Combining alcohol and cocaine is popular among drug users, likely for the combination of the euphoric high from cocaine and the depressant effects that alcohol brings. Some studies even suggest that cocaine users will drink alcohol concurrently to reduce the anxieties and discomfort that comes with cocaine addiction and withdrawal. While cocaine and alcohol are dangerous on their own, the side effects only become more severe when the two are combined.

  • It is important to understand how each of these substances interact with the body on their own.
  • However, a mechanism has been proposed that would explain ethanol’s ability to still attack the acyl-enzyme intermediate based on the presence of what is known as a of residues kitty-corner to the bottom of the active site.
  • People who use cocaine without any ethanol would have no measurable amount of cocaethylene in their system, but the ingestion of even small amounts of ethanol may result in production of cocaethylene .
  • Taking alcohol and cocaine together can cause cocaethylene toxicity in the body.
  • Cocaethylene also has a stronger effect on the heart and nervous system, which leads to an increased risk of heart attack, stroke, and seizure.

Human carboxylesterases and fluorescent probes to image their activity in live cells.

A strong case can be made for adding together the concentrations of cocaine and CE in forensic blood samples when toxicological results are interpreted in relation to acute intoxication and the risk of an overdose death. Cocaine is a sympathomimetic that affects a variety of receptors in the body, releasing specific catecholamine and blocking their reuptake at certain sites. In the short term, cocaine acts as a vasoconstrictor and subjects who use cocaine present with dilated pupils, elevated body temperatures, rapid heart rates, and high blood pressure.

Cocaethylene toxicity

If it is unable to do this because of the overwhelming harmful chemicals in the body, it can result in serious liver damage. This makes it even more difficult to remove the toxins and stop them from causing injury in other parts of the body. The findings from this study confirm those of previous studies that show that cocaethylene has pharmacological properties in common with cocaine, but is less potent. Evidence exists that genetic polymorphisms, drug‐drug interactions, drug-disease interactions and other factors are important determinants of the variability in the therapeutic response to carboxylesterase‐substrate drugs. It has been demonstrated that E12-7 as an exogenous enzyme can efficiently metabolize norcocaethylene in rats and showed an improved catalytic activity against norcocethylene compared to wild-type BChE.

In terms of this central stimulatory effect, cocaine and cocaethylene appear to be equipotent , but cocaethylene’s longer half-life makes its effects more persistent . This ability to prolong the cocaine high may help explain why many cocaine users drink alcohol while using cocaine, even if they are unaware of extending cocaine’s psychoactive effects by consuming ethanol . Central to the psychoactive effects of cocaine is the nucleus accumbens region of the brain, a major part of the ventral striatum that helps to mediate emotions, motivation, reward, and pleasure. In another example, a person with great thirst who is given water will experience a rush of dopamine to the NA. Cocaine can cause dopamine build-up and dopamine activity in the NA that exceeds the levels of dopamine that might occur naturally .


Cocaine addiction is dangerous enough on the system but cocaethylene comes with supercharged effects that are even more deadly. For those who think of themselves as casual cocaine users, they are just at risk as others. The reality is, cocaine overdoses have doubled in the past five years. Here is what you need to know about cocaethylene, a risk of mixing cocaine and alcohol together.

This leads researchers to believe that cocaethylene toxicity is responsible for many sudden deaths and heart problems with cocaine users. Cocaine has a high relapse rate and is known to be one of the most challenging drugs to overcome. There are biological changes to brain cells that occur when it is abused for long periods of time.

The formation of cocaethylene and clinical presentation of ED patients testing positive for the use of cocaine and ethanol. Cocaethylene is largely considered a recreational drug in and of itself, with stimulant, eco sober house boston euphoriant, anorectic, sympathomimetic, and local anesthetic properties. The monoamine neurotransmitters serotonin, norepinephrine, and dopamine play important roles in cocaethylene’s action in the brain.

In addition to the above effects, individuals who chronically and habitually abuse multiple drugs together are at risk to develop a number of significant substance use disorders. In the case of concurrent alcohol and cocaine use, individuals who develop both an alcohol use disorder and a cocaine use disorder will develop a number of complications that require very specialized treatment interventions. The addition of cocaethylene to the alcohol and cocaine already in the system can produce effects that are much more powerful than the effects that alcohol or cocaine alone produce. Cocaine and alcohol are toxic substances that are harmful to the bodily tissues, and they are removed from the bloodstream and metabolized in the liver in order to eliminate them from the body. When an individual uses alcohol and cocaine at the same time, cocaethylene develops in the liver as a result of the metabolic processing of both alcohol and cocaine.

Cocaine and alcohol use disorders are challenging to overcome, and when they are combined, recovery can be even more difficult. For most people,professional rehabis the safest and most effective strategy to achieve sobriety. Importantly, for someone who has developed a severe alcohol dependence, quitting “cold turkey” can be dangerous. It may prove to be very difficult to break out from alcohol and cocaine addiction. People suffering from it may face a series of challenges towards sobriety.

Comparison in humans of the potency and pharmacokinetics of intravenously injected cocaethylene and cocaine

In this context, it is important to remember that the neural circuits affected by cocaine are considered fundamental biological pathways essential for survival . Individuals entering treatment as a result of combined use of alcohol and cocaine face a number of difficult challenges. Treatment providers will need to address the use of both substances concurrently as well as any co-occurring physical and mental health disorders, such as depression, personality disorders, anxiety, etc. Treatment for individuals who have a number of different co-occurring disorders can become very complicated, and it is often fraught with setbacks and potential relapses. These issues are even further complicated by the effects to the body and mind that occur as a result of the prolonged effects of cocaethylene.

If ethanol is present during the metabolism of cocaine, a portion of the cocaine undergoes transesterification with ethanol, rather than undergoing hydrolysis with water, which results in the production of cocaethylene. This has been shown to be effective for the alcohol and cocaine user and the one who abuses both. It is believed there should be professionals that are specifically trained in responding to the needs of someone using cocaine with alcohol.

  • People believe taking both can boost the cocaine high and help avoid withdrawal.
  • In most users, cocaethylene produces euphoria and has a longer duration of action than cocaine.
  • When you mix cocaine, a psychoactive stimulant drug, and alcohol, another powerfully addictive substance, you have cocaethylene.
  • The reality is, cocaine overdoses have doubled in the past five years.

This makes it difficult to predict, in any individual case, the concentration of CE in biological specimens analyzed in clinical and forensic cases. Clauwaert, K; Decaestecker, T; et al. “The determination of cocaine, benzoylecg[…]ht mass spectrometry.” Journal of Analytical Toxicology, November. Now that we understand a little more about what these two substances do individually, let’s better understand what happens when you mix them. Know that there are solutions to your or your loved one’s addiction problems, no matter how severe the addiction is. Prosperity Haven has successfully helped people in the throes of the most serious addictions find sobriety and live happy and successful lives. For this reason, cocaine-infused wine became a popular beverage in the late 1800s in both France and the United States.

Effects of ethanol on cocaine metabolism: formation of cocaethylene and norcocaethylene.

Dopamine originates in the dopaminergic cells of the brain and circulates throughout the body . Circulating dopamine molecules can attach to receptor cells and, in that way, stimulate specific responses. An appropriate number of dopamine molecules are needed at any given time to activate these receptors appropriately, and this dopamine balance is systematically regulated by the brain. By allowing these dopamine molecules to accumulate, the dopamine receptors become excessively stimulated .

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Some research suggests biomarkers for stress and organ damage may help predict SUD risk, but more work needs to be done in this area. Dependence means the body has become used to a drug and needs it to function.


Because the chemical directly affects the bloodstream, tissues, and organs of the body, the chances of having a stroke is significantly heightened. Once the brain is affected, it could cause someone to lose consciousness or become comatose. A nonspecific carboxylesterase that catalyzes the ethyl transesterification of cocaine to ethylcocaine in the presence of ethanol is identified and may play important roles in regulating the metabolic inactivation of cocaine.

Not only are the effects of cocaethylene toxicity greater than cocaine or alcohol, it also lasts for longer. It has a greater half-life than cocaine so it takes longer for the body to eliminate it. This can cause serious side effects because it’s toxins in the body for a longer period of time. This is problematic for people who drink alcohol and take cocaine, as due to the addictive effects of cocaine, users often redose the drug frequently. The more someone drinks alcohol and takes cocaine, the greater the risks of serious health problems or even death.

Evaluation of dose-dependent pharmacokinetics of cocaethylene and cocaine in conscious dogs. Kinetic characterization of human butyrylcholinesterase mutants for the hydrolysis of cocaethylene. Diana is an addiction expert and licensed marriage and family therapist who has been in the field of mental health for over 10 years. If you decide to drink while using cocaine, be sure to use caution and seek out medical help if you have any negative side effects. Alcohol abuse is a common co-occurring disorder with drug use disorders, and effective treatments have been developed to help you or your loved one overcome cravings and compulsions and make a lasting recovery.

Forensic Drug Profile: Cocaethylene

Farooq, Muhammad U.; et al. “Neurotoxic and cardiotoxic effects of cocaine and ethanol.” Journal of Medical Toxicology, September 2009. When a person consumes substances like alcohol or drugs, it can become very harmful to the body. If they stay in the system for too long, the effects are more serious. Like a slow-growing poison, these chemicals may seem harmless at first, but if the body fails to clear them out quickly, they can cause serious physical injury, that may even lead to death. Inhibition of cocaine’s metabolism by both ethanol and cocaethylene may play an important role in mediating the enhanced effects of cocaine in the presence of ethanol.

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  • Child intelligence was measured with the Wechsler Intelligence Scale for Children-III (WISC-III).
  • Like a slow-growing poison, these chemicals may seem harmless at first, but if the body fails to clear them out quickly, they can cause serious physical injury, that may even lead to death.
  • In fact, greater education is needed for patients, their families, and illicit drug users.
  • Though there is no proof of cocaethylene addiction, there is proof that people who start drinking will seek out cocaine also for the effects.

If you’re abusing alcohol and cocaine, or you’re addicted to both substances, it’s important that you seek the right kind of treatment. The consequences of continuing to mix alcohol and cocaine can be extremely damaging to your physical and mental health. Cocaine and alcohol are both dangerous substances when consumed on their own, particularly if consumed in large amounts or abused frequently.

Cocaine and alcohol use is one of the most popular forms ofpolysubstance abuse, the use of two or more substances at the same time. The use of alcohol specifically is a substance that is commonly used with nearly all other forms of drugs. Cocaethylene is a substance created in the body when cocaine and alcohol are used at the same time. Unfortunately, this substance can prove to be dangerous and deadly. We have a proven track record of helping people who have been suffering from cocaine and alcohol addictions to safely find recovery and return to happy and fulfilling lives.

The combination of cocaine and alcohol effects are believed to be one of the most fatal when it comes to substance abuse. Not only are the systems in the body being taxed, but risky behaviors can also put you at risk. Cocaine allows you to drink more while alcohol enhances cocaine, making it last twice as long. Taking alcohol and cocaine together can cause cocaethylene toxicity in the body. Scientists believe this happens because the metabolism of cocaine is altered from the alcohol.

The serum concentrations of cocaethylene depend on both the amount and timing of the two agents consumed. People who use cocaine without any ethanol would have no measurable amount of cocaethylene in their system, but the ingestion of even small amounts of ethanol may result in production of cocaethylene . Likewise, people who consume ethanol but take no cocaine or very little cocaine would not produce cocaethylene . The greatest cocaethylene production would theoretically occur in a person who has a relatively high blood-alcohol level at the point in which they used cocaine . In real-world clinical practice, it can be very difficult to predict cocaethylene concentrations in the blood, even when the exact amounts and timing of alcohol and cocaine use are known.

The cessation of use of illicit opioids correlated to decreases in cocaine and alcohol use in these subjects . In a study of 66 adults in a methadone maintenance program who reported cocaine use, about 60% of subjects said they often took alcohol to help ease the discomfort or unpleasant transitions involved in the use of cocaine or crack . Among polysubstance users, the use of alcohol, opioids, and cocaine is particularly prevalent.