorly with the most common illicit drugs?
A. Alcohol
B. Caffeine
C. Benzodiazepines
D. All of the above
E. None of the above, it’s all good!

12. If you’re taking a combination of drugs and they’re not hitting as much as you’d like, what’s the safest thing to do?
A. Gradually increase the dose of both drugs
B. Gradually increase your dose of one drug
C. Smash your stash
D. Wait a couple of hours and see how you feel

Answers

1. D: All of the above.
Alcohol increases the absorption of THC in cannabis, making you feel more high than if you have weed alone. Leafwell has more info on how to reduce your risks of greening out and how to handle it when it happens.
Visit the Leafwell website

2. D: LSD and MDMA
Read more about candyflipping in our blog post.

3. C: Half of what you would normally take
It’s best to decrease your dose for both substances you’re taking, if you intend to mix. Some combinations will amplify each drug’s effects, so if you take a full dose you could end up way higher than you intended. Remember to check the mix chart for any interactions between substances.

4. B: Overamping
Overamping is when you take more stimulants than your body can process. Symptoms of overamping include: a very high temperature, seizures, difficulty breathing, extreme agitation/paranoia, and loss of consciousness. If someone you know is experiencing these, get medical help immediately. Mixing stimulants can also increase the stress on your cardiovascular system.

5. C: MDMA, ketamine and caffeine
In saying that, drug checkers have also found other substances in tusi such as methamphetamine, novel psychedelic substances, and cocaine, so it can be a bit of a grab-bag.
Read more about tusi on The Level

6. A: Serotonin syndrome
Mixing SSRIs and MDMA dampens your high, which can leave you tempted to take more. MAOIs also affect how you process serotonin and greatly increase your risk of serotonin syndrome.
Read our blog post on mixing MDMA and other party drugs with antidepressants or you can watch our Tiktok about serotonin syndrome for more info.

7. C: Approach with caution

8. B: Caffeine
Caffeine produces a stimulant effect, so is often added to weak MDMA to make it feel more MDMA-like. However, mixing caffeine and MDMA increases the risk of overamping. Synthetic cathinones, a type of new psychoactive substance, are also sometimes found in pressed pills. See our results from last year for more about substances commonly found in pressed pills.
Unfun fact: a 2012 study showed that combining MDMA and caffeine increase the neurotoxicity of MDMA (in rats)

9. D: Tramadol increases the risk of both serotonin syndrome and seizures
Tramadol acts on your serotonin system, which means that taking it with drugs that also affect your serotonin system, for instance MDMA, greatly increases your risk of serotonin syndrome. Tramadol also decreases seizure threshold, so any drugs that increase your risk of seizures will not mix well.
Read more about Tramadol not interacting well with other drugs on Psychonaut Wiki

10. B: Calvin Klein
This combination can be risky as mixing stimulants and depressants leads to more stress on your body as it tries to do two different things at once.
Check out the blog post we did about CK a couple of years back

11. D: All of the above

12. D: Wait for a couple of hours and see how you feel
We definitely recommend the Wait and See approach when it comes to taking anything.

Sometimes drugs take longer than expected to kick in. If you take more because you were impatient it can come back to bite you when everything kicks in and you have to hold on to the floor trying to stay in this dimension.

Also, some drug combinations, such as alcohol with cocaine, will interact and cancel each other’s effects out. This means you don’t feel the effects of either as strongly, but they’re still affecting your body.
If you’ve kept taking more chasing the high, if one drug wears off you may be hit with the effects from the other drug all at once, which can get very messy very quickly.

With other combinations, such as SSRIs and psychedelics, the high from the psychedelic is reduced. We strongly urge you not to stop taking your meds to feel the effects of your substance fully. We wrote about that in the in the party drugs and antidepressants blog we mentioned in question 6.

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