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.
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Mixing drugs is never a good idea. Combining cocaine and alcohol can strain vital organs, including the heart. Taking both drugs at the same time can cause more damage than using either drug alone.

Some people use cocaine to feel more sober when they drink. Others drink alcohol to take the edge off when they use cocaine. Mixing the drugs may seem like it makes you feel better, but they’re actually causing more internal damage than you realize.

Health Effects of Mixing Cocaine and Alcohol

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 alcohol and cocaine causes more harm to the heart and other organs than using either drug on its own, according to a 2013 article by the director of the Center for Substance Abuse Treatment. The mixture also produces a dangerous toxin called cocaethylene in the blood.

Cocaine and alcohol don’t actually negate the effects of one another. They mask the effects, making people unaware of how inebriated they are.

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 drinks alcohol and uses cocaine at the same time, multiple systems in the brain are disrupted. The person may become addicted to multiple drugs.

People with a cocaine addiction and an alcohol addiction may crave the experience of using the drugs at the same time. Altogether, the risks caused by mixing the drugs aren’t worth the supposed benefits.

Why Do People Mix Alcohol and Coke?

Usually people mix alcohol and cocaine for one of two reasons. They want to feel more buzzed, or they want to offset unpleasant side effects of one of the substances.

For example, cocaine is a stimulant that can make people more anxious or unnerved than they want to be. They may drink alcohol to relieve some of the anxiety. In another example, a person who is drunk and sleepy may use cocaine to feel more alert and to stay awake.

Increased energy, alertness and focus are signs of cocaine use.

Some people mix the drugs to ease the crash or hangover from cocaine or alcohol. A cocaine crash is a form of cocaine withdrawal that causes anxiety, irritability and agitation. Alcohol can temporarily relieve some of those symptoms. Hangovers from alcohol cause sleepiness, headache and depression. Cocaine can mask some of those symptoms.

In the long run, using drugs to self-medicate negative feelings or emotions is a bad idea. The substances disrupt the way the brain works, making the symptoms worse over time.

How Alcohol Disrupts Cocaine Metabolism

Alcohol changes the way the body absorbs and metabolizes cocaine. Metabolism refers to how the body breaks down, uses and removes chemicals. Experts believe alcohol makes the blood absorb more cocaine than usual.

If more cocaine is in the blood, more cocaine will reach the brain, heart and other organs. People who mix cocaine and alcohol will feel higher than if they used cocaine alone, but they’ll also have a greater risk of cocaine overdose and other health problems.

To remove cocaine, the body metabolizes the drug into chemicals called metabolites. The body removes these chemicals in urine. The main cocaine metabolite is inactive, so it doesn’t interact with the body. Thus, a person doesn’t feel the effects of cocaine once the drug is metabolized.

When alcohol is in the blood, metabolism is disrupted and a metabolite called cocaethylene forms.


Cocaethylene is a toxic metabolite that forms when alcohol interacts with cocaine. Cocaethylene has a longer half-life than cocaine. That means people feel the effects of cocaine for much longer when they mix it with alcohol than when they use cocaine alone.

Usually, cocaine remains in the system for about a day, but cocaethylene may remain in the body for a longer period of time.

Cocaethylene is also more potent than cocaine. The metabolite is associated with seizure, liver damage and immune system problems. It also causes deadly overdoses at a much higher rate than cocaine.

Some people intentionally drink alcohol while using cocaine to feel the effects of cocaethylene. It causes a more intense high. But it also causes more health problems.

Cocaine addiction can be treated, and people addicted to multiple substances, such as cocaine and alcohol, can receive integrated treatment to recover from both addictions.

Medical Disclaimer: aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

Chris Elkins, MA
Senior Content Writer,
Chris Elkins worked as a journalist for three years and was published by multiple newspapers and online publications. Since 2015, he’s written about health-related topics, interviewed addiction experts and authored stories of recovery. Chris has a master’s degree in strategic communication and a graduate certificate in health communication.

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