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Updated on September 13, 2023
8 min read

The Dangers of Mixing Cocaine and Alcohol

Ellie Swain
Dr P. E. Pancoast, MD
Written by 
7 Sources Cited
Ellie Swain
Written by 
7 Sources Cited

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, while cocaine is a stimulant. When someone uses these opposing drugs simultaneously, the side effects can increase to dangerous levels.

How Does Cocaine Affect the Body?

Cocaine sends high dopamine levels to the parts of the brain that control pleasure. This buildup leads to intense euphoria, high energy, and alertness.

Other effects of cocaine include:

  • Extreme sensitivity to touch, sound, and sight
  • Intense happiness
  • Anger or irritability
  • Paranoia
  • Decreased appetite
  • Headaches
  • Convulsions
  • Seizures
  • Heart disease, heart attack, and stroke
  • Mood changes
  • Sexual performance issues
  • Lung damage
  • HIV or hepatitis, if injected
  • Bowel decay, if swallowed
  • Loss of smell, nosebleeds, runny nose, and trouble swallowing, if snorted

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 thinking, sleeping, and remembering things more difficult. The more people 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 recurrent drug abuse or an overdose.


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How Does Alcohol Affect the Body?

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 worsening, while others will continue to progress even after staying sober. 

Here are six ways alcohol affects the body:1

1. Brain

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.

2. Cardiovascular System

Drinking large amounts of alcohol over time or too much can affect the heart. Heart problems resulting from alcohol use include:

  • Cardiomyopathy (stretching and weakening of heart muscle)
  • Congestive heart failure
  • Irregular heartbeat (arrhythmia)
  • Stroke
  • High blood pressure (hypertension)

3. Liver

Heavy drinking affects the liver. It can lead to the following complications:

4. Pancreas

Alcohol causes the pancreas to create toxic substances that block the normal passages and lead to pancreatitis.

Pancreatitis is dangerous inflammation and swelling of the blood vessels that prevents healthy digestion. This causes the pancreatic enzymes to ‘digest’ the pancreas itself.

5. Cancer

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 have light drinking habits and those who binge drink.

Drinking alcohol correlates with increased risks of certain types of cancer, including head and neck, breast, liver, and esophageal cancers.

6. Immune System

Drinking too much alcohol weakens the immune system, which 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 significant alcohol in one sitting slows the body’s ability to fight infections, even up to 24 hours after their last drink.

Why Do People Mix Cocaine and Alcohol?

As many as 90% of cocaine users are also addicted to alcohol.2 There are various reasons why cocaine and alcohol use is common.

One reason is to experience a ‘better’ ‘high. Using both substances delivers more euphoria than using either drug alone.3

Another reason to use cocaine with alcohol is to feel less drunk. Using cocaine enables a person to drink more alcohol without feeling as intoxicated despite their heavy drinking.3  

However, they are still intoxicated, just more awake. Similarly, alcohol may allow a person to take more cocaine without feeling as high.

Treating Cocaine Withdrawal with Alcohol

Some people combine the two substances to self-treat their cocaine withdrawal. Using alcohol may reduce the discomfort of coming down from cocaine intoxication.

When a cocaine high is about to end, people may feel the following symptoms:

  • Restlessness
  • Being uncomfortable
  • Irritability

People may drink alcohol in an attempt to manage those symptoms. Using both at the same time may help some people feel balanced. With repeated cocaine and alcohol use, the brain becomes dependent on this “synthetic happiness,” leading users to crave this drug combination.


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What Happens if You Mix Cocaine and Alcohol?

Mixing alcohol with drug abuse can lead to various negative effects, such as:

Increased Toxic Effects

Combining cocaine and alcohol creates new metabolites in the body. One of the most powerful of these is cocaethylene.7

Cocaethylene blocks the reuptake of dopamine. It produces feelings of more energy than usual and makes its users crave the two drugs in higher doses over time.

Cocaethylene is more potent than either cocaine or alcohol independently. Because cocaethylene has a longer half-life, its psychoactive effects last longer.

Extended cocaine highs typically cause a significant increase in life-threatening effects. Cocaethylene increases toxicity in the:

  • Heart
  • Liver
  • Other major organs

This substance remains in the body about 4 times longer than cocaine, and its cardiotoxic effects last longer, too.

Alcohol also slows the removal of another metabolite from the kidneys called ethylbenzoylecgonine. This increases the amount of cocaine and cocaethylene in the blood.

Increased Risk of Stroke

Sudden stroke may occur when mixing cocaine and alcohol. Cocaine increases the risk of stroke by:

  • Shrinking blood vessels
  • Raising heart rate and blood pressure
  • Causing risk of sudden brain bleeding
  • Increasing the risk of blood clots

Cocaethylene can increase the risk of stroke even further since it stays in the body for days or weeks.4

Increased Alcohol Consumption

Alcohol can increase cravings for cocaine by triggering the brain’s reward system. This makes it challenging to stop using cocaine.2

Some people binge drink to continue feeling cocaine’s euphoric effects and avoid withdrawal.

Increased Impulsive Behavior

Cocaine and cocaethylene increase dopamine and serotonin levels in the brain and block their reuptake.

This boosts the stimulant effects on the body, leading to:

  • Impulsive and violent behavior
  • Panic attacks
  • Anxiety
  • Depression

Increased Risk of Heart-related Problems

The presence of cocaine and cocaethylene increases heart and liver toxicity. The most significant danger of using cocaine and alcohol is sudden heart-related problems, such as a heart attack or a change in heart rhythms.

The danger to the cardiovascular system may be higher if someone already has heart-related health issues.

Pregnancy Risks

Alcohol and cocaine use during pregnancy will harm both mother and fetus.

Combining alcohol and cocaine during pregnancy can cause:6

  • Miscarriage
  • Stillbirth
  • Premature birth
  • Low birth weight
  • Developmental delays, including problems with learning, attention, emotions, and physical and mental development

These risks depend on various factors, including:

  • Other health problems the mother and fetus have
  • How long the mother used cocaine and alcohol
  • Whether she used other drugs during pregnancy 

Mental Health Effects

Concurrent alcohol and cocaine use increases the tendency for violent thoughts, potentially leading to aggression. In addition, there is a higher chance of committing suicide from anxiety, paranoia, and depression. 4

Alcohol dependence also increases the risk of relapse in cocaine users.


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What Are the Signs of Cocaine and Alcohol Addiction?

Some common signs of cocaine and alcohol addiction include:

  • Problems at work, school, or home
  • Using the substances even if it risks physical safety
  • Trouble with law enforcement that stems from substance use
  • Continuing to use cocaine and alcohol even though using them causes problems

These signs of substance abuse may indicate the need for alcohol addiction treatment.

Acute and Chronic Effects of Cocaine Use

Due to cocaine addiction, the following acute effects may occur immediately after cocaine use:

  • Irritation and burning of the eyes, skin, nose, and throat
  • Nausea, vomiting, and diarrhea
  • Shortness of breath
  • Irregular heartbeat

These long-term health effects may occur after repeated cocaine use:

  • Mutations (genetic changes)
  • Lowered sperm count
  • Liver and kidney damage, including anemia
  • Headaches, confusion, muscle weakness, and coma

Withdrawal Symptoms from Concurrent Use of Alcohol and Cocaine

Because concurrent use of alcohol and cocaine manipulate brain chemicals like norepinephrine and serotonin, withdrawing from the two drugs can cause the following side effects:

  • Irritation
  • Depression
  • Poor-quality sleep
  • Lack of appetite, focus, and energy
  • Paranoia and unclear thinking
  • Poor impulse control and decision-making

Possible Treatment Options for Polysubstance Abuse

Polysubstance abuse is the act of abusing multiple substances. This makes withdrawal more complicated than just dealing with one drug.

Medical professionals generally recommend the following treatment options to manage side effects and withdrawal symptoms from polysubstance abuse:

  • Inpatient medical detox: Medical staff supervise people 24 hours a day during detox. This ensures consistent monitoring of symptoms and quick action if any medical emergencies occur.
  • Medication-assisted treatment: Supervising medical professionals prescribe medication to treat specific withdrawal symptoms. For example, they might prescribe anti-nausea medicine to help with vomiting or recommend antidepressants to treat mood changes.
  • Long-term maintenance: In some cases of polysubstance withdrawal, 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. 

Due to the unpredictability of withdrawal from multiple substances, consistent medical monitoring is necessary. 


Mixing cocaine with alcohol often increases euphoria or higher tolerance to both drug’s side effects. However, this also produces harmful metabolites that can increase the risks of alcohol and cocaine use, such as a higher risk of overdose, alcohol poisoning, and sudden death.

It’s best to watch your drinking and consult your healthcare provider if you’re dealing with alcohol or cocaine addiction.

The support provided during inpatient medical detox reduces the likelihood of relapse. It also increases the chances of safe, successful withdrawal from all substances.

Updated on September 13, 2023
7 sources cited
Updated on September 13, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

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