Mixing Cocaine and Alcohol: Effects and Dangers

Although abuse of cocaine and alcohol has been gradually decreasing, these two substances still affect thousands of people all over the United States. Alcohol is legal to consume for people ages 21 and older in the US, but millions of people also struggle with alcohol use disorder.

 Mixing Cocaine and Alcohol: Effects and Dangers

In 2012, there were a reported 17 million adults, ages 18 and older, who suffered from alcohol use disorder, formerly called alcoholism. Other forms of alcohol abuse – especially heavy drinking and binge drinking – can be equally detrimental to a person’s health.

Both cocaine in powdered form and freebase or “crack” cocaine are also abused by numerous people in the US. About 5.2 percent of people surveyed in the 2015 Youth Risk Behavior Survey (YRBS) through the CDC reported that they had ever used cocaine. This represents a slow, steady decrease, as the highest percentage reported since 1991 was 9.5 percent in 1999. In 2016, the Monitoring the Future Survey found that 2.3 percent of 12th graders tried cocaine in any form in the prior year.

Effects of Cocaine and Alcohol

Cocaine, both powdered and freebase, causes stimulant effects and side effects, such as:

  • An intense, energetic high
  • High energy and mental alertness
  • Constricted blood vessels, causing heart palpitations and high blood pressure
  • Increased body temperature
  • Decreased appetite
  • Increased risk-taking
  • Anxiety and paranoia
  • Restlessness, irritability, and aggression
  • Insomnia
  • Dilated pupils
  • Cravings for more as the drug begins to wear off

Alcohol, being a depressant, has effects that are opposite those of stimulant drugs like cocaine. These effects and side effects include:

  • Slowed reaction time and reflexes
  • Loss of motor coordination
  • Slow speech
  • Reduced inhibitions
  • Blurred vision
  • Impaired judgment
  • Memory loss, even blackouts
  • Confusion, anxiety, and restlessness
  • Depression
  • Increased fatigue or sleepiness
  • Slowed heart rate
  • Reduced blood pressure
  • Slow breathing rate
  • Increased sweating
  • Nausea or vomiting; stomach upset
  • Dehydration

People who struggle with cocaine abuse may mix the drug with alcohol to reduce cocaine’s negative effects, like anxiety or twitching, by adding a depressant. In some cases, mixing cocaine and alcohol occurs because of a social situation. In some instances, a person who drinks too much may take cocaine to increase their physical energy. There are many reasons people may mix these drugs together, but it can be very dangerous to do so.

When Cocaine and Alcohol Are Mixed Together

Mixing recreational drugs together is a very dangerous practice, and it indicates a problem with polydrug abuse. Mixing cocaine and alcohol together is one of the more common forms of polydrug abuse; people often mix these substances together because one will, allegedly, reduce negative symptoms from the other. Alcohol also enhances euphoric effects from many substances, since it acts indirectly on GABA receptors, thereby increasing the release of some neurotransmitters.

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) found that over half of cocaine-dependent individuals also suffered from alcohol dependency, highlighting the close link between these two addictive substances. EMCDDA reported that both drugs were commonly associated with partying and nightlife, so they are often mixed in social scenarios. However, people continue to abuse these drugs together, even outside of social situations, because the self-reported high associated with both is more intense than either drug alone. This can lead to abuse, addiction, dependence, and health consequences.

Too often, people who suffer serious mental health conditions self-medicate with drugs, alcohol, or both before they receive an appropriate diagnosis. People who struggle with bipolar disorder and schizophrenia are especially susceptible to substance abuse and polydrug abuse patterns. People with bipolar disorder are more likely to develop alcohol use disorder as a co-occurring disorder in an attempt to modulate the mania associated with the condition. This population is also at an increased risk of developing cocaine addiction to modulate the effects of depressive episodes. Some people with undiagnosed bipolar disorder may begin to abuse both cocaine and alcohol, attempting to regulate their mood disorder. In reality, drug and alcohol addiction are more likely to make mood disorders like depression, anxiety, and bipolar disorder worse.

Risks of Mixing Cocaine and Alcohol

Alone, both cocaine and alcohol abuse can cause considerable damage to the body, from overdose to long-term, chronic health issues. Together, many of the health dangers increase.

Cocaethylene: A Deadly Byproduct

One of the most serious problems with mixing alcohol and cocaine occurs when the two are metabolized through the liver. The organ produces cocaethylene, which can build up in the body and put stress on major organ systems, particularly the cardiovascular system and the liver itself.

Cocaethylene temporarily enhances the high associated with both cocaine and alcohol, but this euphoria also increases blood pressure, aggressive and violent thoughts, and poor judgment. It will build up to toxic levels in the liver. An increase in cocaethylene has also been linked to sudden death.

Consequences from cocaethylene production include:

  • Myocardial infarction, or heart attack with heart pain
  • Cerebral infarction, or death of blood vessels and brain tissue, leading to brain damage, stroke, or aneurysm
  • Intracranial hemorrhage
  • Cardiomyopathy, or heart disease
  • Cardiac arrhythmia, which can contribute to a later heart attack


Other Short-Term Problems from Mixing Cocaine and Alcohol

Both alcohol and cocaine increase impulsive and risky behavior, decrease the ability to make judgments, and reduce cognitive function. Alcohol also increases the likelihood of memory problems, so a person may not remember risky behaviors they engaged in the night before.

Other side effects from combining alcohol and cocaine include:

  • Increased blood pressure
  • Breathing problems
  • Heart palpitations
  • Increased heart rate
  • Cognitive impairment
  • Loss of motor function and coordination

Loss of inhibitions can lead to risky sexual encounters, needle-sharing, or other dangerous behaviors. This can lead to infections, including HIV, herpes, hepatitis, and bacterial infections.


Long-Term Health Damage from Mixing Cocaine and Alcohol

Recently, a study conducted at Brown University found that combining alcohol and cocaine increased the risk of suicide. Among close to 1,000 people who were admitted to the emergency room for substance abuse, those who mixed cocaine and alcohol were the most likely to attempt suicide within one year after emergency treatment. Out of the study population of 874 individuals, 195 people attempted suicide at least once; 298 of those people struggled with alcohol abuse; 74 struggled with cocaine abuse; and 41 abused both drugs. Those 41 people were 2.4 times more likely to attempt suicide compared to all the other people in the study.

Production of cocaethylene and other metabolites from mixing cocaine and alcohol can damage the liver. The combination also increases body temperature to a dangerous level, which can damage both the liver and kidneys. In addition, reduced oxygen from constricted blood vessels and reduced breathing can damage organs, including the kidneys and liver. Alcohol use disorder and heavy drinking alone can lead to liver failure over time, but this process appears to be sped up when cocaine is added to the mix. Abuse of cocaine for a long time, whether mixed with alcohol or not, can permanently increase blood pressure, which stresses the kidneys and can lead to kidney failure.


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