Cocaine and alcohol can produce dangerous side effects when people combine them. In some cases, the effects of cocaine and alcohol can cause life threatening complications.

In this article, we look at the effects of combining cocaine and alcohol. We also explain what precautions to take and the treatment options.

What is cocaine?

Consuming cocaine and alcohol together can be dangerous due to the higher toxicity.
Cocaine is a powerful stimulant that affects the central nervous system. Cocaine powder comes from the leaves of the South American coca plant. It is a highly addictive drug, and its recreational use is illegal in the United States.

People can take cocaine in different forms:

Powdered cocaine: Coca paste with hydrochloric acid.
“Crack” cocaine: Powdered cocaine mixed with baking soda and water.
Freebase cocaine: Uses ammonia to extract the base to create the purest form of cocaine.
Dealers may also mix cocaine with other additives, such as flour, talcum powder, or other drugs. People may snort, smoke, or inject cocaine.

Effects of cocaine
The side effects of cocaine may include:

• intense high energy
• anxiety
• paranoia
• mood changes, such as aggression or irritability
• increased body temperature
• raised heart rate
• constricted blood vessels, which can cause high blood pressure and heart palpitations
• increased mental alertness
• dilated pupils
• increase in risk taking
• craving more cocaine as the drug wears off, which can lead to addiction
• Effects of alcohol
• The side effects of alcohol can include:

• decrease in reaction times and reflexes
• slower or slurred speech
• loss of coordination
• loss of inhibition
• blurry vision
• memory loss
• blackouts
• depression
• nausea or vomiting
• dehydration
• impaired judgment
• Why people take both
• According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), 23% of people receiving treatment for powder cocaine addiction in 2017 were also receiving treatment for alcohol use disorder.

This co-use may be due to the belief that cocaine and alcohol may counteract each other’s negative effects. Alcohol is a depressant, which means that it usually has the opposite effects to a stimulant such as cocaine.

People also associate both drugs with partying and nightlife. If someone is taking cocaine in a social situation where alcohol is present, or vice versa, they may consume both.

Cocaine and alcohol can lead to higher impulsivity and lower inhibitions, which can increase risk taking. The combination of cocaine and alcohol can also cause people to take more of either or both drugs, which may lead to an overdose.

What happens when combined
Alcohol and cocaine can each cause dangerous health risks on their own. However, combining cocaine with alcohol can increase the health risks, as they have a higher toxicity when people take them together.

The liver processes, or metabolizes, any toxic substances that build up in the bloodstream. The body can then eliminate these waste products, usually through urine.

Research suggests that alcohol disrupts the metabolism of cocaine, leading to the production of cocaethylene, a substance that may be 30% more toxic than cocaine.

Alcohol also slows down the elimination process, which means that the liver is unable to expel all of the cocaethylene, leaving about 20% remaining in the liver. Further alcohol consumption can cause cocaethylene to pass into the bloodstream, harming tissues and organs.

Severe side effects and risks of both
The combination of cocaine and alcohol increases the risk of severe effects compared with using just one or the other. Mixing cocaine with alcohol can produce severe and sometimes fatal side effects, such as:

• overdose
• stroke
• bleeding in the brain
• heart attack
• irregular heartbeat
• heart damage
• liver damage
• increased risk of cancer
• organ failure
• increased risk of HIV or hepatitis C through injecting cocaine
• increased risk of suicide attempt
• sudden death from cocaethylene toxicity
• How long it stays in the system
• The time that cocaine remains in the system can depend on the amount of the drug that people take. Cocaine can appear in urine tests up to 3 days after taking it, but for a heavy user, the test may be positive for as long as 2 weeks.

Cocaine can appear in a blood or saliva test for up to 2 days and show in a hair test for months or even years after the initial use.

Alcohol slows down the elimination process, so it may take longer than this for cocaine to leave the body when a person takes it alongside alcohol.

Following consumption, alcohol can show for up to 6 hours in a blood test, 24 hours in a urine or saliva test, and 90 days in a hair test.

Precautions
All drug use carries risks. Taking certain precautions may help reduce the risk of the effects of cocaine and alcohol. The following harm reduction steps may help:

• giving any vehicle keys to someone who is staying sober before taking any drugs
• eating a meal before drinking
• staying hydrated
• staying with a trusted person who can monitor behavior
• having condoms to hand to reduce the risk of unsafe sex
• limiting the number of days on which cocaine and alcohol use occurs
• If people want to stop taking cocaine and alcohol, it is best to undergo a detox with medical supervision. Doing this can help prevent potentially dangerous withdrawal symptoms.

Legality
In the U.S., alcohol is legal for people over the age of 21 to purchase. Cocaine is legal for some specific medical treatments but illegal for recreational use.

In the U.S., 45 states now have Good Samaritan laws, which protect drug users and witnesses from persecution in the event of an overdose. This law can enable emergency responders to reach people faster and save lives.

Treatment
If people have an overdose of cocaine and alcohol, they will need immediate medical care. Treatment for an overdose may include:

• stomach pumping
• help with breathing by using intubation
• restoring normal body temperature
• treating complications, such as organ damage
• intravenous fluids to prevent dehydration
• Treatment for cocaine and alcohol addiction may involve a medical detox. This process, which takes place under medical supervision, eliminates cocaine and alcohol from the body.

Healthcare professionals will monitor the person 24-7 to reduce the risk of severe withdrawal symptoms and help them stay as comfortable as possible. Medical staff can also deal with any underlying physical or mental health conditions that arise.

People may follow a medical detox with treatment for addiction. Therapy treatment, such as cognitive behavioral therapy, may help people learn new behaviors and coping strategies to help them with long-term abstinence.

When to get help
If a person suspects that someone has taken an overdose of cocaine and alcohol, they will need to contact medical help immediately. They should stay with the person until medical help arrives.

Anyone who has or knows someone who has a drug addiction may wish to consider contacting a support network.

Outlook
Combining cocaine and alcohol can cause serious long-term mental and physical health complications. In some cases, an overdose of either or both can be fatal.

Recovery will depend on the frequency and severity of cocaine and alcohol use and the overall health of the person.

People can recover from cocaine and alcohol use disorders, and treatment can help them abstain from the future use of these drugs.

Summary
Taking cocaine and alcohol together produces far more dangerous side effects than taking just one or the other.

Combining cocaine and alcohol creates cocaethylene, which is a highly toxic substance that can cause life threatening complications. In some cases, it can cause sudden death.

If people have severe side effects from cocaine, alcohol, or both, or they have taken an overdose, they will need immediate medical treatment.

People can receive help and treatment for alcohol and drug use disorder by contacting a drug and alcohol helpline or support network.

Alcohol / Addiction / Illegal DrugsDrugs