Cocaethylene – Risks of Mixing Alcohol & Cocaine

What is Cocaethylene?
How Long Does Cocaethylene Stay in Your System?
Cocaethylene Effects on Brain Systems and Behavior
Do Drug Tests Test for Cocaethylene?
How Long Does Cocaethylene Stay in Your Urine?

What is Cocaethylene?

Cocaine and alcohol abuse remains a significant problem in our society. When combined, alcohol and cocaine can produce chemical reactions in the body that create a substance called cocaethylene — a byproduct of cocaine. This substance can increase the power of the effects and the risks of each substance – and can cause an overdose or death.

This substance also stays around for a much longer time in the body than cocaine, and its toxic effects last longer. Alcohol also slows the removal of another metabolite, ethylbenzoylecgonine, from the kidneys. This raises the blood levels of cocaine and cocaethylene.

How Is Cocaethylene Produced?

The liver is the primary organ linked with the detoxification process in the body. Most toxins or wastes from alcohol and drugs like cocaine are processed through the liver. Cocaine and alcohol harm the body’s tissue and must be removed from the bloodstream. The liver plays a crucial role in cleaning out the toxins in the blood and body. Cocaethylene develops and is processed through the liver.

This substance is produced about two hours after ingestion of both cocaine and alcohol. The body is halted from completely processing cocaine when it’s mixed with alcohol, creating cocaethylene. Since both substances are heavy and cause severe side effects, the body’s metabolizing system is slowed down, leaving twenty percent of the drug remaining in the body. The idea of this processing happening in the liver is to avoid toxins going into or staying in the bloodstream, but when a person continues to drink after using cocaine, the bloodstream, tissues, and other organs are damaged.

Cocaethylene Toxicity

Concurrent use of cocaine and alcohol produces another psychoactive substance known as cocaethylene which has pharmacological properties similar to that of cocaine but which has a plasma half-life three to five times that of cocaine. This slow removal from the body makes it an attractive drug for abuse. However, this substance has been associated with seizures, liver damage, and compromised functioning of the immune system. It also carries an 18- to 25-fold increase over cocaine alone in risk for immediate death.

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Cocaethylene Facts


Cocaethylene is the ethyl ester of benzoylecgonine. It is structurally similar to cocaine, which is the methyl ester of benzoylecgonine. This substance is formed by the liver when cocaine and ethanol coexist in the blood.

Molar mass: 317.38 g/mol

ChEMBL Id: 608806

ChemSpider ID: 559082

Classification: Ester

Cocaethylene Common Side Effects

  • Increase risk of stroke
  • Cardiac depression or chest pain
  • Increased heart rate
  • Sedation or coma
  • Increased perceived level of intoxication
  • It can cause damage to veins, arteries and nerve tissue, which can cause serious long-term effects or death.

Common Cocaethylene Symptoms of Overdose

  • Irregular heartbeat
  • Seizures
  • High body temperature
  • Trouble breathing
  • Agitation
  • Anxiety

Cocaethylene Toxicity Produces the Following Symptoms:

A great deal of research is focused on cocaethylene toxicity or cocaethylene poisoning, but all data currently available indicates that it is significantly more dangerous than either cocaine or alcohol. Physical dangers include cardiotoxic events like heart attacks, arrhythmia and cardiomyopathy, even in otherwise healthy adults. Neurotoxic events may include cerebral hemorrhage (bleeding into the brain) or stroke. Moreover, with regular cocaine and alcohol co-consumption, long-term structural damage happens in parts of the brain that are responsible for behavioral regulation and appropriate decision making. Mixing alcohol and cocaine also increases the risk of liver failure and immune system dysfunction.

  • The cardiovascular effects. Cocaethylene increases heart rate and blood pressure more than cocaine. In fact, this substance is thought to be over 10 times more cardiotoxic than cocaine.
  • Cocaethylene and trauma. Cocaine intoxication increases the risk and worsens outcomes for trauma patients because cocaine has adverse hemodynamic and systemic effects which can exacerbate morbidity and even increase mortality in trauma patients.
  • Neurological effects. Adult mammals experience neurogenesis to a limited extent over the course of their lifetime. This may be adversely affected by this substance. In a study of mice, the long-term exposure of animals to ethanol and cocaine induced pathological changes in the brain and neurodegeneration.
Cocaine and alcohol are two substances that are different in a lot of ways, but they do have something in common, and that’s the fact that they’re widely abused.

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Cocaethylene Effects

The effects of cocaethylene in the liver and bloodstream are more potent in those who use both alcohol and cocaine together on a regular basis. Moreover, some of the effects on brain systems and behavior, such as sudden heart attacks or impulsive behaviors, may even occur in occasional users who combine cocaine and alcohol.

  • Increased toxic effects: This substance is significantly more toxic than cocaine. Laboratory studies suggest that it may have a toxicity level 30 percent higher than cocaine. Once the liver begins producing it, the chemical keeps being released in the system and remains in the body up to three times longer than cocaine, resulting in increased potential for toxic effects. Cocaethylene toxicity may be associated with a number of sudden deaths and cardiovascular events that occur in cocaine users.
  • Increased risk of cardiovascular issues: It increases blood pressure and heart rate even more than cocaine does. Moreover, it impairs the ability of the heart muscle to contract. These issues are believed to increase the risk even further for people using only alcohol or cocaine alone and cause significant cardiovascular issues.
  • Increased risk for stroke: It may also result in an increased risk for stroke compared to individuals who only use alcohol or cocaine.
  • Increased potential for liver damage: Because of its significant toxicity, the presence of this substance in the liver will add to the potential to develop liver damage compared to the use of alcohol or cocaine alone.
  • Greater perceived effects of both drugs: This substance blocks the reuptake of dopamine in the brain, producing greater euphoric effects for both alcohol and cocaine and also increasing the potential that an individual will continue to abuse both drugs.
  • Longer method of action: It has a greater half-life than cocaine; therefore, it is more slowly eliminated than cocaine. This results in potentially more serious effects as it remains in the system longer.
  • Increased alcohol consumption: A number of studies suggest that the presence of cocaethylene may actually result in increased alcohol consumption. people who consume alcohol and cociane often binge drink. Chronic binge drinking is linked with a number of issues, including cardiovascular issues, liver damage, nerve damage, poor judgment, alcohol poisoning and a quicker development of severe alcohol dependence.
  • Increased impulsivity: Cocaethylene’s affinity to increase both serotonin and dopamine levels in the brain increases the risk that a person will engage in more impulsive behaviors, including potential violence.
  • Potential for death: The National Institute on Drug Abuse (NIDA) has suggested that cocaine and alcohol may be the most common two-drug combination that results in death.

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How Long Does Cocaethylene Stay in Your System?

How long cocaethylene stays in your system depends on numerous factors, like if the individual was a chronic cocaine and alcohol user. However, cocaine alone does not last long in the body, and the elimination half life of cocaethylene can last anywhere from 14 hours to over 50 hours. Therefore, an individual needs to not drink or take cocaine for over a week for the cocaethylene metabolite to completely exit the body.

Cocaethylene Half life

Cocaethylene metabolite has a longer half-life than cocaine, so that people who combine cocaine and ethanol may experience a longer lasting, as well as more intense, psychoactive effect. Cocaethylene is the only known instance where a new psychoactive substance is formed entirely within the body. Cocaethylene, is considered more toxic to the cardiovascular and hepatic systems than cocaine, the parent drug, and it has a longer plasma elimination half-life (about 2 hours) than cocaine (about 1 hour). The serum concentration of cocaethylene metabolite is not readily predictable because it is based on the timing of the use of ethanol with cocaine and the quantities used. Producing a precise cocaethylene half-life calculator may not be possible at present time.

n overdose can also happen when mixing Cocaine and alcohol

Cocaethylene Drug Test

The individual variability can also affect if cocaethylene shows up on a drug and alcohol tests and can depend on the method of testing.

Testing Hair for Cocaethylene

Cocaethylene traces can be detected in hair. Generally, a 1.5-inch hair sample can detect use within the previous 90 days.

Testing Cocaethylene in Urine

How long does cocaethylene stay in urine? Cocaethylene can be found in urine. What is the cocaethylene detection time in urine? Although little data exist on how long it stays in urine, it is detectable for at least several days. How long does cocaethylene stay in your urine depends on several factors.

Testing Blood for Cocaethylene

The half-life of cocaethylene in plasma, or the liquid portion of blood, is about two hours. Since it takes five half-lives to completely rid the body of a drug, cocaethylene can be detectable in plasma for up to 10 hours after the last use of cocaine.

Testing Saliva for Cocaethylene

Cocaethylene can be found in saliva, although studies have been limited to detecting it on the same day as cocaine use. As a result, it’s unclear how long cocaethylene can remain in saliva.

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Cocaethylene Detection

Cocaethylene is an active metabolite of cocaine. Moreover, cocaethylene has a plasma half-life of three to five times the half-life of cocaine and is associated with seizure, liver damage, and compromised immune function. Cocaethylene is detectable for much longer periods than cocaine, in both urine and blood, because it does not bind as strongly to the carboxylesterase. Cocaethylene concentrations generally relate to the time elapsed since cocaine dosing and may affect the cocaethylene detection time in urine.

Factors That Impact the Cocaethylene Detection Timeline

There are several elements that can influence the amount of time it will take a person’s body to eliminate Cocaethylene . These include:

The amount of cocaine and alcohol consumed and how long it has been used for. individuals who use cocaine chronically and in greater amounts may have traces of cocaine and/or its metabolites in their systems for longer periods of time

The purity of the cocaine: If there are significant differences in the purity of the cocaine, it could result in different elimination times from the body, since it could contain drastically different amounts of actual cocaine.

Individual differences in metabolism: Genetics, age, gender, and some physical health issues may also influence the metabolism of cocaine and thus the amount of time that cocaine and/or its metabolites remain in the body.

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Alcohol and Cocaine Addiction Treatment

First and foremost, if you think a loved one is abusing cocaine and alcohol, you should research the substances and their associated addiction to understand better what your loved one needs.  Next, you must plan an intervention to provide your loved ones with options to battle the effects of cocaine and alcohol addiction in a safe and supportive environment. During this intervention, offer compassion and support instead of judgment. Lastly, show your support throughout the entire treatment process.

In addition, prolonged drug use can have severe physical and psychological effects on you, so it is essential to seek treatment as soon as possible. Inpatient drug rehab offers intensive care that can help you promptly get through the early stages of cocaine withdrawal

Cocaine and Alcohol Detox

Medical detox is often considered the first stage of treatment. It will help you navigate the complicated cocaine and alcohol detox withdrawal but doesn’t address patterns of thought and behavior contributing to drug use. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete the cocaine and alcohol detox.

Cravings are very common during drug detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can give medication and medical expertise to lessen cravings and withdrawal symptoms.

Inpatient Alcohol and Cocaine Addiction Rehab

There isn’t one treatment approach or style that will suit everyone. Treatment should speak to the needs of the individual. Inpatient rehab and addiction treatment aren’t just about drug use. the goal is to help the patient stop using cocaine and alcohol, but drug rehab should also focus on the whole person’s needs.

Addiction is a complex but treatable disease that affects brain function and behavior. When someone or their family is considering different treatment facilities, they should account for the complexity of addiction and the needs of the individual. The objective of attending an inpatient rehab center for addiction treatment is to stop using the drug and re-learn how to live a productive life without it.

Following a full medical detox, most people benefit from inpatient rehab. Inpatient drug rehab can last anywhere from 28 days to several months. Patients stay overnight in the rehab facility and participate in intensive treatment programs and therapy. Once someone completes rehab, their addiction treatment team will create an aftercare plan, which may include continuing therapy and participation in a 12-step program like Narcotics Anonymous.


Many rehab programs will also have early morning classes or programs. Group sessions occur during inpatient rehab, as do individual therapy sessions. Family therapy may be part of inpatient rehab when it’s feasible. Alternative forms of therapy may be introduced during inpatient rehab, like a holistic therapy program, yoga for addiction recovery, or an addiction treatment massage therapy.

Several different modalities of psychotherapy have been used in the treatment of mental health disorders along with addiction, including:

  • Cognitive Behavioral Therapy (CBT) – is an effective treatment that involves changing both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression.
  • Dialectical Behavioral Therapy – is a comprehensive mental health and substance abuse treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. The main goal of DBT is to help a person develop what is referred to as a “clear mind.” 
  • Solution-focused therapy is an approach interested in solutions that can be quickly implemented with a simple first step leading to further positive consequences.

Dual Diagnosis Treatment

Drug abuse and mental health disorders often co-occur. Traumatic experiences can often result in mental health disorders and substance abuse. Dual-diagnosis rehabilitation treats both of these issues together. The best approach for the treatment of dual diagnosis is an integrated system. This strategy treats both the substance abuse problem and the mental disorder simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend mainly on the treatment for both diseases done by the same team or provider.

Medication Assisted Treatments (MAT)

Medication-Assisted Treatments (MAT) for substance use and mental health disorders are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.

Please, do not try to detox on your own. The detox process can be painful and difficult without medical assistance. However, getting through the detox process is crucial for continued treatment. We Level Up provide proper care with round-the-clock medical staff to assist your recovery through our opioid addiction treatment program medically. So, reclaim your life, and call us to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions.

Cocaine and Alcohol Rehab Near Me

Alcohol and cocaine addiction is a condition that can cause major health problems, such as an overdose. We Level Up NJ rehab treatment & detox center can provide you, or someone you love, the tools to recover from this with professional and safe treatment. Feel free to call us to speak with one of our counselors. We can inform you about this condition and clarify issues like cocaine withdrawal symptoms. Our specialists know what you are going through. Please know that each call is private and confidential.

n overdose can also happen when mixing Cocaine and alcohol

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