What Happens When You Mix Alcohol and Cocaine? The Dangers of Cocaethylene

What is Cocaethylene?

Cocaethylene is an active metabolite of cocaine and alcohol. An active metabolite is a modified form of the parent drug that continues producing effects in the body.

Cocaethylene toxicity is far more potent than cocaine or alcohol use alone. Its effects are also more intense and longer lasting.

How is Cocaethylene Produced?

The liver usually begins cocaethylene production within two hours of alcohol and cocaine use. As cocaethylene enters the bloodstream, it attaches to the same receptors in the brain seen in cocaine administration.²

When you consume cocaine, the liver can eliminate it relatively quickly. Simultaneous ingestion of alcohol interferes with this process, slowing cocaine metabolism by 20 percent and producing cocaethylene.²

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What is the Half-Life of Cocaethylene?

The half-life of cocaethylene is roughly two and a half hours. It is three to five times longer than the elimination half-life of cocaine but shorter than alcohol.¹⁰ 

A half-life is the time it takes your body to eliminate half of the total amount of drugs you consume. For instance, cocaine’s half-life is roughly one hour, which means it takes around two hours for your body to eliminate the drug from your system entirely.

Dangers of Mixing Alcohol and Cocaine

When you take cocaine and alcohol together, your body produces cocaethylene. This substance enhances the euphoric effects of both drugs. Cocaethylene effects are also more intense and last longer than alcohol or cocaine use alone.

Other health risks and complications of cocaethylene include:^5,8,9

• Decreased motor function
• Liver damage
• Kidney failure
• Reduced blood pressure
• Increased heart rate
• Higher blood pressure
• Higher risk of stroke
• Increased risk of violent behavior and suicide due to poor judgment
• Heightened risk of anxiety, panic attacks, depression
• Increased risk of cardiac arrest, including sudden heart attacks
• Intracranial hemorrhage
• Death

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Why Do People Mix Alcohol and Cocaine?

When partying, people can make bad decisions, sometimes involving drug use. Usually, this consists of having too many drinks and waking up the following day with a nasty hangover. But sometimes, it involves other drugs, such as cocaine.

People sometimes take alcohol and cocaine together, thinking they can counteract each other’s adverse effects. Because alcohol is a depressant and cocaine is a stimulant, they can “balance” each other out. 

While it might sound good in theory, this is a dangerous myth.

Mixing both cocaine and alcohol leads to cocaethylene, a highly toxic substance. Cocaethylene toxicity is higher than either drug alone and can lead to substance use disorder and severe health risks. 

Effects of Alcohol

Alcohol is a central nervous system (CNS) depressant. That means it slows down the activity in your brain and CNS. 

Alcohol consumption affects the brain in a variety of ways.

These include:

• Euphoria
• Slurred speech
• Reduced coordination or balance
• Higher sociability, confidence, and aggression
• Lower attention span
• Slower reaction time

With increased alcohol consumption, these effects intensify, leading to alcohol poisoning. Effects of alcohol poisoning:

• Reduced body temperature
• Memory impairment
• Vomiting
• Slowed heart rate
• Death

Alcohol also interacts with various other substances, amplifying their effects. One of the most common alcohol interactions is alcohol and cocaine.

Effects of Cocaine

Cocaine is a highly addictive stimulant used in the United States since the late 19th century. Stimulants speed up the activity in your brain and CNS.

Cocaine comes in several forms. The most common is a fine white powder. There is also a fat-soluble, solid form known as “freebase” cocaine and a solid rock crystal known as crack cocaine.

Regardless of how it a person consumes it, a typical cocaine high has the following characteristics:

• Euphoria
• Heightened sensitivity to touch and sound
• Increased sociability, confidence, and aggression
• Increased mental alertness

With increased cocaine intake, side effects can include:

• Increased body temperature 
• Increased heart rate
• Convulsions
• Impaired breathing
• Mood disorders

Long-time cocaine users can expect difficulty sleeping, liver damage, and cognitive issues due to brain atrophy.⁷ 

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How Long Do Cocaine and Alcohol Stay in Your System?

Your body usually processes cocaine within roughly four hours. For alcohol, it takes about one hour for your body to metabolize one standard drink.

Cocaethylene can remain in your system for three to five times longer than cocaine.¹⁰ However, various drug tests can detect cocaine and alcohol long after these periods.

Tests can detect cocaine or its metabolites in the following ways:

• Blood — Up to 12 hours
• Saliva — between two and nineteen hours 
• Urine — around two to four days
• Hair — up to 90 days

On the other hand, tests can detect alcohol through the:

• Blood — Up to six hours
• Breath — 12 to 24 hours
• Saliva — 12 to 24 hours
• Urine — 12 to 72 hours
• Hair — Up to 90 days

Treatment for Alcohol & Cocaine Addiction 

When substance use involves at least two drugs or more, it is called polysubstance use. Withdrawal from multiple substances at the same time is an incredibly complex issue. 

The first step is checking into an addiction treatment center for substance use. Here, substance use treatment professionals can monitor drug users 24 hours a day as they purge the toxic effects of cocaethylene from their systems. 

After the initial detox and patient monitoring, addiction treatment can occur. Options for addiction treatment include:

• Inpatient treatment: Inpatient treatment is when you remain at the treatment center for an extended time. It allows you to stay in close contact with medical professionals and receive intensive therapy, support, and counseling.
• Outpatient treatment: Outpatient treatment is when you attend regular therapy sessions but live outside the facility. This type of treatment is more flexible and may be a better fit for people with work and other responsibilities. 
• Medication-assisted treatment (MAT): MAT uses medications to treat the cravings and withdrawal symptoms commonly associated with chronic drug use.  These may include disulfiram, naltrexone, topiramate, valproate, and baclofen.³ 
• Cognitive Behavioral Therapy (CBT): CBT helps you become aware of your thoughts and how those thoughts influence your behavior. Professionals can use this therapy to help people recognize triggers, develop better coping strategies, and avoid relapse.
• Support Groups: Support groups, like Alcoholics Anonymous, allow you to share your struggles and experiences with others who face similar issues. They can provide you with a safe space to receive emotional support.

Summary

Cocaethylene is the result of simultaneous cocaine and alcohol usage. That means you should avoid using both of these substances together.

Withdrawal from multiple substances is complicated. However, various treatments are available to help you safely and effectively detox from polysubstance use.