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Cocaine and Alcohol Interactions

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Cocaine and Alcohol: A Dangerous Combination

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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How Cocaine Affects The Body

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:

  • 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 issues
  • Lung damage
  • HIV or hepatitis, if injected
  • Bowel decay, if swallowed 
  • Loss of smell, nosebleeds, runny nose, and trouble swallowing, if snorted 

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.

How Alcohol Affects 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 progressing, while others will continue to progress even after stopping drinking. 

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 

Drinking large amounts of alcohol over time or too much on one occasion affects 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 also affects the liver. It can lead to liver inflammation, including: 

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 on the blood vessels that prevents healthy digestion. The pancreatic enzymes begin 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 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.

6. Immune System

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.

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Why Do People Mix Cocaine and Alcohol?

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.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.

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What Happens if You Mix Cocaine and Alcohol?

There are various side effects, risks, and dangers of mixing cocaine and alcohol:

Increased toxic effects

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:

  • Heart
  • Liver
  • Other major organs

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.

Increased risk of stroke

Sudden stroke may occur when combining cocaine and alcohol. 

Cocaine increases the risk of stroke by:

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

Cocaethylene can increase the risk of stroke even further by staying in the body for days or weeks.4

Increased alcohol consumption

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.

Increased impulsivity 

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:

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

Increased risk of heart-related problems

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.

Pregnancy risks

Alcohol and cocaine use during pregnancy will have dangerous effects on 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 

Other risks

Mixing cocaine and alcohol increases the risk for various health problems, including:

  • Sudden stroke
  • Heart attack
  • Violent behavior
  • Paranoia
  • Anxiety
  • Depression
  • Unclear thinking
  • Seizures
  • Liver damage
  • Increased body temperature
  • Intense drug cravings
  • Increased cancer risk 
  • Sudden death

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

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

Possible Treatment Options for Polysubstance Abuse

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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Updated on March 25, 2022
7 sources cited
  1. Alcohol's Effects on the Body, National Institute on Alcohol Abuse and Alcoholism (NIH)
  2. Lacoste, Jérôme et al. “Cocaïne et alcool : des liaisons dangereuses” [Cocaine and alcohol: a risky association]. Presse medicale (Paris, France : 1983) vol. 39,3 : 291-302
  3. Pennings, Ed J M et al. “Effects of concurrent use of alcohol and cocaine.” Addiction (Abingdon, England) vol. 97,7 : 773-83
  4. Esse, Katherine et al. “Epidemic of illicit drug use, mechanisms of action/addiction and stroke as a health hazard.” Brain and behavior vol. 1,1 : 44-54
  5. Oliveira, K D et al. “Prevalence of cocaine and derivatives in blood and urine samples of trauma patients and correlation with injury severity: a prospective observational study.” European journal of trauma and emergency surgery : official publication of the European Trauma Society vol. 45,1 : 159-165
  6. Sanvisens, Arantza et al. “Alcohol Consumption during Pregnancy: Analysis of Two Direct Metabolites of Ethanol in Meconium.” International journal of molecular sciences vol. 17,3 417. 22 Mar. 2016
  7. Jones, Alan Wayne. “Forensic Drug Profile: Cocaethylene.” Journal of analytical toxicology vol. 43,3 : 155-160

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