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The Dangers Of Mixing Cocaine With Alcohol

Brenda Munnerlyn, RN, BSN

Medically reviewed by

Brenda Munnerlyn, RN, BSN

March 18, 2019

Mixing cocaine and alcohol creates cocaethylene, a toxic substance that stays in the system longer than cocaine alone. Drinking alcohol with cocaine also increases the risk of overdose and heart problems.

About two million people in the United States use cocaine, and many of them drink alcohol with it. Alcohol is mixed with many drugs with little regard to the dangers and long-term effects. Mixing cocaine and alcohol comes with a unique risk, as the two substances react in the liver to create a third substance called cocaethylene.

What Is Cocaethylene?

Cocaethylene has a chemical structure similar to that of cocaine and also has similar effects. However, its elimination half-life is three to five times longer than cocaine. This means that it takes much longer for half of the created cocaethylene to leave the body than cocaine alone.

People who are unaware of cocaethylene may assume that cocaine wears off sooner and take repeated doses to maintain their high. This could raise toxicity within the body to dangerous levels and cause an overdose.

Some reports claim that cocaethylene has a more potent effect than cocaine as well. This means that it can also be more damaging to someone’s physical health.

Cocaethylene has been linked to serious negative health effects, such as:

  • seizures
  • liver damage
  • stroke
  • bleeding in the brain
  • heart attack
  • irregular heartbeat
  • weakened heart muscles

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The Dangers Of Mixing Cocaine With Alcohol

Cocaine is a stimulant and alcohol is a depressant. This means that they have opposing effects on the central nervous system. It may seem that they balance each other out. Many people mix cocaine and alcohol so they can drink more and experience less of a “comedown” from cocaine.

What really happens is that a person feels dampened effects of each substance, which usually leads them to consume more. This raises toxicity in their body to dangerously high levels and poses the risk of overdose because they are unable to tell how intoxicated they are.

When used alone, drugs and alcohol lower a person’s inhibitions and increase the chance that they will engage in dangerous or irresponsible behavior. Mixing cocaine and alcohol makes this even more likely.

Some individuals may drive a vehicle while intoxicated by drugs and alcohol, putting themselves and others at risk. Others may take part in risky sexual behavior, which can lead to unwanted pregnancy and the spread of diseases like Hepatitis C and HIV. Both cocaine and alcohol cause dehydration, which can lead to a condom breaking, even if someone thinks they are being safe.

Because alcohol is linked to memory problems and may cause a person to black out, a person may not even remember what they did under the influence of cocaine and alcohol.

Short-Term Effects Of Cocaine And Alcohol

Since the effects of cocaine and alcohol contrast, using the two substances together causes stress on the body. While cocaine is working to energize a person, alcohol is slowing them down and inducing relaxation. This especially strains the heart, as cocaine makes it beat faster and alcohol does the opposite.

Some short-term effects of cocaine are:

  • increased breathing rate
  • raised blood pressure
  • faster heart rate
  • increased energy and alertness
  • euphoria
  • talkativeness
  • dilated pupils
  • paranoia

Some short-term effects of alcohol are:

  • decreased breathing rate
  • lowered blood pressure
  • slowed heart rate
  • decreased reaction time
  • sedation
  • slurred speech
  • blurred vision
  • impaired judgement

Cocaine and alcohol can both cause someone to feel anxious or restless. Cocaine use has been linked to sudden death, and alcohol can cause severe respiratory depression, which may also be fatal. Mixing cocaine and alcohol increases the risk of complication and can worsen negative effects from each substance.

Long-Term Effects Of Mixing Cocaine And Alcohol

Both alcohol and cocaine are metabolized (broken down) in the liver. When the liver is working to eliminate two substances, it takes longer for each to be excreted. This is not only hard on the liver, but also increases the risk of overdose.

If someone takes repeated doses of cocaine because they expect the drug to be out of their system, it can cause an accumulation of cocaine that primes them for overdose. When enough cocaine is taken for someone to overdose, it is toxic to the liver.

Alcohol is also damaging to the liver, whether or not it is combined with another drug. It can cause severe liver damage that may lead to cancer, cirrhosis (scar tissue), and alcoholic hepatitis (swelling of blood vessels). Mixing cocaine and alcohol can be even more harmful to the liver.

Though alcohol lowers blood pressure initially, heavy alcohol use can lead to high blood pressure. The same is true of cocaine. Combining the two makes it more likely that someone will experience high blood pressure, a condition that can lead to many serious heart problems as well as kidney damage. Even when taken alone, alcohol and cocaine increase a person’s risk of heart attack and other heart issues.

A 2016 study also found that people who use cocaine and alcohol together have a higher chance of committing suicide.

Cocaine And Alcohol Addiction And Withdrawal

Both cocaine and alcohol are addictive substances. Using them together may increase someone’s risk of becoming addicted to one or both because they are generally used in higher amounts when combined. Polysubstance abuse can also complicate healing from addiction and lengthen the withdrawal process.

Withdrawing from two substances may result in severe symptoms. Alcohol withdrawal can be life-threatening because the body develops a physical dependence on it and reacts adversely if someone stops drinking. Paired with psychological withdrawal symptoms from cocaine, it can be very difficult for someone to detox from both substances at once.

Medically supervised detox programs are available to help individuals who suffer from alcohol dependence, and some provide resources for people struggling with cocaine use as well. These programs keep a person stabilized and safe through the withdrawal process. They may offer counseling and therapy for emotional support, which can help with any type of addiction.

Treatment For Cocaine And Alcohol Addiction

Whether someone is addicted to cocaine, alcohol, or both, they can reduce the risk of ill effects by seeking treatment as soon as possible. Though it may seem daunting, there are plenty of drug and alcohol rehab centers that address polysubstance addiction and provide individualized care.

Treatment for any addiction is based on changing the way a person thinks, acts, and lives their life. While many components of treatment are tailored to the individual, the overall goal is to break through negative thought patterns that lead to destructive life choices.

This may be done through therapies like individual and group counseling, meditation, art, fitness, and family involvement. A combination of research-based treatment methods works to prevent relapse by healing the whole person, from the inside out.

Center for Substance Abuse Research - Cocaine

Center for Substance Abuse Research - Alcohol

National Center for Biotechnology Information - Neurotoxic and cardiotoxic effects of cocaine and ethanol

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