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Mixing Cocaine and Alcohol

Alcohol is often consumed alongside other illicit substances, making some people wonder what happens when you mix cocaine and alcohol. Mixing cocaine and alcohol can lead to dangerous, even life-threatening consequences due to the formation of a toxic chemical called cocaethylene. Thus, it is critical to avoid using cocaine and alcohol together.

Whether you take cocaine occasionally, regularly, or have used it once or twice, it is crucial to understand the risks of mixing it with alcohol. Both substances affect the mind and body, even when taken alone, and there are even more significant risks when consumed together.

There’s a myth out there about using cocaine and alcohol together. People believe taking both can boost the cocaine high and help avoid withdrawal. This is just not true. In fact, mixing cocaine and alcohol can have deadly results. Cocaine and alcohol don’t actually negate the effects of one another. They mask the effects, making people unaware of how inebriated they are.

As cocaine is a stimulant and alcohol is a depressant, the collective pressure they put on your body and mind can be dangerous. Some people use cocaine and alcohol simultaneously to increase the effects of both substances. However, this combination can easily lead to life-threatening consequences such as overdose or alcohol poisoning.

Cocaine and Alcohol
Mixing cocaine and alcohol has been associated with a greater risk of suicidal tendencies. Prolonged use can also take a toll on your long-term physical health, which can be life-threatening.

What Happens When You Mix Alcohol and Cocaine ?

Cocaine is snorted and goes to the liver via nasal vessels. On the other hand, alcohol reaches the liver via circulation. When consumed together, Cocaine and alcohol are metabolized in the liver, which results in producing a neurological toxin called Cocaethylene.  

Cocaethylene has pharmacological properties similar to that of cocaine but has a plasma half-life three to five times that of cocaine. Cocaethylene has been associated with seizures, liver damage, and compromised immune system functioning. It also carries an 18- to 25-fold increase over cocaine alone in risk for immediate death.

Cocaine-alcohol produced greater euphoria and increased perception of well-being relative to cocaine. Heart rate significantly increased following cocaine-alcohol administration comparable to either drug alone. Cocaine concentrations were greater following cocaine-alcohol administration. Cocaethylene had a longer half-life with increasing concentrations relative to cocaine at later time points.

Enhanced psychological effects during cocaine-alcohol abuse may encourage the ingestion of more significant amounts of these substances over time, placing users at heightened risk for greater toxicity than with either drug alone.

Toxic levels of cocaethylene build-up in the liver have been linked to sudden death as well as the following negative physical consequences:

  • Myocardial infarction (or painful heart attack)
  • Cerebral infarction (damage to brain tissue, leading to stroke or aneurysm)
  • Intracranial hemorrhage (bleeding in the brain)
  • Cardiomyopathy (heart disease)
  • Cardiac arrhythmia (irregular heartbeat)

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Effects of Cocaine and Alcohol Mixed 

Mixing cocaine and other stimulants increases the risk of having a heart attack or experiencing respiratory failure, a life-threatening condition characterized by an inability to breathe. Alcohol causes both stimulant and depressant effects. Mixing cocaine and alcohol causes more harm to the heart and other vital organs than using either drug on its own. 

Using multiple drugs at once can also increase the risk of addiction. Drugs manipulate the pleasure and reward system in the brain. When a person uses cocaine and drinks alcohol simultaneously, multiple systems in the brain are disrupted and may become addicted to multiple drugs.

Both cocaine and alcohol have negative long-term effects on the body. With chronic cocaine use, the brain starts to adapt to this new synthetic happiness by stopping the production of naturally occurring dopamine. Along with this, the neural circuits involved in stress become increasingly sensitive, leading to increased negative moods and irritability when not taking the drugs.

Long-time users of alcohol also face a whole host of psychological and physical issues. Heavy drinking can be a significant contributing factor to alcohol liver damage, including alcoholic hepatitis and cirrhosis. It can contribute to cardiological issues such as cardiomyopathy, high blood pressure, and an increased chance of stroke or heart attack. Heavy long-term alcohol use has also been associated with many types of cancers including mouth, throat, larynx, colorectal, liver, and esophageal cancer.

Side Effects of Cocaine and Alcohol Together 

Taking alcohol and cocaine together can amplify the individual side effects of each substance. Additionally, there are many long-term and short-term side effects associated with combining alcohol and cocaine, including:

  • Cardiotoxicity (heart toxicity)
  • Breathing problems
  • Increased heart rate
  • Cognitive impairment
  • Increased blood pressure
  • Loss of coordination and motor function
  • Violent thoughts and threats
  • Heart palpitations
  • Cerebral infarction (death of blood vessels and blood tissue)
  • Stroke
  • Death

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Understanding Alcohol Abuse

Alcohol abuse, also known as alcoholism, is a disease that affects people from all walks of life. In 2018, the World Health Organization (WHO) [3] reported that alcohol contributed to more than 200 diseases and injury-related health conditions, ranging from liver diseases, road injuries, and violence to cancers, cardiovascular diseases, and suicides.

Alcohol is a psychoactive substance with dependence-producing properties. One of the most important facts to remember about alcoholism is its progression. It begins in an early stage that looks nothing like a life-threatening disease, proceeds into a middle stage where problems start to appear and intensify, and gradually advances into the late, degenerative stages of evident physiological dependence, physical and psychological deterioration.

Because alcohol is encouraged by our culture, we get the idea that it isn’t dangerous. However, alcohol is the most potent and most toxic of the legal psychoactive drugs. Alcoholism is a devastating, potentially fatal disease. The primary symptom of having it is telling everyone–including yourself–that you are not an alcoholic.

Cocaine and Alcohol
Cocaine and alcohol cause dangerous health effects when they’re mixed together. In the blood, they form a toxic chemical called cocaethylene. Using both drugs at the same time strains the heart, injures the liver, and damages the brain.

Understanding Cocaine Abuse

Before we can understand how cocaine interacts with alcohol, we first need to learn how cocaine impacts the body. Cocaine is an illegal stimulant that is also overly abused. Cocaine can be used as crack cocaine or in a powdered form. To increase profits, many cocaine dealers mix the substance with things like “cornstarch, talcum powder, or flour” and may “also mix it with other drugs such as the stimulant amphetamine, or synthetic opioids including fentanyl.”

These extra substances make a dangerous compound, as “adding synthetic opioids to cocaine is especially risky when people using cocaine don’t realize it contains this dangerous additive. Increasing numbers of overdose deaths among cocaine users might be related to this tampered cocaine.”

Whether the user knows if the cocaine has an additive or not, they most likely will proceed with its use. In most cases, people snort the powdered form through their noses or rub it into their gums. The powder can also be dissolved and injected into the bloodstream. Once cocaine is processed, it is called “freebase cocaine”.

In the heating process, the crystal rock makes a crackling sound. The crystal is heated to create vapors that can be inhaled into the lungs. Cocaine can also be used with other substances. A stronger combination than cocaine and alcohol is cocaine and heroin, known as a speedball.

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Understanding Cocaine and Alcohol Abuse

One reason why people start using cocaine and alcohol is to self-medicate and dull emotional anxiety or depressive mood. Alcohol and drug use is a common coping mechanism. When the coping mechanism becomes polydrug use, there are multiple diagnoses at play. In most cases, people begin self-medicating to avoid understanding their symptoms and lack an appropriate diagnosis.

Individuals who struggle with schizophrenia and bipolar disorder are especially at risk of substance abuse and polydrug patterns. Research has shown that a particular demographic is more likely to develop an alcohol use disorder; people with bipolar disorder. This is because of the attempt to modulate mania linked with the condition.

Individuals suffering from bipolar disorder have the tendency to use alcohol and are also susceptible to developing an addiction to cocaine to modulate the effects of the depressive episodes. While these individuals with either undiagnosed or diagnosed bipolar disorder use these drugs to alleviate their symptoms, the combinations of drug use make mood disorders like anxiety, depression, and bipolar worse for a variety of reasons.

Polydrug use is, unfortunately, more common than we like to think, and one drug does enough harm to the body alone when abused. Both drugs can cause damage to the user’s body and social and emotional well-being, while also increasing their risk of long-term, chronic health issues or overdose. The health dangers of one drug are enhanced by polydrug use and dual diagnoses.

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Cocaine and Alcohol Addiction Treatment

Treatment for a cocaine and alcohol addiction typically involves medically-assisted detox and therapy in an inpatient rehabilitation program. These programs greatly increase your chances of a successful recovery, even though psychological dependence on cocaine and alcohol is a severe condition that is difficult to overcome. If you are considering treatment for cocaine and alcohol addiction, it is helpful to seek a substance abuse evaluation from an addiction professional to determine the right type of support.

Deciding to find treatment for cocaine and alcohol addiction is the first step toward recovery. It is also the most important step. Once you admit to yourself that you’re struggling with cocaine and alcohol addiction, the only way to go is forward. 

The brain does not simply go back to normal when the drug and alcohol use stops. It could take several supports, therapy, counseling, and treatment methods to help you effectively overcome the disease. Not everyone needs cocaine addiction treatment, but such help is beneficial to those who have suffered adverse reactions to their sustained drug use, including cocaine overdose

Treatment for cocaine addiction may include:

There are thousands of treatment centers in the country, but not all of them are right for everyone. Those looking for help need to find a center that specifically offers treatment for cocaine and alcohol addiction. It is important that this center is also able to treat other drugs being used and co-occurring mental conditions. If you or a loved one is struggling with cocaine and alcohol addiction. We Level Up NJ addiction specialists are standing by to help.

Cocaine and Alcohol
Many who seek to stop using cocaine and alcohol choose to enter medical detox, which is an intervention designed to help you safely and comfortably eliminate both substances from your body.

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[1] NCBI –

[2] NCBI –

[3] WHO –