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Cocaine and Alcohol


Risks in Mixing Cocaine and Alcohol. Treatment for Polysubstance Addictions

Mixing Cocaine and Alcohol

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

Whether you use cocaine occasionally, regularly, or have used it once or twice, it is important 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. Some people believe taking both can boost the high coming from the effects of cocaine and help avoid alcohol withdrawal. This is just not true. In fact, mixing cocaine and alcohol can have fatal results. 

Cocaine and Alcohol
Mixing cocaine and alcohol has been linked with a greater risk of suicidal tendencies. There are many negative physical symptoms, which can be deadly.

Cocaine and alcohol don’t negate the effects of one another. Instead, they mask the effects, making people unaware of how intoxicated 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.

What Happens When You Mix Cocaine and Alcohol?

Cocaine is snorted and goes to the liver via nasal vessels. On the other hand, alcohol reaches the liver via circulation. When used 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 liver damage, seizures, and compromised immune system functioning [1]. It also carries an 18- to 25-fold increase over cocaine alone in risk for overdose leading to immediate death.

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

Enhanced psychological effects during simultaneous cocaine and 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 associated with sudden death as well as the following negative physical consequences:

  • Myocardial infarction (or painful heart attack)
  • Cardiomyopathy (heart disease)
  • Cerebral infarction (damage to brain tissue, leading to stroke or aneurysm)
  • Intracranial hemorrhage (bleeding in the brain)
  • 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(polysubstance use) can also increase the risk of addiction. Drugs manipulate the pleasure and reward system in the brain. When a person mix cocaine and alcohol, multiple systems in the brain are disrupted and may increase the risks of becoming addicted to multiple drugs.

Admitting you have an addiction to cocaine and alcohol can be difficult. Remember, many people understand what you’re going through, and help is out there.

Both cocaine and alcohol have adverse 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. Alcohol and kidneys have direct connections. Kidney disease can lead to kidney failure. You may then need to endure regular kidney dialysis to filter your blood and keep things properly balanced,

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

Before we can understand how cocaine interacts with alcohol, we first need to learn how cocaine affects the body. Cocaine is a 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.

Cocaine and Alcohol
An overdose can also happen when mixing Cocaine and alcohol

What is 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, and 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.

What is Cocaine and Alcohol Abuse?

One reason why some people start combining 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 polysubstance use, there are multiple diagnoses at play. In most cases, people begin self-medicating to avoid understanding their symptoms and lack an appropriate diagnosis.

People who struggle with schizophrenia and bipolar disorder are especially at risk of substance abuse and polysubstance 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 struggling with bipolar disorder tend 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.

Polysubstance 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 polysubstance use and co-occurring disorder.

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How Long Does Cocaine Stays In The System?

It is almost impossible to determine an exact timeframe that cocaine (also known as coke, crack, flake, rocks, and snow) will show up on a drug test. How long cocaine stays in the system depends on many variables, including a person’s metabolism, body mass, age, hydration level, and other factors.

After last use, cocaine or its metabolites typically may show up on a blood or saliva test for up to two days, a urine test for up to three days, and a hair test for months to years. A heavy user can test positive on a urine test for up to two weeks. 

Cocaine metabolites are often detectable in a person’s urine for only two to three days after the last use of the drug. However, individuals who use large amounts of cocaine may have detectable levels for two weeks.

The liver is the organ in the body that is responsible for metabolizing cocaine. It breaks down the drug into smaller compounds that are called metabolites. A major cocaine metabolite is called benzoylecgonine, which is normally measured during urine analysis to determine if a person has used cocaine recently since it can be detected in urine for a longer period of time than cocaine itself.

There are several different methods to test if this drug is present in a person’s system.

  • Cocaine can be detected in sweat for up to a few weeks after last use.
  • Cocaine metabolites can often be detected in urine samples for two to three days after last use, but individuals who are heavy users may have detectable metabolites in their urine for up to two weeks.
  • Cocaine in blood samples is typically detectable for 12 hours after last use. Benzoylecgonine can be detected in blood for about 48 hours after the last use of the drug.
  • Hair samples may have detectable levels of cocaine for months and even years after last use.
  • Cocaine or its metabolites can be detected in saliva for about one to two days after last use.

Several different factors influence the amount of time that cocaine remains in an individual’s system.

  • An individual’s metabolism has an important influence on the amount of time that cocaine or any drug remains in an individual’s system.
  • The amount of cocaine a person uses and how often they use it can impact how long the drug remains in their system. Cocaine and its metabolites may be detectable for longer periods of time in heavy users.
  • Since most individuals who use cocaine obtain it from illicit sources, there is no regulation of the purity of that cocaine. Thus, the actual dosage of cocaine that a person uses can vary greatly. As aforementioned, the amount of cocaine that a person uses can affect how long it is present in their body.

Treatment for Polysubstance Addictions

Alcohol is the most abused addictive substance in America, as more than 17 million people in the United States are considered to suffer from addiction to alcohol. The Substance Abuse and Mental Health Service Administration (SAMHSA) publishes that over 1.5 million American adults are considered to be currently abusing a prescription drug. 

Mixing cocaine and alcohol can lead to addiction and dangerous side effects, including a greater risk of overdose. The brain does not simply go back to normal when the drug and alcohol use stops. It could take therapy, counseling, and treatment methods to help you effectively overcome addiction. 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. In addition, it’s crucial that these individuals get help from a qualified addiction rehabilitation center. 

Cocaine and Alcohol
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.

Polysubstance abuse is the consumption of more than one substance at the same time. While some drug users have a preferred drug, other users have several drugs they like to take. Polysubstance abuse is common, and these drug users are clinically classified as having multiple comorbid substance disorders. Because withdrawal from multiple substances is more complicated than withdrawal from one substance, inpatient medical detox is generally recommended. The goal of treatment is to restore some or all normal functioning to the liver by addressing the underlying issue of mixing cocaine and alcohol.

If you are struggling with alcohol use, it’s crucial to first get an accurate assessment of all the symptoms. When the symptoms have been evaluated by a mental health professional, it may be determined that another form of mental condition is present and needs a particular type of treatment. Very often, some combination of psychotherapy, medication, and/or lifestyle changes are effective for coping with functional. 

Medically-Assisted Detox

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

Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can provide necessary medication and medical expertise to lessen cravings and the effects of withdrawals.


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 making changes in 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.” 
  • Person-Centered Therapy – is a strategy that allows and encourages clients to understand and resolve their concerns in a safe, supportive environment.
  • 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. In many cases, traumatic experiences can result in a mental health disorder 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. In this strategy, both the substance abuse problem and the mental disorder are treated simultaneously. Regardless of which diagnosis (mental health or substance abuse problem) came first, long-term recovery will depend largely on the treatment for both disorders done by the same team or provider.

Medication-Assisted Treatments

Medication-Assisted Treatments (MAT) for substance use disorders 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.

 If you or a loved one are struggling with long-term drug abuse and a co-occurring mental health condition such as depression, contact one of our helpful treatment specialists today. We Level Up can provide information on dual diagnosis and detox programs that may fit your specific needs.

cocaine and alcohol
 For people who use cocaine and alcohol regularly, a consistent and long-term solution toward recovery is required

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[1] NCBI –

[2] NCBI –

[3] WHO –