Medically Reviewed by Dr P. E. Pancoast, MD
In this article
Some people use alcohol and cocaine together to increase the effects of both substances. However, this combination can lead to life-threatening consequences such as overdose or alcohol poisoning.
Alcohol is a depressant; cocaine is a stimulant. When someone uses these opposing drugs simultaneously, the side effects can increase to dangerous levels.
Cocaine and alcohol should never be taken together. The risks greatly outweigh any perceived reward.
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Cocaine sends high dopamine levels to the parts of the brain that control pleasure. Dopamine is a natural chemical messenger in the body.
This buildup provides intense feelings of euphoria, energy, and alertness called a high.
Other effects of cocaine include:
People may experience intense cravings for cocaine’s high. The more they use cocaine, the more their brain adapts to it.
With long-term use, they will require a stronger dose to experience the same high they did before. This can lead to addiction or overdose.
Stronger, more frequent doses contribute to long-term changes in brain chemistry. The body and mind will begin to rely on the drug. These changes make it more difficult to think, sleep, and remember things.
Chronic alcohol use negatively affects how the body looks and functions. Some of these changes are reversible when a person quits drinking, some will just stop progressing, while others will continue to progress even after stopping drinking.
Here are six ways alcohol affects the body:1
Alcohol affects the brain’s communication pathways. It interferes with how the brain looks and works. These disruptions can alter mood and behavior, which makes it harder to think clearly or coordinate movement.
Drinking large amounts of alcohol over time or too much on one occasion affects the heart.
Heart problems resulting from alcohol use include:
Heavy drinking also affects the liver. It can lead to liver inflammation, including:
Alcohol causes the pancreas to create toxic substances that block the normal passages and lead to pancreatitis. Pancreatitis is dangerous inflammation and swelling on the blood vessels that prevents healthy digestion. The pancreatic enzymes begin to ‘digest’ the pancreas itself.
Drinking alcohol contributes to several types of cancer. The more alcohol someone regularly drinks over time, the more likely they are to develop alcohol-related cancer. This applies to people who only drink one drink per day and those who binge drink.
Drinking alcohol correlates with increased risks of certain types of cancer. These cancers include head and neck, breast, liver, and esophageal.
Drinking too much alcohol weakens the immune system. This makes the body more prone to disease.
Chronic drinkers are more likely to develop diseases like pneumonia and tuberculosis than people who don’t drink. Drinking a significant amount of alcohol on one occasion slows the body’s ability to fight infections, even up to 24 hours after drinking heavily.
As many as 90 percent of people dependent on cocaine are also addicted to alcohol.2
There are various reasons why people use alcohol and cocaine together.
One reason is to experience a ‘better’ ‘high. Using both substances delivers an increased sense of euphoria than using either drug alone.3
Another reason may be to feel less drunk. Using cocaine enables a person to drink more alcohol without feeling as intoxicated. They may still feel alert and coordinated, despite drinking a lot.3 However, they are still intoxicated, just more awake.
Likewise, alcohol may allow a person to take more cocaine without feeling as high.
Some people combine the two substances to treat cocaine withdrawal. Using alcohol may reduce the discomfort of coming down from cocaine intoxication.
When a cocaine high is finishing, people can feel restless, uncomfortable, and irritable. They may drink alcohol in attempt to manage those symptoms.
Cocaine is a stimulant, while alcohol is a depressant. As such, using both at the same time may help some people feel balanced.
Note: This feeling is not genuine. Combining substances dangerously changes the body’s natural balance. People are more ‘wide awake’ with impaired thinking and coordination but less tiredness.
There are various side effects, risks, and dangers of mixing cocaine and alcohol:
Combining cocaine and alcohol creates new elements. One of the most powerful of these is cocaethylene.7 This product is stronger than alcohol or cocaine alone.
Cocaethylene increases toxicity to the:
This substance remains in the body about 4 times longer than cocaine. Its toxic effects last longer, too.
Additionally, alcohol slows the removal of another metabolite from the kidneys called ethylbenzoylecgonine. This heightens the blood levels of cocaine and cocaethylene.
Sudden stroke may occur when combining cocaine and alcohol.
Cocaine increases the risk of stroke by:
Cocaethylene can increase the risk of stroke even further by staying in the body for days or weeks.4
Alcohol can increase cravings for cocaine. This makes it challenging to stop using cocaine.2
Some people binge drink to continue feeling cocaine’s effects and avoid withdrawal.
Cocaine and cocaethylene increase levels of the brain chemicals dopamine and serotonin and block their reuptake.
This boosts the stimulant effects on the body, leading to:
The rise of cocaine and cocaethylene increases heart and liver toxicity. The most significant danger of using both cocaine and alcohol is sudden heart-related problems, such as a heart attack or a change in heart rhythms.
The risk level may be higher if someone already has heart-related health issues.
Alcohol and cocaine use during pregnancy will have dangerous effects on both mother and fetus.
Combining alcohol and cocaine during pregnancy can cause:6
These risks depend on various factors, including:
Mixing cocaine and alcohol increases the risk for various health problems, including:
People who use alcohol and cocaine are also more likely to have injuries or adverse reactions. They’re also more likely to visit emergency rooms (ERs).5
Some common signs of cocaine and alcohol addiction include:
Withdrawal from multiple substances is more complicated than withdrawal from one drug. Because of this, medical professionals generally recommend inpatient medical detox for polysubstance abuse.
During detox, medical staff supervise people 24 hours a day. This ensures consistent monitoring of symptoms and quick action if any medical emergencies occur.
Additionally, supervising medical professionals often prescribe medication to treat specific withdrawal symptoms. For example, they might prescribe anti-nausea medicine to help with vomiting or an upset stomach. Or, they might recommend antidepressants to treat mood changes.
In some cases, long-term maintenance medication may be necessary. For example, if someone regularly abuses prescription painkillers, staff may provide an opioid medicine like methadone or buprenorphine.
Cocaine withdrawal symptoms aren’t typically as intense. Medical professionals will monitor the symptoms as necessary.
Due to the unpredictability of withdrawal from multiple substances, consistent medical monitoring is necessary. Additionally, the support available in medical detox reduces the likelihood of relapse. It also increases the chances of safe, successful withdrawal from all substances.
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